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Herrin K, Upton E, Young A. Towards meaningful community ambulation in individuals post stroke through use of a smart hip exoskeleton: A preliminary investigation. Assist Technol 2024; 36:198-208. [PMID: 37493447 DOI: 10.1080/10400435.2023.2239555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 07/27/2023] Open
Abstract
Stroke is the leading cause of long-term disability in the United States, leaving survivors with profound mobility challenges that impact independent community ambulation. Evidence shows assistance at the hip during walking may be beneficial for stroke survivors. In this cross-over design study, we examine the impact of a novel hip exoskeleton on both functional and patient reported outcomes measuring speed, fall risk, gait symmetry, energy expenditure and perceived walking ability during both indoors and outdoors in single and serial counting dual task paradigms. Nine ambulatory stroke survivors with hemiplegia were included. No differences were seen between the exoskeleton and baseline conditions for any outcomes. Only the patient reported outcome in which subjects were asked to rate their ability to walk outdoors approached statistical significance (p = 0.051) with greater improvement reported for the exoskeleton condition. When asked to rate several key factors about the exoskeleton, weight and assistance emerged as primary perceived negative factors of the exoskeleton underscoring the need for improvements to the technology in this area. Despite lack of differences across groups, some individuals responded positively to the exoskeleton for several functional outcomes measured, highlighting the need for additional exploration into the use of personalized hip exoskeletons for post-stroke rehabilitation.
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Affiliation(s)
- Kinsey Herrin
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, USA
| | - Emily Upton
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, USA
| | - Aaron Young
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, USA
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Liu J, Yang Y, Shi H, Sun M, Feng R. Developing and evaluating a mindfulness-based finger/hand exercise intervention for ethnically diverse older adults with and without disabilities: A feasibility study. Geriatr Nurs 2024; 56:148-158. [PMID: 38350340 DOI: 10.1016/j.gerinurse.2024.02.008] [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: 12/21/2023] [Revised: 01/18/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
Few exercise interventions target ethnic minority older adults, especially those with disability. We evaluated feasibility of newly-developed finger/hand exercises to promote health in ethnically diverse older adults with/without disability. We conducted 10-minute video exercises daily, supervised by research assistants. The feasibility, evaluated via three studies, focused on recruitment, intervention fidelity, safety, outcome assessment, and acceptability. Studies varied in design and delivery methods, being conducted across settings (senior centers, apartments). We enrolled 101 Chinese older adults (mean age = 72) without disability in Study 1, and 15 older Africans/Hispanics with disability (mean age = 70) in Studies 2 and 3. Intervention, either in-person or online, was implementable and acceptable with high fidelity. Attendance was satisfactory (79.6%, 74.2%, 76.7%) and attrition was low (12%, 0%, 0%). Outcome measures data was ascertained. No adverse events were observed. Preliminary findings indicate feasibility, acceptability, and safety of the simple finger/hand exercise for diverse older adults.
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Affiliation(s)
| | - Yi Yang
- University of Pennsylvania, United States
| | - Haoer Shi
- University of Pennsylvania, United States
| | | | - Rui Feng
- University of Pennsylvania, United States
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Yang Y, Zeng Z, van Schooten KS, Sum RKW, Shen J, Ho CY, Chan KP, Cheong D. Effects of a multicomponent physical activity programme, Mobility-Fit, compared with a standard care lower limb strengthening programme, to promote safe mobility among older adults in care facilities: protocol for a cluster randomised controlled trial. BMJ Open 2024; 14:e082403. [PMID: 38267249 PMCID: PMC10823931 DOI: 10.1136/bmjopen-2023-082403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Upper limb and core strength training is essential for older adults to safely perform daily activities. However, existing exercise programmes mainly focus on lower limb strength and are not designed or delivered to suit people with different functional capacities. This study describes the design of a two-arm cluster randomised controlled trial to examine the effects of a multicomponent physical activity (PA) programme, Mobility-Fit, on mobility and frailty in older adults living in care facilities. METHODS AND ANALYSIS 160 older adults from 20 care facilities in Hong Kong will be recruited and randomised by care facilities (1:1) to an intervention or a control group. Participants in the intervention group will attend the Mobility-Fit programme, led by facility-based instructors, three times per week, 45 min per session, for 12 weeks, while the control group will participate in a standard care lower limb strengthening programme offered by the care facility. Participants will then be followed up for 9 months. Mobility-Fit comprises agility, postural coordination, balance and strength training, with suitable dosage based on participant's baseline physical and cognitive function. The primary outcomes encompass upper and lower limb strength, trunk stability, reaction time, mobility function and fall efficacy. Secondary outcomes comprise daily PA level and performance, frailty, cognitive function and quality of life. A repeated measures analysis of variance (ANOVA) and generalised estimating equation (GEE) will be used to examine changes in outcomes over time and between groups. Data will be analysed following the intention-to-treat principles. We will also evaluate programme implementation and health economics throughout the follow-up period. ETHICS AND DISSEMINATION Ethical approval was acquired in November 2022 from the Joint CUHK-NTEC Clinical Research Ethics Committee in Hong Kong (CREC-2022-459). Informed consent will be obtained from participants. The results of the study will be disseminated through peer-reviewed articles, conference presentations and social media. TRIAL REGISTRATION NUMBER ChiCTR2300072709.
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Affiliation(s)
- Yijian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Jockey Club Institute of Aging, The Chinese University of Hong Kong, Hong Kong, China
| | - Ziwei Zeng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Kimberley S van Schooten
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Raymond Kim-Wai Sum
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiahao Shen
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Cheuk-Yin Ho
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka-Po Chan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Debbie Cheong
- B.C. Recreation and Parks Association (BCRPA), Vancouver, British Columbia, Canada
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Rice J, Li LC, Davis JC, Pahor M, Madden K, Wei N, Wong H, Skelton DA, McCormick S, Falck RS, Barha CK, Rhodes RE, Loomba S, Sadatsafavi M, Liu-Ambrose T. Supporting physical activity for mobility in older adults with mobility limitations (SuPA Mobility): study protocol for a randomized controlled trial. Trials 2023; 24:769. [PMID: 38017467 PMCID: PMC10685660 DOI: 10.1186/s13063-023-07798-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Limited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15-24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient physical activity. Evidence shows that increasing physical activity by 50 min of moderate intensity physical activity in sedentary older adults with mobility limitations can improve mobility and reduce the incidence of mobility disability. To maximize the healthy life span of older adults, it is necessary to find effective and efficient interventions that can be delivered widely to prevent mobility limitations, increase physical activity participation, and improve quality of life in older adults. We propose a randomized controlled trial to assess the effect of a physical activity health coaching intervention on mobility in older adults with mobility limitations. METHODS This randomized controlled trial among 290 (145 per group) community-dwelling older adults with mobility limitations, aged 70-89 years old, will compare the effect of a physical activity health coaching intervention versus a general healthy aging education program on mobility, as assessed with the Short Physical Performance Battery. The physical activity health coaching intervention will be delivered by exercise individuals who are trained in Brief Action Planning. The coaches will use evidence-based behavior change techniques including goal-setting, action planning, self-monitoring, and feedback to improve participation in physical activity by a known dose of 50 min per week. There will be a total of 9 health coaching or education sessions delivered over 26 weeks with a subsequent 26-week follow-up period, wherein both groups will receive the same duration and frequency of study visits and activities. DISCUSSION The consequences of limited mobility pose a significant burden on the quality of life of older adults. Our trial is novel in that it investigates implementing a dose of physical activity that is known to improve mobility in older adults utilizing a health coaching intervention. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration System: NCT05978336; registered on 28 July 2023.
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Affiliation(s)
- Jordyn Rice
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Linda C Li
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Jennifer C Davis
- University of British Columbia-Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Marco Pahor
- University of Florida, Gainesville, FL, 32611, USA
| | - Kenneth Madden
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Nathan Wei
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Hubert Wong
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Dawn A Skelton
- Glasgow Caledonian University, Cowcaddens Rd, Glasgow, G4 0BA, UK
| | - Sioban McCormick
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Ryan S Falck
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Cindy K Barha
- University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Ryan E Rhodes
- University of Victoria, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada
| | - Sohail Loomba
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Mohsen Sadatsafavi
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Teresa Liu-Ambrose
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada.
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Khalili M, Jonathan C, Hocking N, Van der Loos M, Mortenson WB, Borisoff J. Perception of autonomy among people who use wheeled mobility assistive devices: dependence on environment and contextual factors. Disabil Rehabil Assist Technol 2023; 18:1066-1073. [PMID: 34618618 DOI: 10.1080/17483107.2021.1978565] [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: 06/05/2020] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate and compare the perceived autonomy of people using wheeled mobility assistive devices (WMADs) in five community-based environments. To evaluate how personal, environmental, and assistive device-related factors impact the perceived autonomy of WMAD users. METHOD A study-specific questionnaire was used to evaluate perceived satisfaction of WMAD users with their autonomy in five environments: the Home Environment, Buildings Outside of the Home Environment, Outdoor Built Environment, Outdoor Natural Environment, and Transportation. For each environment, participants rated their satisfaction with autonomy about 15 personal, environmental, and assistive device-related factors. Qualitative perceptions were also collected with open-ended questions. RESULTS Participants included 123 full- and part-time community-dwelling WMAD users. Participants' overall satisfaction with autonomy in the Outdoor Natural Environment was statistically significantly lower compared to the other four environments (p < 0.05). In all environments, the top factor respondents were most satisfied with was WMAD ease of use. Their least satisfaction was when negotiating stairs, curbs, or obstacles in the Home, Buildings Outside of the Home, and the Outdoor Built Environments. In the Outdoor Natural Environment, the most dissatisfaction was with manoeuvring on different terrains. Responses to open-ended questions supported the quantitative findings and highlighted the effects of various factors on autonomy (e.g., subject-environment familiarity). CONCLUSIONS WMAD users reported the greatest restriction to their autonomy in outdoor environments. Different context-specific factors were found to impact autonomy in different environments. Understanding how environment-specific contextual factors contribute to overall perception of autonomy may inform the development of future strategies to overcome identified limitations and challenges.Implications for RehabilitationWheeled mobility assistive device (WMAD) users experienced the highest autonomy in their home environments, specifically, when having access to home modification services.WMAD users had the lowest autonomy in the outdoor natural environment, with manoeuvrability on different terrains being the main predictor of the overall satisfaction with autonomy in this environment.Environment-specific contextual factors with significant impacts on perceived autonomy were identified that can inform the design and development of future WMADs (e.g., distance travelled, safety).
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Affiliation(s)
- Mahsa Khalili
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Chelsea Jonathan
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Nicole Hocking
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Machiel Van der Loos
- Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
- International Collaboration on Repair Discoveries, Vancouver, Canada
- GF Strong Rehabilitation Research Program, Vancouver, Canada
| | - Jaimie Borisoff
- International Collaboration on Repair Discoveries, Vancouver, Canada
- British Columbia Institute of Technology, Vancouver, Canada
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Brandenbarg P, Hoekstra F, Barakou I, Seves BL, Hettinga FJ, Hoekstra T, van der Woude LHV, Dekker R, Krops LA. Measurement properties of device-based physical activity instruments in ambulatory adults with physical disabilities and/or chronic diseases: a scoping review. BMC Sports Sci Med Rehabil 2023; 15:115. [PMID: 37735403 PMCID: PMC10512652 DOI: 10.1186/s13102-023-00717-0] [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: 12/09/2022] [Accepted: 08/22/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND People with physical disabilities and/or chronic diseases tend to have an inactive lifestyle. Monitoring physical activity levels is important to provide insight on how much and what types of activities people with physical disabilities and/or chronic diseases engage in. This information can be used as input for interventions to promote a physically active lifestyle. Therefore, valid and reliable physical activity measurement instruments are needed. This scoping review aims 1) to provide a critical mapping of the existing literature and 2) directions for future research on measurement properties of device-based instruments assessing physical activity behavior in ambulant adults with physical disabilities and/or chronic diseases. METHODS Four databases (MEDLINE, CINAHL, Web of Science, Embase) were systematically searched from 2015 to April 16th 2023 for articles investigating measurement properties of device-based instruments assessing physical activity in ambulatory adults with physical disabilities and/or chronic diseases. For the majority, screening and selection of eligible studies were done in duplicate. Extracted data were publication data, study data, study population, device, studied measurement properties and study outcome. Data were synthesized per device. RESULTS One hundred three of 21566 Studies were included. 55 Consumer-grade and 23 research-grade devices were studied on measurement properties, using 14 different physical activity outcomes, in 23 different physical disabilities and/or chronic diseases. ActiGraph (n = 28) and Fitbit (n = 39) devices were most frequently studied. Steps (n = 68) was the most common used physical activity outcome. 97 studies determined validity, 11 studies reliability and 6 studies responsiveness. CONCLUSION This scoping review shows a large variability in research on measurement properties of device-based instruments in ambulatory adults with physical disabilities and/or chronic diseases. The variability highlights a need for standardization of and consensus on research in this field. The review provides directions for future research.
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands.
| | - Femke Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, V1V 1V7, Canada
| | - Ioulia Barakou
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Bregje L Seves
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, NE1 8ST, UK
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, 1081 BT, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
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Desai RH, Kiserow R, Mullings A, Smith M, Tucker S, Eyler A, Stark S, Morgan K. Exploring the Perspectives of Adults Aging With Long-Term Physical Disabilities on Physical Activity: A Qualitative Study. Am J Health Promot 2023; 37:654-663. [PMID: 36624040 PMCID: PMC10468916 DOI: 10.1177/08901171221151123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Adults aging with long-term physical disabilities (AAwPD) face personal and environmental barriers to living independently, but little is known about their perspectives on and experiences with physical activity (PA). PURPOSE The purpose of this study was to explore the perspectives of AAwPD on PA. RESEARCH DESIGN Qualitative semi-structured interviews with AAwPD were conducted virtually via phone or videoconference. STUDY SAMPLE A convenience sample of AAwPD aged 45-65 and living with a physical disability for at least 5 years was recruited through aging organizations, disability organizations, and social media in St. Louis, Missouri until thematic saturation was reached (n = 20). DATA COLLECTION AND ANALYSIS Participants were asked semi-structured interview questions about their perspectives and experiences with PA following an interview guide developed by disability, aging, and qualitative research experts. Data were analyzed using text analysis in NVivo 12. Codes were developed into themes by the research team and validated using member checking methods. RESULTS Four themes emerged from the data: barriers and facilitators to engaging in PA, motivations and beliefs regarding PA, benefits of PA, and PA routines and habits. Participants reported a desire to engage in more PA but described barriers such as pain and fatigue symptoms, secondary health conditions, lack of social support, and fear of falling. Accessibility of facilities and equipment (eg, lack of ramps or equipment not at wheelchair height) and transportation barriers (eg, inconvenient schedules or excessive wait times) were specifically described as major environmental barriers. CONCLUSION Most participants' reported PA routines did not meet the quantity or intensity levels recommended by current guidelines. These results may help inform healthcare providers, community programs, and future interventions to improve PA levels for AAwPD, an underserved but growing demographic.
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Affiliation(s)
- Rachel Heeb Desai
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Rachel Kiserow
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Alicia Mullings
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Megan Smith
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Susan Tucker
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Amy Eyler
- Washington University in St. Louis, Brown School of Public Health, St. Louis, MO
| | - Susan Stark
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Kerri Morgan
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
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Best KL, Bourassa S, Sweet SN, Routhier F. Expert consensus for a digital peer-led approach to improving physical activity among individuals with spinal cord injury who use manual wheelchairs. J Spinal Cord Med 2023; 46:53-61. [PMID: 34726571 PMCID: PMC9897743 DOI: 10.1080/10790268.2021.1986308] [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] [Indexed: 02/06/2023] Open
Abstract
CONTEXT Active Living Lifestyles for manual wheelchair users (ALLWheel) uses a digital peer-led approach to incorporate two behavior change theories to address a critical need for leisure-time physical activity (LTPA) programs for individuals with spinal cord injury (iSCI). OBJECTIVE The objective of this study was to obtain expert opinion and consensus for the ALLWheel program. DESIGN Mixed-methods (qualitative and quantitative) were used to gather expert opinion and consensus for the ALLWheel program using an action research approach. SETTING Rehabilitation center. PARTICIPANTS Experts in SCI and LTPA included iSCI who used manual wheelchairs, healthcare professionals, and community collaborators. PROCEDURES Two, 90-minute focus groups were conducted and transcribed verbatim, analyzed thematically, and the results were used to create a Delphi survey. Delphi surveys were completed online using consecutive rounds until ≥70% consensus per item was attained. Cumulative percent concordances were calculated to determine consensus. RESULTS Twelve experts in SCI and LTPA participated in focus groups. Four themes were generated: Need for LTPA programs; Important considerations; Perceptions about peer-coaches; and Feelings about smartphones, which were used to generate the Delphi survey. Consensus on the ALLWheel program was attained in two rounds. CONCLUSIONS Experts established a need for fun and personalized community-based LTPA programs. Ensuring that healthcare professionals would be involved in the ALLWheel program alleviated safety concerns, and experts agreed there were benefits of peers delivering the program. Experts agreed that the ALLWheel program targeted important psychological factors (i.e. autonomy, relatedness, self-efficacy, and motivation) and affirmed the potential for a potentially large geographic reach.
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Affiliation(s)
- Krista L. Best
- Department of Rehabilitation, Université Laval, Quebec City, Canada,Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada,Correspondence to: Krista L. Best, Centre for interdisciplinary research in rehabilitation and social integration (Cirris); Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 525, boulevard Wilfrid-Hamel, Quebec City, QC, G1M 2S8, Canada; Ph: +1 4185299141 ext. 6041.
| | - Sophie Bourassa
- Department of Rehabilitation, Université Laval, Quebec City, Canada,Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Shane N. Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, Canada,Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
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Safa F, McClellan N, Bonato S, Rueda S, O’Brien KK. The Role of the Social Determinants of Health on Engagement in Physical Activity or Exercise among Adults Living with HIV: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13528. [PMID: 36294111 PMCID: PMC9602835 DOI: 10.3390/ijerph192013528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Physical activity (PA) and exercise are an effective rehabilitation strategy to improve health outcomes among people living with HIV (PLWH). However, engagement in exercise among PLWH can vary. Our aim was to characterize the literature on the role of social determinants of health (SDOH) on engagement in PA or exercise among adults living with HIV. We conducted a scoping review using the Arksey and O'Malley Framework. We searched databases between 1996 and 2021. We included articles that examined PA or exercise among adults with HIV and addressed at least one SDOH from the Public Health Agency of Canada Framework. We extracted data from included articles onto a data extraction charting form, and collated results using content analytical techniques. Of the 11,060 citations, we included 41 articles, with 35 studies involving primary data collection 23 (66%) quantitative, 8 (23%) qualitative, and four (11%) mixed methods. Of the 14,835 participants, 6398 (43%) were women. Gender (n = 24 articles), social support (n = 15), and income and social status (n = 14) were the most commonly reported SDOH in the literature with the majority of studies addressing only one SDOH. Future research should consider the intersection between multiple SDOH to better understand their combined impact on engagement in PA or exercise among PLWH.
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Affiliation(s)
- Farhana Safa
- Institute for Mental Health Policy Research (IMHPR), Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
| | - Natalia McClellan
- AIDS Community Care Montreal, SIDA Bénévoles Montréal, Montreal, QC H2L 2Y4, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research (IMHPR), Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Kelly K. O’Brien
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON M5G 1V7, Canada
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Brandenbarg P, Hoekstra F, Krops LA, Seves BL, Hettinga FJ, Hoekstra T, Dekker R, van der Woude LHV. Physical activity behaviour up to 1 year post-rehabilitation among adults with physical disabilities and/or chronic diseases: results of the prospective cohort study ReSpAct. BMJ Open 2022; 12:e056832. [PMID: 35705356 PMCID: PMC9204426 DOI: 10.1136/bmjopen-2021-056832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Little is known of physical activity behaviour among adults with a disability and/or chronic disease during and up to 1 year post-rehabilitation. We aimed to explore (1) dose characteristics of physical activity behaviour among adults with physical disabilities and/or chronic diseases during that period, and (2) the effects of personal characteristics and diagnosis on the development of physical activity over time. METHODS Adults with physical disabilities and/or chronic diseases (N=1256), enrolled in the Rehabilitation, Sports and Active lifestyle study, were followed with questionnaires: 3-6 weeks before (T0) and 14 (T1), 33 (T2) and 52 (T3) weeks after discharge from rehabilitation. Physical activity was assessed with the adapted version of the Short Questionnaire to ASsess Health enhancing physical activity. Dose characteristics of physical activity were descriptively analysed. Multilevel regression models were performed to assess physical activity over time and the effect of personal and diagnosis characteristics on physical activity over time. RESULTS Median total physical activity ranged from 1545 (IQR: 853-2453) at T0 to 1710 (IQR: 960-2730) at T3 min/week. Household (495-600 min/week) and light-intensity (900-998 min/week) activities accrued the most minutes. Analyses showed a significant increase in total physical activity moderate-intensity to vigorous-intensity physical activity and work/commuting physical activity for all time points (T1-T3) compared with baseline (T0). Diagnosis, age, sex and body mass index had a significant effect on baseline total physical activity. CONCLUSION Physical activity is highly diverse among adults with physical disabilities and/or chronic diseases. Understanding this diversity in physical activity can help improve physical activity promotion activities.
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Femke Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bregje L Seves
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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11
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Physical Competence, Physical Well-Being, and Perceived Physical Literacy among Older Adults in Day Care Centers of Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073851. [PMID: 35409534 PMCID: PMC8997690 DOI: 10.3390/ijerph19073851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
In Hong Kong, where the aging problem is inevitable, it is increasingly common for older adults to be admitted to day care centers. However, there has been limited research exploring conceivable indicators of healthy aging among older adults in such settings. The present study investigated the associations among the three indicators (physical competence, physical well-being, and perceived physical literacy) among older adults in day care centers of Hong Kong. A total of 97 participants (aged 60 years old or above) participated in the study from April to July 2021 amid the COVID-19 pandemic. Data on participants’ sociodemographic information, physical competence (PC), physical well-being (PWB), and perceived physical literacy (PPL) were collected. Our results showed that the level of PC reached a high level among the participants. Positive correlations were found between PC and PWB and between PPL and PWB (r = 0.22−0.23, p < 0.05). However, PC was not associated with PPL (r = 0.11, p > 0.05). In addition, as a component within PPL, “knowledge and understanding” (KU) was found to be correlated with PC (r = 0.21, p < 0.05) and had a positive and moderate correlation with PWB (r = 0.35, p < 0.01). The results suggest that older adults admitted to day care centers maintain and enhance their physical competence to improve their physical well-being. Greater knowledge and understanding of physical literacy and physical health should be delivered among day care centers considering future development.
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12
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Morgan KA, Taylor KL, Walker CW, Tucker S, Dashner JL, Hollingsworth H. Mobility Disability and Exercise: Health Outcomes of an Accessible Community-Based Center. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:836655. [PMID: 36188910 PMCID: PMC9397740 DOI: 10.3389/fresc.2022.836655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022]
Abstract
ObjectiveThe purpose of this study was to determine how support and guidance provided by trained professionals during a 12-week, community-based transition exercise program, impact health outcomes and continued engagement in physical activity for persons with a mobility disability (PwMD).DesignA single arm pre-post design was used.SettingAccessible community-based health and wellness center.ParticipantsThe study included 244 PwMD using a mobility device.InterventionsParticipants completed a 12-week transition exercise program provided through an accessible community facility that provided education and support to complete endurance and strength related exercises as well as programming to encourage transition to self-directed engagement in exercise.Main Outcome MeasuresBodyweight, BMI, pain, perceived exertion, speed, and distance during cardiovascular fitness testing, and strength were measured pre and post exercise program. The number of participants that signed up for a monthly membership after the program was also monitored.ResultsFor the total group, average pain reported over previous 30 days decreased significantly (p < 0.01), current daily pain decreased significantly (p < 0.05), perceived exertion at the end of the 9-min endurance test decreased significantly (p < 0.05), and the four upper extremity strength exercises showed large, significant strength gains (p < 0.01) after the program. There was no significant change in bodyweight, BMI, or speed and distance completed during endurance testing. At the completion of the program, 76% of participants enrolled in a monthly membership at the facility with the intentions to continue to exercise regularly.ConclusionsThis study provides evidence that an accessible community-based exercise program, with a transitional component supported by trained professionals, can support the exercise goals of PwMD and improve strength, decrease pain, and may promote regular exercise adoption for PwMD.
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Affiliation(s)
- Kerri A. Morgan
- Enabling Mobility in the Community Laboratory, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
- *Correspondence: Kerri A. Morgan
| | - Kelly L. Taylor
- Occupational Therapy Program, Murray State University, Paducah, KY, United States
| | - Carla Wilson Walker
- Enabling Mobility in the Community Laboratory, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
| | - Susan Tucker
- Enabling Mobility in the Community Laboratory, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
| | - Jessica L. Dashner
- Enabling Mobility in the Community Laboratory, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
| | - Holly Hollingsworth
- Enabling Mobility in the Community Laboratory, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
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13
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Nie Q, Rogers WA. Understanding Health Self-Management Challenges and Needs for Older Adults with and without Mobility and Sensory Disabilities. PROCEEDINGS OF THE INTERNATIONAL SYMPOSIUM OF HUMAN FACTORS AND ERGONOMICS IN HEALTHCARE. INTERNATIONAL SYMPOSIUM OF HUMAN FACTORS AND ERGONOMICS IN HEALTHCARE 2022; 11:10.1177/2327857922111006. [PMID: 38529361 PMCID: PMC10961976 DOI: 10.1177/2327857922111006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Health self-management could be challenging for older adults with disabilities and technology has great potential to support them for managing health activities. Assessing users' needs is a significant technique to develop useful technologies. However, studies overwhelmingly collected and analyzed qualitative data in smaller samples or quantitative data in populations with single type of disability. This study aimed to analyze a national level dataset to assess the frequency of and challenges with managing health activities in older population with and without disabilities and identify potential support solutions to provide guidance for technology interventions. In this study, 4,541 older adults from the National Health and Aging Trends Study were grouped into five sub-groups (non-disability, mobility, vision, hearing, multiple disability). The findings indicated lower participation in wellness activities (e.g., exercise) than disease management activities (e.g., taking medicines, going to medical appointment). Around one tenth of older adults reported difficulty with tracking medicines and 23.4%-64.3% of respondents reported being accompanied during medical appointments. Managing health activities was more challenging for older adults with mobility and multiple disabilities. They were more likely to have difficulties and receive assistance with managing these activities, including accessing online health information. In conclusion, needs of older adults to manage health varied across activities and for people with different types of disabilities. We provide direction for person-centered and tailored interventions to respond to these needs.
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Affiliation(s)
- Qiong Nie
- University of Illinois Urbana-Champaign
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14
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Pans M, Úbeda-Colomer J, Monforte J, Devís-Devís J. Physical Activity and Accomplishment of Recommendations in University Students with Disabilities: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115540. [PMID: 34067266 PMCID: PMC8196807 DOI: 10.3390/ijerph18115540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 11/20/2022]
Abstract
University settings are socio-environmental contexts that can reduce health disparities in students with disabilities. Therefore, the aim of this study was twofold: (a) to examine the longitudinal physical activity (PA) changes of Spanish university students with disabilities during a three-year period; and (b) to identify the accomplishment of the World Health Organization’s PA recommendations in this period. A three-year follow-up cohort study was conducted on 355 university students with disabilities (172 men, 183 women). The participants completed an electronic survey on PA after which a descriptive analysis, longitudinal (Wilcoxon tests) and cross-sectional pairwise comparisons (Mann–Whitney U and Kruskal–Wallis tests) were performed on non-normal data. The results show no significant PA changes during the three-year period. The cross-sectional comparisons between the waves presented a reduction in vigorous PA according to sex and similar values by age, origin of disability, and socioeconomic status. A global reduction of 0.6% was found in achieving the recommendations between the waves. We also found an increase of 5.3% in the participants classified as overweight–obese during this period. The findings offered in this study have important implications for university disability care services and sports services. University policies should focus on rethinking PA and sports programs for students with disabilities.
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Affiliation(s)
- Miquel Pans
- AFES Research Group, Departament d’Educació Física i Esportiva, FCAFE, Universitat de València, 46010 València, Spain; (M.P.); (J.Ú.-C.); (J.D.-D.)
| | - Joan Úbeda-Colomer
- AFES Research Group, Departament d’Educació Física i Esportiva, FCAFE, Universitat de València, 46010 València, Spain; (M.P.); (J.Ú.-C.); (J.D.-D.)
| | - Javier Monforte
- Department of Sport and Exercise Sciences, Durham University, 42 Old Elvet, Durham DH1 3HN, UK
- Correspondence:
| | - José Devís-Devís
- AFES Research Group, Departament d’Educació Física i Esportiva, FCAFE, Universitat de València, 46010 València, Spain; (M.P.); (J.Ú.-C.); (J.D.-D.)
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15
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Veerubhotla A, Hong E, Knezevic S, Spungen A, Ding D. Estimation of Physical Activity Intensity in Spinal Cord Injury Using a Wrist-Worn ActiGraph Monitor. Arch Phys Med Rehabil 2020; 101:1563-1569. [PMID: 32502566 DOI: 10.1016/j.apmr.2020.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To derive accelerometer count thresholds for classifying time spent in sedentary, light intensity, and moderate-to-vigorous physical activity (MVPA) in manual wheelchair users (MWUs) with spinal cord injury (SCI). DESIGN Participants completed 18 activities of daily living and exercises for 10 minutes each with a 3-minute break between activities while wearing a COSMED K4b2 portable metabolic cart and an ActiGraph activity monitor on the dominant wrist. A linear regression was computed between the wrist acceleration vector magnitude and SCI metabolic equivalent of task (MET) for 80% of the participants to obtain thresholds for classifying different activity intensities, and the obtained thresholds were tested for accuracy on the remaining 20% of participants. This cross-validation process was iterated for 1000 times to evaluate the stability of the thresholds on data corresponding to different proportions of sedentary, light intensity, and MVPA. MET values of 1.5 or lower were classified as sedentary behavior, MET values between 1.5 and 3 were classified as light intensity, and MET values of 3 or higher were classified as MVPA. The final thresholds were then validated on an out-of-sample independent dataset. PARTICIPANTS MWUs (N=17) with SCI in the out-of-sample validation data set. INTERVENTIONS Not applicable. SETTING Research lab, community MAIN OUTCOME MEASURES: Accelerometer thresholds to classify sedentary, light intensity, and MVPA were obtained and their accuracy tested using cross-validation and an out-of-sample dataset. RESULTS The threshold between sedentary and light intensity was 2057 counts-per-minute, and the threshold between light intensity and MVPA was 11,551 counts per minute. Based on the out-of-sample validation, the obtained thresholds had an overall accuracy of 85.6%, with a sensitivity and specificity of 95.3% and 97.4% for sedentary behavior, 87.8% and 84.5% for light intensity, 68.5% and 96.3% for MVPA, respectively. CONCLUSION Accelerometer-based thresholds can be used to accurately identify sedentary behavior. However, thresholds may not provide accurate estimations of MVPA throughout the day when participants engage in more resistance-based activities.
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Affiliation(s)
- Akhila Veerubhotla
- Department of Rehabilitation Sciences and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Department of Veteran Affairs Pittsburgh Healthcare System, Pittsburgh, PA
| | - EunKyoung Hong
- Spinal Cord Damage Research Center, James J Peters VA Medical Center, Bronx, NY; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Steven Knezevic
- VA Rehabilitation Research & Development Service, National Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY
| | - Ann Spungen
- Spinal Cord Damage Research Center, James J Peters VA Medical Center, Bronx, NY; VA Rehabilitation Research & Development Service, National Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY
| | - Dan Ding
- Department of Rehabilitation Sciences and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Department of Veteran Affairs Pittsburgh Healthcare System, Pittsburgh, PA.
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16
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Fanning J, Rejeski WJ, Chen SH, Guralnik J, Pahor M, Miller ME. Relationships Between Profiles of Physical Activity and Major Mobility Disability in the LIFE Study. J Am Geriatr Soc 2020; 68:1476-1483. [PMID: 32196636 DOI: 10.1111/jgs.16386] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/21/2020] [Accepted: 02/01/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the relationship between time spent in light physical activity (LPA) and in moderate to vigorous physical activity (MVPA) and the pattern of accumulation on the risk for major mobility disability (MMD) in a large multicenter study of physical activity (PA) and aging, the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN Data were collected from individuals randomized to a PA intervention as part of the LIFE study, an eight-center single-blind randomized clinical trial conducted between February 2010 and December 2013. SETTING Lifestyle Interventions and Independence for Elders Study PARTICIPANTS: Older adult participants (78.4 years; N = 507) at risk for MMD. INTERVENTION All older adults included in these analyses were randomized to a structured PA intervention that included two center-based plus three to four home-based exercise sessions per week with a primary goal of walking for 150 minutes weekly. Participants attended the intervention for 2.5 years on average. MEASUREMENTS MMD was defined as the inability to complete a 400-m walk within 15 minutes and without assistance. Physical function was assessed via the Short Physical Performance Battery (SPPB). Actigraph accelerometers were used to quantify amount and variability in LPA and MVPA. RESULTS In an adjusted Cox proportional hazards regression, we identified a significant interaction (P = .017) between SPPB score and LPA amount and variability such that more LPA was associated with a reduced risk for MMD among those with higher initial function, as was lower variability (eg, via distributing LPA across the day). The SPPB × MVPA interaction was significant (P = .04), such that more MVPA was associated with lower MMD risk among those with lower function. Finally, greater MVPA variability was associated with lower risk for MMD. CONCLUSION A prescription of PA for older adults should account for key factors such as physical function and emphasize both amount and pattern of accumulation of PA from across the intensity continuum. J Am Geriatr Soc 68:1476-1483, 2020.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina
| | - W Jack Rejeski
- Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina
| | - Shyh-Huei Chen
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jack Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Michael E Miller
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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17
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Brown CJ, Chirino AFC, Cortez CM, Gearhart C, Urizar GG. Conceptual Art for the Aging Brain: Piloting an Art-Based Cognitive Health Intervention. ACTIVITIES, ADAPTATION & AGING 2020. [DOI: 10.1080/01924788.2020.1719584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Colette J. Brown
- Department of Psychology, California State University, Long Beach, CA, USA
- School of Art, California State University, Long Beach, CA, USA
| | | | | | - Cassandra Gearhart
- Department of Psychology, California State University, Long Beach, CA, USA
| | - Guido G. Urizar
- Department of Psychology, California State University, Long Beach, CA, USA
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18
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Hollis ND, Zhang QC, Cyrus AC, Courtney-Long E, Watson K, Carroll DD. Physical activity types among US adults with mobility disability, Behavioral Risk Factor Surveillance System, 2017. Disabil Health J 2020; 13:100888. [PMID: 32061542 DOI: 10.1016/j.dhjo.2020.100888] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/10/2020] [Accepted: 01/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Physical Activity Guidelines for Americans, second edition, recommend that all adults participate in moderate-intensity equivalent aerobic physical activity at least 150-300 min/week for substantial health benefits and muscle-strengthening activities involving all major muscle groups 2 or more days a week. The prevalence of the general population meeting the Guidelines and the types of physical activity in which they engage have been described elsewhere. Similar descriptions are lacking for individuals with mobility disability whose physical activity profiles may differ from the general population. OBJECTIVE This study examined patterns of aerobic and muscle-strengthening physical activity among US adults with mobility disability. METHODS We used 2017 Behavioral Risk Factor Surveillance System data from 66,635 adults with mobility disability. We estimated the percentage who engaged in any aerobic physical activity, met the aerobic and/or muscle-strengthening guidelines, and who participated in specific activities. RESULTS Less than half (45.2%) of US adults with mobility disability reported engaging in aerobic physical activity, and 39.5% met one or both components of the physical activity guidelines. Walking was the most commonly reported activity type (34.0%). CONCLUSIONS Walking is a common activity type among adults with mobility disability. Efforts to make walking or wheelchair rolling a safe, viable option are important to helping decrease barriers that may limit the ability of those with mobility disability to engage in walking or other physical activity types.
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Affiliation(s)
- NaTasha D Hollis
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA; Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA.
| | - Qing C Zhang
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Alissa C Cyrus
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Elizabeth Courtney-Long
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Kathleen Watson
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, National Center of Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Dianna D Carroll
- Epidemiology Workforce Branch, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA; Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA
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19
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Krops LA, Geertzen JHB, Horemans HLD, Bussmann JBJ, Dijkstra PU, Dekker R. Feasibility and short-term effects of Activity Coach+: a physical activity intervention in hard-to-reach people with a physical disability. Disabil Rehabil 2020; 43:2769-2778. [PMID: 31999496 DOI: 10.1080/09638288.2020.1717650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Existing physical activity interventions do not reach a considerable proportion of physically disabled people. This study assessed feasibility and short-term effects of Activity Coach+, a community-based intervention especially targeting this hard-to-reach population. METHODS Feasibility was determined by reach, dropouts, and compliance with the protocol. Physical activity was measured with the Activ8 accelerometer and the adapted SQUASH questionnaire. Health outcomes were assessed by body composition, blood pressure, hand grip force, 10-metre walk test, 6-minute walk test, and the Berg Balance Scale. The RAND-36, Exercise Self-Efficacy Scale, Fatigue Severity Scale, and IMPACT-S were administered. Measurements were performed at baseline and after 2 and 4 months. Changes over time were analysed by Friedman tests. RESULTS Twenty-nine participants enrolled during the first 4 months, of whom two dropped out. Intervention components were employed in 86-100% of the participants. Physical activity did not change after the implementation of Activity Coach+. Body mass index (p = 0.006), diastolic blood pressure (p = 0.032), walking ability (p = 0.002), exercise capacity (p = 0.013), balance (p = 0.014), and vitality (p = 0.049) changed over time. CONCLUSIONS Activity Coach + is feasible in a community setting. Indications for effectivity of Activity Coach + in hard-to-reach people with a physical disability were found.Implications for rehabilitationActivity Coach + was able to reach physically disabled people living in community, a population that is assumed hard-to-reach.Activity Coach + was feasible in a population of persons with a physical disability that was heterogeneous with respect to age and (severity of) disability.The current study provides the first indications for the beneficial health effects of Activity Coach + in hard-to-reach people with a physical disability.
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Affiliation(s)
- L A Krops
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - J H B Geertzen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - H L D Horemans
- Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands
| | - J B J Bussmann
- Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands
| | - P U Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands
| | - R Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
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20
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Phillips LJ, Petroski GF, Conn VS, Brown M, Leary E, Teri L, Zimmerman S. Exploring Path Models of Disablement in Residential Care and Assisted Living Residents. J Appl Gerontol 2018; 37:1490-1516. [PMID: 27708073 PMCID: PMC5538951 DOI: 10.1177/0733464816672048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined the relationships between individual and environmental factors and physical activity, and between physical activity and functional limitations and disability in residential care/assisted living (RC/AL) residents. Participants completed questionnaires and physical performance tests, and wore the Fitbit Motion Tracker® to capture physical activity. Model fit was analyzed using two-level path models with residents nested within RC/AL settings. Model parameters were estimated using the MPlus robust maximum likelihood method. A multilevel model with good fit (root mean square error of approximation = 0.07, comparative fit index [CFI] = 0.91) showed that persons with greater exercise self-efficacy were more physically active, and persons who were more physically active had better physical function and less disability. Setting-level factors did not significantly correlate with physical activity or disability. Although environmental factors may influence physical activity behavior, only individual factors were associated with physical activity in this sample of RC/AL residents.
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Affiliation(s)
| | | | | | | | | | - Linda Teri
- 2 University of Washington, Seattle, USA
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21
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Krops LA, Folkertsma N, Hols DHJ, Geertzen JHB, Dijkstra PU, Dekker R. Target population's requirements on a community-based intervention for stimulating physical activity in hard-to-reach physically disabled people: an interview study. Disabil Rehabil 2018; 41:2272-2279. [PMID: 29852788 DOI: 10.1080/09638288.2018.1462411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Purpose: To explore ideas of the target population about a community-based intervention to stimulate physical activity in hard-to-reach physically disabled people. Materials and methods: Semi-structured interviews were performed with 21 physically disabled people, and analyzed using thematic analyses. Findings were interpreted using the integrated Physical Activity for People with a Disability and Intervention Mapping model. Results: The intervention should aim to stimulate intrinsic motivation and raise awareness for the health effects of physical activity. It should provide diverse activities, increase visibility of these activities, and improve image of physical activity for physically disabled people. Participants suggested to provide individual coaching sessions, increase marketing, present role models, and assign buddies. Potential users should be approached personally through intermediate organizations, or via social media and word of mouth promotion. Participants suggested that users, government, sponsors, and health insurers should finance the intervention. Self-responsibility for being physically active was strongly emphasized by participants. Conclusions: An intervention to stimulate physical activity in hard-to-reach physically disabled people should be individualized, include personal support, and should include marketing to improve image of physical activity of physically disabled people. The intervention that fulfills these requirements should be developed and tested for effects in future research. Implications for rehabilitation An intervention to stimulate physical activity in physically disabled people should aim to raise awareness for the health effects of physical activity, stimulate intrinsic motivation, offer diverse activities, increase the visibility of the possible activities, and improve the image of physical activity for physically disabled people. An intervention should include both individual- and environmental-level intervention methods. Physically disabled people most emphasized individual-level characteristics of an intervention. For intervention development, professionals should take into account that physically disabled people believe that being physically active is a person's own responsibility.
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Affiliation(s)
- Leonie A Krops
- a Department of Rehabilitation Medicine , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Nienke Folkertsma
- b Center for Human Movement Sciences , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Doortje H J Hols
- b Center for Human Movement Sciences , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Jan H B Geertzen
- a Department of Rehabilitation Medicine , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Pieter U Dijkstra
- a Department of Rehabilitation Medicine , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,c Department of Oral and Maxillofacial Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Rienk Dekker
- a Department of Rehabilitation Medicine , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,d Center of Sports Medicine , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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22
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Sawyer ADM, Jones R, Ucci M, Smith L, Kearns A, Fisher A. Cross-sectional interactions between quality of the physical and social environment and self-reported physical activity in adults living in income-deprived communities. PLoS One 2017; 12:e0188962. [PMID: 29240791 PMCID: PMC5730220 DOI: 10.1371/journal.pone.0188962] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 11/16/2017] [Indexed: 11/18/2022] Open
Abstract
Background Understanding the environmental determinants of physical activity in populations at high risk of inactivity could contribute to the development of effective interventions. Socioecological models of activity propose that environmental factors have independent and interactive effects of physical activity but there is a lack of research into interactive effects. Objectives This study aimed to explore independent and interactive effects of social and physical environmental factors on self-reported physical activity in income-deprived communities. Methods Participants were 5,923 adults in Glasgow, United Kingdom. Features of the social environment were self-reported. Quality of the physical environment was objectively-measured. Neighbourhood walking and participation in moderate physical activity [MPA] on ≥5 days/week was self-reported. Multilevel multivariate logistic regression models tested independent and interactive effects of environmental factors on activity. Results ‘Social support’ (walking: OR:1.22,95%CI = 1.06–1.41,p<0.01; MPA: OR:0.79,95%CI = 0.67–0.94,p<0.01), ‘social interaction’ (walking: OR:1.25,95%CI = 1.10–1.42,p<0.01; MPA: OR:6.16,95%CI = 5.14–7.37,p<0.001) and ‘cohesion and safety’ (walking: OR:1.78,95%CI = 1.56–2.03,p<0.001; MPA: OR:1.93,95%CI = 1.65–2.27,p<0.001), but not ‘trust and empowerment’, had independent effects on physical activity. ‘Aesthetics of built form’ (OR:1.47,95%CI = 1.22–1.77,p<0.001) and ‘aesthetics and maintenance of open space’ (OR:1.32, 95%CI = 1.13–1.54,p<0.01) were related to walking. ‘Physical disorder’ (OR:1.63,95%CI = 1.31–2.03,p<0.001) had an independent effect on MPA. Interactive effects of social and physical factors on walking and MPA were revealed. Conclusions Findings suggest that intervening to create activity-supportive environments in deprived communities may be most effective when simultaneously targeting the social and physical neighbourhood environment.
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Affiliation(s)
- Alexia D. M. Sawyer
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- * E-mail:
| | - Russell Jones
- Glasgow Centre for Population Health, Third Floor, Olympia Building, Bridgeton Cross, Glasgow, United Kingdom
| | - Marcella Ucci
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, Central House, London, United Kingdom
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ade Kearns
- Urban Studies, University of Glasgow, Glasgow, United Kingdom
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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23
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Schieir O, Hogg-Johnson S, Glazier RH, Badley EM. Sex Variations in the Effects of Arthritis and Activity Limitation on First Heart Disease Event Occurrence in the Canadian General Population: Results From the Longitudinal National Population Health Survey. Arthritis Care Res (Hoboken) 2017; 68:811-8. [PMID: 26473753 DOI: 10.1002/acr.22764] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 10/01/2015] [Accepted: 10/13/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To estimate sex-specific effects of arthritis and activity limitation on incident heart disease in a nationally representative, Canadian longitudinal population-based survey. METHODS Information on sociodemographic variables, self-reported physician-diagnosed chronic conditions (including arthritis and heart disease), activity limitations, and traditional risk factors was collected every 2 years from 1994-1995 through 2010-2011 as part of the longitudinal Canadian National Population Health Survey. Deaths due to ischemic heart disease (International Classification of Diseases, Tenth Revision [ICD-10] codes I20-I25) and heart failure (ICD-10 codes I50.0-I50.9) were confirmed against the Canadian Vital Statistics Database. Discrete-time survival analysis stratified by sex was used to estimate effects of arthritis and activity limitation on first heart disease event occurrence. RESULTS The study included 12,591 participants with no prior history of heart disease and 1,783 incident heart disease events. After adjusting for common risk factors, arthritis was associated with a significant increased risk of incident heart disease in women (adjusted odds ratio [OR] 1.58, 95% confidence interval [95% CI] 1.23-2.02). Even higher risks were reported in women with arthritis and activity limitation (OR 2.19, 95% CI 1.61-2.97). Arthritis was not associated with incident heart disease in men, except for when also reported with activity limitation (OR 1.60, 95% CI 1.14-2.26). CONCLUSION Women with arthritis, and men with arthritis and activity limitation, have significant excess risks for developing heart disease in the general population. These findings point to the need for improved access to arthritis care, cardiovascular prevention strategies, particularly in women with arthritis, and directed interventions toward prevention of activity limitation.
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Affiliation(s)
- Orit Schieir
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Sheilah Hogg-Johnson
- University of Toronto Dalla Lana School of Public Health and Institute for Work and Health, Toronto, Ontario, Canada
| | - Richard H Glazier
- Institute for Clinical Evaluative Sciences, and Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Elizabeth M Badley
- University of Toronto Dalla Lana School of Public Health and Toronto Western Research Institute, Toronto, Ontario, Canada
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24
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Mansfield A, Brooks D, Tang A, Taylor D, Inness EL, Kiss A, Middleton L, Biasin L, Fleck R, French E, LeBlanc K, Aqui A, Danells C. Promoting Optimal Physical Exercise for Life (PROPEL): aerobic exercise and self-management early after stroke to increase daily physical activity-study protocol for a stepped-wedge randomised trial. BMJ Open 2017; 7:e015843. [PMID: 28667222 PMCID: PMC5726051 DOI: 10.1136/bmjopen-2017-015843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/07/2017] [Accepted: 04/25/2017] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Physical exercise after stroke is essential for improving recovery and general health, and reducing future stroke risk. However, people with stroke are not sufficiently active on return to the community after rehabilitation. We developed the Promoting Optimal Physical Exercise for Life (PROPEL) programme, which combines exercise with self-management strategies within rehabilitation to promote ongoing physical activity in the community after rehabilitation. This study aims to evaluate the effect of PROPEL on long-term participation in exercise after discharge from stroke rehabilitation. We hypothesise that individuals who complete PROPEL will be more likely to meet recommended frequency, duration and intensity of exercise compared with individuals who do not complete the programme up to 6 months post discharge from stroke rehabilitation. METHODS AND ANALYSIS Individuals undergoing outpatient stroke rehabilitation at one of six hospitals will be recruited (target n=192 total). A stepped-wedge design will be employed; that is, the PROPEL intervention (group exercise plus self-management) will be 'rolled out' to each site at a random time within the study period. Prior to roll-out of the PROPEL intervention, sites will complete the control intervention (group aerobic exercise only). Participation in physical activity for 6 months post discharge will be measured via activity and heart rate monitors, and standardised physical activity questionnaire. Adherence to exercise guidelines will be evaluated by (1) number of 'active minutes' per week (from the activity monitor), (2) amount of time per week when heart rate is within a target range (ie, 55%-80% of age-predicted maximum) and (3) amount of time per week completing 'moderate' or 'strenuous' physical activities (from the questionnaire). We will compare the proportion of active and inactive individuals at 6 months post intervention using mixed-model logistic regression, with fixed effects of time and phase and random effect of cluster (site). ETHICS AND DISSEMINATION To date, research ethics approval has been received from five of the six sites, with conditional approval granted by the sixth site. Results will be disseminated directly to study participants at the end of the trial, and to other stake holders via publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT02951338; Pre-results.
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Affiliation(s)
- Avril Mansfield
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Dina Brooks
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
- West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Denise Taylor
- St Joseph’s Care Group, Thunder Bay, Ontario, Canada
- Northern Ontario School of Medicine, West Campus, Thunder Bay, Ontario, Canada
| | - Elizabeth L Inness
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Laura Middleton
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Louis Biasin
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca Fleck
- Regional Rehabilitation Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Esmé French
- Northwestern Ontario Regional Stroke Network, Thunder Bay, Ontario, Canada
| | - Kathryn LeBlanc
- Regional Rehabilitation Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Anthony Aqui
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Cynthia Danells
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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25
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Loprinzi PD, Addoh O, Mann JR. Association between muscle strengthening physical activities and mortality among American adults with mobility limitations. Prev Med 2017; 99:207-210. [PMID: 28216379 DOI: 10.1016/j.ypmed.2017.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/12/2017] [Accepted: 02/13/2017] [Indexed: 11/27/2022]
Abstract
Compared to aerobic-based physical activity, less research has evaluated the effects of muscle-strengthening physical activity (MSPA) on mortality. Additionally, limited research has evaluated this among adults with mobility limitations, which was this study's purpose. Data from the 2003-2006 NHANES, with follow-up through 2011, were used (analyzed in 2016). MSPA was assessed via self-report, with all-cause, CVD-specific, and cancer-specific mortality assessed as the outcome variables. Analyses were limited to adults with mobility limitations (N=1411), assessed via a validated questionnaire. After adjustments, those meeting MSPA guidelines (vs. not) had a 38% reduced hazard of all-cause death (HR=0.62; 95% CI: 0.41-0.95). Results were similar for CVD-specific mortality (HR=0.46; 95% CI: 0.23-0.97) and cancer-specific mortality (HR=0.27; 95% CI: 0.06-1.20). Meeting MSPA guidelines is associated with reduced all-cause and cause-specific mortality among adults with mobility limitations. This is an encouraging observation as adults with mobility limitations may be unable to engage in sufficient amounts of aerobic-based physical activity. Thus, promotion of MSPA among this population may be of critical importance.
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Affiliation(s)
- Paul D Loprinzi
- Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, University of Mississippi, United States.
| | - Ovuokerie Addoh
- Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, University of Mississippi, United States
| | - Joshua R Mann
- Department of Preventive Medicine, University of Mississippi Medical Center, United States
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26
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Merali S, Cameron JI, Barclay R, Salbach NM. Characterising community exercise programmes delivered by fitness instructors for people with neurological conditions: a scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:e101-e116. [PMID: 26445890 DOI: 10.1111/hsc.12282] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 06/05/2023]
Abstract
A scoping review was conducted to characterise evaluations of community-based exercise programmes (CBEPs) delivered by fitness instructors to people with neurological conditions. Literature published from 1946 to April 2014 in MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews and the grey literature were searched. Search terms included community, programme, exercise, adult, brain disease and spinal cord disease. Two reviewers independently screened titles and abstracts for inclusion. One author reviewed full-text articles to evaluate eligibility. Studies were included if the study objective was to evaluate an exercise programme, the programme was community-based and delivered by fitness instructors, exercise participants were ≥18 years of age and had a neurological condition, and a full-text article was available and written in English. After reviewing 1785 titles and abstracts, 18 (1.01%) articles describing 15 studies were included in the review. One author completed data abstraction from the included studies. A second reviewer independently verified the extracted data for accuracy. Exercise programmes most commonly included people with stroke (47%) and Parkinson's disease (40%), incorporated a stand-alone (80%), multi-component (20%), group (67%), individual (20%) and combined format (13%), strength training (40%) and functional/task-oriented training (40%), reported a minimum walking requirement (67%), and involved a healthcare professional (HCP) with various roles (53%), including training (27%), advising and supporting (33%). The most commonly examined participant outcomes were health-related quality of life (60%) and functional balance (47%). More research is needed to develop CBEPs targeting individuals with low ambulatory function and multiple neurological conditions, to develop recommendations for the involvement of HCPs in CBEPs and document their involvement, and to evaluate system-level outcomes such as cost, healthcare utilisation and impact on caregivers. The findings support a number of considerations to guide future research into CBEPs delivered by fitness instructors for individuals with neurological conditions.
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Affiliation(s)
- Saira Merali
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Jill I Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Ruth Barclay
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Nancy M Salbach
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
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27
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Piatt JA, Nagata S, Zahl M, Li J, Rosenbluth JP. Problematic secondary health conditions among adults with spinal cord injury and its impact on social participation and daily life. J Spinal Cord Med 2016; 39:693-698. [PMID: 26833021 PMCID: PMC5137571 DOI: 10.1080/10790268.2015.1123845] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE This exploratory study describes the problematic secondary health conditions among adults with a spinal cord injury (SCI) and the impact these health concerns have on social participation and daily life. DESIGN Cross-sectional survey design. SETTING A community-based rehabilitation program within the United States. PARTICIPANTS Fifty-six adults (33 males and 23 females; age 18 to 73 [M = 39.4, SD = 12.7]) with SCI participating in the community-based rehabilitation program. METHODS Subjects identified the top five problematic secondary health conditions related to his/her SCI, belief about the impact these conditions have on social participation and daily life, and if they believed the secondary health condition(s) were avoidable. RESULTS The top problematic areas identified were bladder control, pain, bowel control, and pressure ulcers, and 73% felt these problems were unavoidable. In addition, more than 66% had each of these problems continuously during the last 12 months. When examining the impact of the problematic secondary health conditions, 75% identified that the primary problem had a significant impact on social participation and 64% identified it significantly impacted daily life. CONCLUSION Although the majority of the participants were actively participating in a community-based rehabilitation wellness program, it appears that they thought engagement in social participation and daily life were negatively impacted by the secondary health conditions and unavoidable. The results suggested unfulfilled goals despite the emphasized efforts of medical providers to help manage the secondary conditions. Future research should examine why individuals with SCI still have a difficult time managing secondary health conditions.
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Affiliation(s)
- Jennifer A. Piatt
- Indiana University, School of Public Health, Bloomington, IN, USA,Correspondence to: Jennifer A. Piatt, Indiana University, School of Public Health, HPER Building 133, 1025 E. Seventh Street, Bloomington, IN 47405-7109, USA.
| | - Shinichi Nagata
- Indiana University, School of Public Health, Bloomington, IN, USA
| | - Melissa Zahl
- Oklahoma State University, School of Applied Health and Educational Psychology, Stillwater, OK, USA
| | - Jing Li
- Department of Epidemiology and Biostatistics, Indiana University, School of Public Health, Bloomington, IN, USA
| | - Jeffrey P. Rosenbluth
- Department of Physical Medicine & Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA
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Mendoza-Vasconez AS, Linke S, Muñoz M, Pekmezi D, Ainsworth C, Cano M, Williams V, Marcus BH, Larsen BA. Promoting Physical Activity among Underserved Populations. Curr Sports Med Rep 2016; 15:290-7. [PMID: 27399827 PMCID: PMC5371027 DOI: 10.1249/jsr.0000000000000276] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Underserved populations, including racial/ethnic minorities, individuals with low socioeconomic status, and individuals with physical disabilities, are less likely to engage in sufficient moderate to vigorous physical activity (MVPA) and are thus at increased risk of morbidity and mortality. These populations face unique challenges to engaging in MVPA. Learning how to overcome these challenges is a necessary first step in achieving health equity through health promotion research. In this review of the literature, we discuss issues and strategies that have been used to promote MVPA among individuals from underserved populations, focusing on recruitment, intervention delivery, and the use of technology in interventions. Physical activity promotion research among these vulnerable populations is scarce. Nevertheless, there is preliminary evidence of efficacy in the use of certain recruitment and intervention strategies including tailoring, cultural adaptation, incorporation of new technologies, and multilevel and community-based approaches for physical activity promotion among different underserved populations.
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Affiliation(s)
- Andrea S Mendoza-Vasconez
- 1 Department of Family Medicine and Public Health, University of California, La Jolla, CA; 2 Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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29
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Macera CA, Cavanaugh A, Bellettiere J. State of the Art Review: Physical Activity and Older Adults. Am J Lifestyle Med 2016; 11:42-57. [PMID: 30202313 DOI: 10.1177/1559827615571897] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/18/2014] [Accepted: 01/12/2015] [Indexed: 12/31/2022] Open
Abstract
Physical activity is an important component of a healthy lifestyle for all adults and especially for older adults. Using information from the updated 2008 Physical Activity Guidelines, 3 dimensions of physical activity are identified for older adults. These include increasing aerobic activity, increasing muscle-strengthening activity, and reducing sedentary or sitting behavior. Although the overall goal of the physical activity recommendations is to prevent chronic diseases and conditions from developing, many older adults are already affected. Therefore, suggested types of physical activity are described for specific diseases and conditions that are designed to mediate the condition or prevent additional disability. Finally, barriers to participation in physical activity specific to older adults are described, and possible solutions offered. Encouraging older adults to continue or even start a physical activity program can result in major health benefits for these individuals.
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Affiliation(s)
- Caroline A Macera
- Graduate School of Public Health (CAM) San Diego State University, San Diego, California.,Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health (JB) San Diego State University, San Diego, California.,Joint Doctoral Program in Public Health Epidemiology, San Diego State University and University of California at San Diego, San Diego, California (AC)
| | - Alyson Cavanaugh
- Graduate School of Public Health (CAM) San Diego State University, San Diego, California.,Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health (JB) San Diego State University, San Diego, California.,Joint Doctoral Program in Public Health Epidemiology, San Diego State University and University of California at San Diego, San Diego, California (AC)
| | - John Bellettiere
- Graduate School of Public Health (CAM) San Diego State University, San Diego, California.,Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health (JB) San Diego State University, San Diego, California.,Joint Doctoral Program in Public Health Epidemiology, San Diego State University and University of California at San Diego, San Diego, California (AC)
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30
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Promoting Optimal Physical Exercise for Life: An Exercise and Self-Management Program to Encourage Participation in Physical Activity after Discharge from Stroke Rehabilitation-A Feasibility Study. Stroke Res Treat 2016; 2016:9476541. [PMID: 27313948 PMCID: PMC4904109 DOI: 10.1155/2016/9476541] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/13/2016] [Accepted: 04/20/2016] [Indexed: 02/03/2023] Open
Abstract
People with stroke do not achieve adequate levels of physical exercise following discharge from rehabilitation. We developed a group exercise and self-management program (PROPEL), delivered during stroke rehabilitation, to promote uptake of physical activity after discharge. This study aimed to establish the feasibility of a larger study to evaluate the effect of this program on participation in self-directed physical activity. Participants with subacute stroke were recruited at discharge from one of three rehabilitation hospitals; one hospital offered the PROPEL program whereas the other two did not (comparison group; COMP). A high proportion (11/16) of eligible PROPEL program participants consented to the study. Fifteen COMP participants were also recruited. Compliance with wearing an accelerometer for 6 weeks continuously and completing physical activity questionnaires was high (>80%), whereas only 34% of daily heart rate data were available. Individuals who completed the PROPEL program seemed to have higher outcome expectations for exercise, fewer barriers to physical activity, and higher participation in physical activity than COMP participants (Hedge's g ≥ 0.5). The PROPEL program delivered during stroke rehabilitation shows promise for reducing barriers to exercise and increasing participation in physical activity after discharge. This study supports feasibility of a larger randomized trial to evaluate this program.
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Lor L, Hill K, Jacoby P, Leonard H, Downs J. A validation study of a modified Bouchard activity record that extends the concept of 'uptime' to Rett syndrome. Dev Med Child Neurol 2015; 57:1137-42. [PMID: 26108439 DOI: 10.1111/dmcn.12838] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to investigate the validity of using a Bouchard activity record (BAR) in individuals with Rett syndrome to measure physical activity, as compared with pragmatic criterion standard measures of walking status and step counts recorded using the StepWatch activity monitor (SAM). METHOD During the waking hours of 1 day, 43 females (mean age 21y, SD 9y) wore a SAM whilst a proxy completed a modified BAR. Responses to the BAR were compared among participants, who were grouped according to walking status, using the Mann-Whitney two-sample rank-sum test. Relationships were sought between BAR responses and step counts using linear regression. RESULTS According to the proxy-reported BAR responses, those who needed assistance with walking spent more time sitting (median [interquartile range] 9h 15min [8h 8min-10h 30min] vs 6h 15min [4h 15min-8h 30min]; p<0.001) and less time standing (1h [38min-1h 30min] vs 2h 15min [45min-3h 45min]; p=0.04) than those who could walk independently. In those who could walk independently, time classified as 'uptime' (standing and walking) using the BAR was associated with increased step count (r(2) =0.58; p<0.001). INTERPRETATION These data support the validity of proxy-reported BAR responses. In those who could walk independently, uptime, classified using the BAR, could be used to estimate daily step count. This tool offers an inexpensive method for clinicians to gain insights into physical activity levels in individuals with Rett syndrome.
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Affiliation(s)
- Leon Lor
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.,Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, The University of Western Australia, Perth, WA, Australia
| | - Peter Jacoby
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Jenny Downs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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Beevi FHA, Miranda J, Pedersen CF, Wagner S. An Evaluation of Commercial Pedometers for Monitoring Slow Walking Speed Populations. Telemed J E Health 2015; 22:441-9. [PMID: 26451900 DOI: 10.1089/tmj.2015.0120] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Pedometers are considered desirable devices for monitoring physical activity. Two population groups of interest include patients having undergone surgery in the lower extremities or who are otherwise weakened through disease, medical treatment, or surgery procedures, as well as the slow walking senior population. For these population groups, pedometers must be able to perform reliably and accurately at slow walking speeds. The objectives of this study were to evaluate the step count accuracy of three commercially available pedometers, the Yamax (Tokyo, Japan) Digi-Walker(®) SW-200 (YM), the Omron (Kyoto, Japan) HJ-720 (OM), and the Fitbit (San Francisco, CA) Zip (FB), at slow walking speeds, specifically at 1, 2, and 3 km/h, and to raise awareness of the necessity of focusing research on step-counting devices and algorithms for slow walking populations. MATERIALS AND METHODS Fourteen participants 29.93 ±4.93 years of age were requested to walk on a treadmill at the three specified speeds, in four trials of 100 steps each. The devices were worn by the participants on the waist belt. The pedometer counts were recorded, and the error percentage was calculated. RESULTS The error rate of all three evaluated pedometers decreased with the increase of speed: at 1 km/h the error rates varied from 87.11% (YM) to 95.98% (FB), at 2 km/h the error rates varied from 17.27% (FB) to 46.46% (YM), and at 3 km/h the error rates varied from 22.46% (YM) to a slight overcount of 0.70% (FB). CONCLUSIONS It was observed that all the evaluated devices have high error rates at 1 km/h and mixed error rates at 2 km/h, and at 3 km/h the error rates are the smallest of the three assessed speeds, with the OM and the FB having a slight overcount. These results show that research on pedometers' software and hardware should focus more on accurate step detection at slow walking speeds.
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Affiliation(s)
- Femina H A Beevi
- 1 Section of ECE, Department of Engineering, Aarhus University , Aarhus, Denmark
| | - Jorge Miranda
- 2 Algorithm Center, University of Minho , Guimarães, Portugal
| | - Christian F Pedersen
- 1 Section of ECE, Department of Engineering, Aarhus University , Aarhus, Denmark
| | - Stefan Wagner
- 1 Section of ECE, Department of Engineering, Aarhus University , Aarhus, Denmark
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Snook JD, Oliver M. Perceptions of Wellness From Adults With Mobility Impairments. JOURNAL OF COUNSELING AND DEVELOPMENT 2015. [DOI: 10.1002/jcad.12027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Joy-Del Snook
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
- Now at Department of Counseling and Special Populations; Lamar University
| | - Marvarene Oliver
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
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Alingh RA, Hoekstra F, van der Schans CP, Hettinga FJ, Dekker R, van der Woude LHV. Protocol of a longitudinal cohort study on physical activity behaviour in physically disabled patients participating in a rehabilitation counselling programme: ReSpAct. BMJ Open 2015; 5:e007591. [PMID: 25633288 PMCID: PMC4316554 DOI: 10.1136/bmjopen-2015-007591] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Stimulating physical activity behaviour in persons with a physical disability is important, especially after discharge from rehabilitation. A tailored counselling programme covering both the period of the rehabilitation treatment and the first months at home seems on the average effective. However, a considerable variation in response is observed in the sense that some patients show a relevant beneficial response while others show no or only a small response on physical activity behaviour. The Rehabilitation, Sports and Active lifestyle (ReSpAct) study aims to estimate the associations of patient and programme characteristics with patients' physical activity behaviour after their participation in a tailored counselling programme. METHODS AND ANALYSIS A questionnaire-based nationwide longitudinal prospective cohort study is conducted. Participants are recruited from 18 rehabilitation centres and hospitals in The Netherlands. 2000 participants with a physical disability or chronic disease will be followed during and after their participation in a tailored counselling programme. Programme outcomes on physical activity behaviour and patient as well as programme characteristics that may be associated with differences in physical activity behaviour after programme completion are being assessed. Data collection takes place at baseline and 14, 33 and 52 weeks after discharge from rehabilitation. ETHICS AND DISSEMINATION The study protocol has been approved by the Medical Ethics Committee of the University Medical Centre Groningen and at individual participating institutions. All participants give written informed consent. The study results will provide new insights into factors that may help explain the differences in physical activity behaviour of patients with a physical disability after they have participated in the same physical activity and sports stimulation programme. Thereby, it will support healthcare professionals to tailor their guidance and care to individual patients in order to stimulate physical activity after discharge in a more efficient and effective way. TRIAL REGISTRATION NUMBER NTR3961.
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Affiliation(s)
- Rolinde A Alingh
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, TheNetherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, TheNetherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Florentina J Hettinga
- Centre of Sport and Exercise Science, School of Biological Sciences, University of Essex, Colchester, UK
| | - Rienk Dekker
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, TheNetherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Escobar-Viera CG, Jones PD, Schumacher JR, Hall AG. Association between living alone and physical inactivity among people with and without disability, Florida Behavioral Risk Factor Surveillance System, 2009. Prev Chronic Dis 2014; 11:E173. [PMID: 25299979 PMCID: PMC4193062 DOI: 10.5888/pcd11.140182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People with disability may be at risk of developing diseases due to physical inactivity; social support from family and friends is positively related to engaging in regular physical activity. We compared the association between living alone and engagement in physical activity among people with and without disability in Florida. We used multivariate logistical regression to analyze 2009 Florida Behavioral Risk Factor Surveillance System data (n = 10,902) to assess differences in physical activity in disability levels for respondents who lived alone versus those who did not. Respondents with a disability were less likely to engage in physical activity than were people without a disability, regardless of disability type, and the lowest rates of engaging in physical activity were found for people with disability who lived alone. Public health efforts should consider the role of household composition when targeting physical activity interventions among people with disability.
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Affiliation(s)
- César G Escobar-Viera
- Department of Health Services, Research, Management and Policy, University of Florida, College of Public Health and Health Professions, PO Box 100195, Gainesville, FL 32610-0195. E-mail:
| | - Patrice D Jones
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida
| | - Jessica R Schumacher
- Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin
| | - Allyson G Hall
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida
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Winberg C, Flansbjer UB, Rimmer JH, Lexell J. Relationship Between Physical Activity, Knee Muscle Strength, and Gait Performance in Persons With Late Effects of Polio. PM R 2014; 7:236-44. [DOI: 10.1016/j.pmrj.2014.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 11/29/2022]
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Abstract
The objectives of this three-phased investigation were to (1) characterize existing recreational programming opportunities for tenants residing in assisted living (AL) and (2) gather perceptions on factors influencing activity program planning and delivery. Using an integrated knowledge translation framework during a one-year collaboration, we targeted 51 publicly funded AL sites from two health authorities in British Columbia. We conducted an activity calendar review, staff survey, and interactive symposia to identify factors that enabled or restricted recreational programming. From the information obtained, we determined that all AL sites delivered recreational programming. Although exercise and physical activity opportunities were perceived as having high importance, most activities were social. Staff reported confidence in delivering this type of programming and believed it met the holistic needs of tenants, including their mental well-being, and fostered a sense of community. Future avenues for increasing physical activity of AL tenants should address individual, site, and organizational characteristics.
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Rubio E, Comín M, Montón G, Martínez T, Magallón R. [Health and social services used by the rural elderly]. Rev Esp Geriatr Gerontol 2014; 49:217-22. [PMID: 25005158 DOI: 10.1016/j.regg.2014.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 03/20/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To describe the use of health and social services, and to analyze the influence of functional capacity for Instrumental Activities of Daily Living (IADL) and other factors in their use. METHOD Cross-sectional study in a non-institutionalized population older than 64 years old in a basic rural health area of Zaragoza. DEPENDENT VARIABLES use of different health and social services. Main independent variable: functional capacity for IADL according to the Lawton-Brody. Confounding variables: sociodemographic, physical exercise, comorbidity, self-perceived health, walking aids, social resources and economic resources (OARS-MAFQ). The relationship between the use of services and functional capacity for IADL was assessed using crude OR (ORC) and adjusted (adjusted OR) with CI95% by means of multivariate logistic regression models. RESULTS The use of social and health services increased with age and worse functional capacity for IADL. The increased use of health services was related with bad stage of health, limited social and economic resources, physical inactivity and female. The increased use of home help services was related with limited social resources, low education level and male. Regular physical activity and using walking aids were associated with greater participation in recreational activities. CONCLUSIONS The probability of using social and health services increased in older people with impaired functional capacity for IADL. The specific use of them changed according to differences in health, demographic and contextual features.
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Affiliation(s)
| | - Magdalena Comín
- Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza
| | | | | | - Rosa Magallón
- Red de Investigación en Atención Primaria (redIAPP) (Carlos III 06/018), Instituto Aragonés de Ciencias de la Salud
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Mudge S, Kayes NM, Stavric VA, Channon AS, Kersten P, McPherson KM. Living well with disability: needs, values and competing factors. Int J Behav Nutr Phys Act 2013; 10:100. [PMID: 23964930 PMCID: PMC3765294 DOI: 10.1186/1479-5868-10-100] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 08/19/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Obesity is more prevalent for disabled people (estimated as being between 27-62%) compared to the general population (17-22%). Disabled people are more likely to report poorer general health and acquire a range of obesity-related secondary conditions. Although there are many physical activity and nutrition initiatives aimed at obesity prevention, little is known about whether these options are relevant and accessible for disabled people. The Living Well Study aimed to better understand the issues faced by disabled people when engaging in physical activity and healthy eating. METHODS The study drew on a participatory action research design involving key stakeholders. There were two core cyclical phases (A and B), in which data collection was followed by a period of analysis, reflection and refinement. Focus groups and interviews were held with individuals who experience a range of disabilities, family members, service providers and representatives from disability advocacy groups. We sought to explore the importance and meaning of physical activity and healthy eating and factors that influenced engagement in these. Data in phase A were analysed using conventional content analysis drawing on constant comparative methods to identify themes of importance. In phase B, data analysis occurred alongside data collection, using a structured template to summarise participants' agreement or disagreement with the draft themes and recommendations, until the themes and recommendations were refined based on participants' corroboration. RESULTS 146 participants aged between 10-69 years, from both rural and urban areas and of different cultural backgrounds participated. Seven interconnecting themes that related to engagement in living well behaviours emerged with a wide range of external factors (such as people, knowledge, time, cost, identity and the environment) impacting on living well options. The central theme - It depends: needs, values and competing factors - emphasised the complexity faced by a disabled person when balancing the external factors with their own personal values and needs in order to arrive at a decision to engage in healthy living behaviours. CONCLUSIONS Although disabled people experience similar issues when participating in healthy living behaviours as those living without disability, additional factors need to be addressed in order to improve opportunities for 'living well' in these populations. This information has implications for health professionals to target the relevance and content of interventions.
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Affiliation(s)
- Suzie Mudge
- Person Centred Research Centre, Health & Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Nicola M Kayes
- Person Centred Research Centre, Health & Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Verna A Stavric
- Health & Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Alexis S Channon
- Person Centred Research Centre, Health & Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Paula Kersten
- Person Centred Research Centre, Health & Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Kathryn M McPherson
- Person Centred Research Centre, Health & Rehabilitation Research Institute, AUT University, Auckland, New Zealand
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Rosenberg DE, Bombardier CH, Artherholt S, Jensen MP, Motl RW. Self-reported depression and physical activity in adults with mobility impairments. Arch Phys Med Rehabil 2012; 94:731-6. [PMID: 23164977 DOI: 10.1016/j.apmr.2012.11.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 11/09/2012] [Accepted: 11/12/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To test hypothesized associations between depression and physical activity among adults with multiple sclerosis (MS), spinal cord injury (SCI), muscular dystrophy (MD), and postpolio syndrome (PPS). DESIGN Cross-sectional survey. SETTING Survey responses collected from individuals in the Washington state area (participants with SCI) and across the United States (participants with MS, MD, and PPS). PARTICIPANTS Convenience sample of participants were surveyed (N=1676; MD, n=321; PPS, n=388; MS, n=556; SCI, n=411). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Patient Health Questionnaire-9 (PHQ-9) assessing depressive symptoms and the International Physical Activity Questionnaire (IPAQ) and Godin Leisure Time Exercise Questionnaire (GLTEQ) assessing physical activity. RESULTS The average age was 56 years, 64% were women, 92% were white, 86% had a high school degree or higher, and 56% walked with an assistive device or had limited self-mobility. The IPAQ and GLTEQ explained a small but statistically significant and unique amount of the variance in PHQ-9 scores in all diagnostic groups, with no significant differences in the relation by condition, age, or mobility status (IPAQ R(2)=.004; GLTEQ R(2)=.02; both P<.02). CONCLUSIONS Both physical activity measures demonstrated a small but statistically significant association with depression in all 4 diagnostic groups. Research is needed to determine longitudinal relations and whether physical activity interventions could promote improved mood in adults with physical disabilities.
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Physical Activity among Veterans and Nonveterans with Diabetes. J Aging Res 2012; 2012:135192. [PMID: 22848827 PMCID: PMC3403379 DOI: 10.1155/2012/135192] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Accepted: 05/17/2012] [Indexed: 11/17/2022] Open
Abstract
Engaging in regular physical activity (PA), with or without a corresponding decrease in weight, is associated with improved health outcomes. The purpose of this study was to quantify the extent to which PA differed between veterans and nonveterans and to determine how diabetes and age influenced this association. Data from the 2009 Behavioral Risk Factor Surveillance System were used in this study. Respondents were classified as having diabetes if they reported ever being diagnosed with diabetes except during pregnancy. Respondents who reported ever serving on active military duty were classified as veterans. Based on self-report, we calculated the average minutes per week of moderate, vigorous, and total activity. After adjusting for sex, race and ethnicity, household income, education level, body mass index (BMI), and recent health checkup, veteran status was associated with a small but significantly larger amount of average weekly moderate PA (2.2 minutes, P = 0.0058) but not average weekly vigorous PA (−0.02 minutes, P = 0.98). Diabetes and prediabetes were associated with significantly lower mean levels of both moderate and vigorous intensity PA, as was increasing age. Consistent with prior research, veterans engaged in more PA than nonveterans. The association between diabetes, age, and physical activity did not differ by veteran status.
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