1
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Xiong T, Krusche M. [Wearables in rheumatology]. Z Rheumatol 2024; 83:234-241. [PMID: 37289217 PMCID: PMC10973074 DOI: 10.1007/s00393-023-01377-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 06/09/2023]
Abstract
As a result of digitalization in medicine wearable computing devices (wearables) are becoming increasingly more important. Wearables are small portable electronic devices with which the user can record data relevant to health, such as number of steps, activity profile, electrocardiogram (ECG), heart and breathing frequency or oxygen saturation. Initial studies on the use of wearables in patients with rheumatological diseases show the opening up of new possibilities for prevention, disease monitoring and treatment. This study provides the current data situation and the implementation of wearables in the discipline of rheumatology. Additionally, future potential fields of application as well as challenges and limits of the implementation of wearables are illustrated.
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Affiliation(s)
- Tingting Xiong
- Sektion für Rheumatologie und entzündliche Systemerkrankungen, III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Martin Krusche
- Sektion für Rheumatologie und entzündliche Systemerkrankungen, III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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Spiteri K, Xerri de Caro J, Grafton K, Laventure B, Broom DR. Physical Activity and Sedentary Behaviour with Retirement in Maltese Civil Servants: A Dialectical Mixed-Method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14598. [PMID: 36361478 PMCID: PMC9654557 DOI: 10.3390/ijerph192114598] [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: 08/30/2022] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Retirement is a life event that can influence physical activity (PA) and sedentary behaviour (SB) and can be used as an opportunity to promote positive lifestyle choices. The aims of this study were to (a) to identify changes in PA and SB resulting from retirement and (b) to explore predictors of any changes in PA and SB following retirement in Maltese civil servants. (2) Methods: a hybrid mixed-method (MM) study, using first quantitative followed by qualitative methods, of civil servants aged ≥60 years, who were followed during their retirement transition for two years. A proportion of the research participants in the MM study retired while the others remained employed. Questionnaires and semi-structured interviews were used to collect data. (3) Results: there were no changes in total PA and sitting behaviour with retirement in Maltese civil servants. People who retired carried out more domestic PA compared to when they were in employment, which resulted in more moderate-intensity PA behaviour. People perceived that their sitting time increased with retirement in the qualitative interviews, but this was not observed in the quantitative data. Past PA behaviour was an important predictor of future PA behaviour, but not for SB. (4) Conclusions: A change in PA occurs with the retirement transition. However, the uptake of exercise is a personal choice that is dependent on previous experience. Increasing SB is perceived as part of the retirement plan but is not necessarily seen in the measured quantitative data.
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Affiliation(s)
- Karl Spiteri
- Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
- Physiotherapy Department, St. Vincent De Paul Long-Term Care Facility, LQA 3301 Luqa, Malta
| | - John Xerri de Caro
- Physiotherapy Department, Faculty of Health Sciences, University of Malta, MSD 2080 Msida, Malta
| | - Kate Grafton
- School of Health & Social Care, University of Lincoln, Lincoln LN6 7TS, UK
| | | | - David R. Broom
- Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
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3
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Berry A, McCabe CS, Halls S, Muir S, Walsh N. Beliefs, motives and gains associated with physical activity in people with osteoarthritis. Musculoskeletal Care 2021; 19:52-58. [PMID: 32890412 DOI: 10.1002/msc.1507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Osteoarthritis (OA) affects approximately 8.75 million people in the United Kingdom. Physical activity is recommended as a core treatment, yet 44% of people with OA are inactive. Motivation and self-efficacy for exercise are considered to be key factors contributing to sustained engagement with physical activity. The aim of this study was to explore the beliefs, motives (what an individual aims to attain through participating in physical activity) and gains (what people feel they might get from participation) associated with physical activity engagement in a group of people with OA. DESIGN AND METHOD This study adopted a cross-sectional survey research design, using two validated questionnaires: the Exercise Motives and Gains Inventory and the Exercise Self-Efficacy Scale. RESULTS Data were gathered from 262 people with OA between August 2015 and January 2016. Those who were most active reported higher levels of both motivation and self-efficacy and were active for enjoyment, to avoid negative health, and for health and fitness reasons. A comparison of motives and gains revealed higher gain scores for social engagement and enjoyment, compared with associated motive scores. CONCLUSION This study provides evidence of the central role that motives, gains and self-efficacy play in facilitating engagement with physical activity in this population. Future interventions should aim to foster increased self-efficacy for physical activity and promote autonomous forms of motivation by emphasising the importance of choosing activities which are enjoyable, as well as highlighting the value of social engagement.
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Affiliation(s)
- Alice Berry
- Centre for Health and Clinical Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Candy S McCabe
- Centre for Health and Clinical Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
- Dorothy House Hospice Care, Winsley, UK
| | - Serena Halls
- Centre for Health and Clinical Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Sarah Muir
- Research Centre for Behaviour Change, Psychology Department, Bournemouth University, Bournemouth, UK
| | - Nicola Walsh
- Centre for Health and Clinical Research, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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Li LC, Feehan LM, Xie H, Lu N, Shaw C, Gromala D, Aviña‐Zubieta JA, Koehn C, Hoens AM, English K, Tam J, Therrien S, Townsend AF, Noonan G, Backman CL. Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2020; 72:1755-1765. [DOI: 10.1002/acr.24199] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Linda C. Li
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
| | - Lynne M. Feehan
- University of British Columbia Vancouver British Columbia Canada
| | - Hui Xie
- Arthritis Research Canada, Richmond, and Simon Fraser University Burnaby British Columbia Canada
| | - Na Lu
- Arthritis Research Canada, Richmond, and Simon Fraser University Burnaby British Columbia Canada
| | - Chris Shaw
- Simon Fraser University Surrey British Columbia Canada
| | - Diane Gromala
- Simon Fraser University Surrey British Columbia Canada
| | - J. Antonio Aviña‐Zubieta
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts Vancouver British Columbia Canada
| | - Alison M. Hoens
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
| | - Kelly English
- Arthritis Research Canada Richmond British Columbia Canada
| | - Johnathan Tam
- Arthritis Research Canada Richmond British Columbia Canada
| | | | | | - Greg Noonan
- Vancouver General Hospital Vancouver British Columbia Canada
| | - Catherine L. Backman
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
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5
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Cary MA, Gyurcsik NC. Differences in adaptive and maladaptive psychosocial responses to chronic pain among adults with varying physical activity levels. Br J Pain 2020; 15:259-269. [PMID: 34381611 DOI: 10.1177/2049463720942535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim Chronic pain is a global public health problem that detrimentally impacts people's health and well-being. Physical activity is beneficial and a recommended self-management strategy for adults living with chronic pain. Yet, many of them struggle to meet the public health recommendation of 150+ minutes/week of moderate-vigorous physical activity. Identifying modifiable factors related to physical activity participation is needed. Adaptive (i.e., self-regulatory efficacy to overcome pain and related barriers [SRE-pain], psychological flexibility) and maladaptive (i.e. pain anxiety) responses were the modifiable factors examined in the present study. The purpose was to investigate whether adults living with chronic pain who were sufficiently active, insufficiently active or inactive significantly differed in their adaptive and maladaptive responses to chronic pain. Methods Adults with self-reported chronic pain for 6+ months (N = 318) completed an online survey that measured physical activity, psychological flexibility, SRE-pain and pain anxiety. Sufficiently active (n = 139), insufficiently active (n = 91) and inactive (n = 88) groups were identified. Results A significant multivariate analysis of covariance (MANCOVA) (p < .001) with univariate follow-up tests illustrated that the sufficiently active individuals reported the highest psychological flexibility and SRE-pain compared to insufficiently active and inactive individuals (p's < .001). Overall, sufficiently active participants responded the most adaptively and least maladaptively to their pain, followed by the insufficiently active. Inactive participants responded the most maladaptively. Conclusion Identifying differences in adaptive and maladaptive responses to pain highlights possible modifiable factors to target in future physical activity intervention research that focuses on improving chronic pain self-management.
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Affiliation(s)
- Miranda A Cary
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, Kelowna, BC, Canada
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Cramp F, Thomas R, Haase AM, Domaille M, Manns S, Swales C, Hurfurt J, Walsh NE. Promoting engagement in physical activity in early rheumatoid arthritis: A proof-of-concept intervention study. Musculoskeletal Care 2020; 18:487-500. [PMID: 32666652 DOI: 10.1002/msc.1493] [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] [Received: 05/27/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE(S) The aim of this study is to test the feasibility and acceptability of promoting engagement in physical activity in early rheumatoid arthritis (PEPA-RA) to inform a future trial. DESIGN A 'proof of concept' study was carried out. SETTING This study was conducted in community hospitals delivered by musculoskeletal primary care physiotherapists. PARTICIPANTS Participants were 12 adults with rheumatoid arthritis (RA) diagnosed 6-24 months previously (nine females, three males; mean age 58 years, range 23-79). INTERVENTION The intervention consisted of five sessions, that is, four group sessions and one individual session facilitated by a physiotherapist over 12 weeks including patient education and support for behaviour change as well as supervised practical exercise. MAIN OUTCOMES The main outcomes were attendance, completion of outcome measures, adverse events, and participant and physiotherapist feedback views relating to the intervention. RESULTS Overall attendance was 85%, with sessions missed due to illness or RA flare. Outcome measure completion ranged from 83% to 100%. There were no clinically meaningful changes in pain or function at 12 weeks, but mean 6-min walk distance improved from 394 to 440 m. No serious adverse events were reported, and participants were generally positive about the intervention. Suggested minor modifications for the group sessions included venue accessibility and ensuring that physical activity time was protected. Several participants indicated that they would have liked to receive the intervention earlier following diagnosis. CONCLUSIONS PEPA-RA and the outcomes appear feasible and acceptable. Overall, small beneficial effects were noted at 12 weeks for most outcomes. Challenges to recruitment resulted in a smaller than anticipated sample size, and the majority of participants were active at baseline indicating that future recruitment needs to target less active individuals.
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Affiliation(s)
- Fiona Cramp
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Rachel Thomas
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Anne M Haase
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,School for Policy Studies, University of Bristol, Bristol, UK.,School of Health, Victoria University of Wellington, PO Box 600, Wellington, 6140, New Zealand
| | - Melissa Domaille
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Manns
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Caroline Swales
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,Patient Research Partner, Bristol, UK
| | - Judy Hurfurt
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,Patient Research Partner, Bristol, UK
| | - Nicola E Walsh
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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Li LC, Feehan LM, Xie H, Lu N, Shaw CD, Gromala D, Zhu S, Aviña-Zubieta JA, Hoens AM, Koehn C, Tam J, Therrien S, Townsend AF, Noonan G, Backman CL. Effects of a 12-Week Multifaceted Wearable-Based Program for People With Knee Osteoarthritis: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e19116. [PMID: 32618578 PMCID: PMC7367519 DOI: 10.2196/19116] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/01/2020] [Accepted: 06/03/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Current guidelines emphasize an active lifestyle in the management of knee osteoarthritis (OA), but up to 90% of patients with OA are inactive. In a previous study, we demonstrated that an 8-week physiotherapist (PT)-led counseling intervention, with the use of a Fitbit, improved step count and quality of life in patients with knee OA, compared with a control. OBJECTIVE This study aimed to examine the effect of a 12-week, multifaceted wearable-based program on physical activity and patient outcomes in patients with knee OA. METHODS This was a randomized controlled trial with a delay-control design. The immediate group (IG) received group education, a Fitbit, access to FitViz (a Fitbit-compatible app), and 4 biweekly phone calls from a PT over 8 weeks. Participants then continued using Fitbit and FitViz independently up to week 12. The delay group (DG) received a monthly electronic newsletter in weeks 1 to 12 and started the same intervention in week 14. Participants were assessed in weeks 13, 26, and 39. The primary outcome was time spent in daily moderate-to-vigorous physical activity (MVPA; in bouts ≥10 min) measured with a SenseWear Mini. Secondary outcomes included daily steps, time spent in purposeful activity and sedentary behavior, Knee Injury and OA Outcome Score, Patient Health Questionnaire-9, Partners in Health Scale, Theory of Planned Behavior Questionnaire, and Self-Reported Habit Index. RESULTS We enrolled 51 participants (IG: n=26 and DG: n=25). Compared with the IG, the DG accumulated significantly more MVPA time at baseline. The adjusted mean difference in MVPA was 13.1 min per day (95% CI 1.6 to 24.5). A significant effect was also found in the adjusted mean difference in perceived sitting habit at work (0.7; 95% CI 0.2 to 1.2) and during leisure activities (0.7; 95% CI 0.2 to 1.2). No significant effect was found in the remaining secondary outcomes. CONCLUSIONS A 12-week multifaceted program with the use of a wearable device, an app, and PT counseling improved physical activity in people with knee OA. TRIAL REGISTRATION ClinicalTrials.gov NCT02585323; https://clinicaltrials.gov/ct2/show/NCT02585323.
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Affiliation(s)
- Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, BC, Canada
| | - Lynne M Feehan
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Arthritis Research Canada, Richmond, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Na Lu
- Arthritis Research Canada, Richmond, BC, Canada
| | - Christopher D Shaw
- School of Interactive Art & Technology, Simon Fraser University, Burnaby, BC, Canada
| | - Diane Gromala
- School of Interactive Art & Technology, Simon Fraser University, Burnaby, BC, Canada
| | - Siyi Zhu
- Arthritis Research Canada, Richmond, BC, Canada
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - J Antonio Aviña-Zubieta
- Arthritis Research Canada, Richmond, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, BC, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, BC, Canada
| | | | | | - Anne F Townsend
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancashire, United Kingdom
| | - Gregory Noonan
- Mary Pack Arthritis Program, Vancouver General Hospital, Vancouver, BC, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Richmond, BC, Canada
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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Soto SH, Callahan LF, Bahorski S, Altpeter M, Hales DP, Phillips A, Carthron D, Rini C. The Role of Cohabitating Partner and Relationship Characteristics on Physical Activity among Individuals with Osteoarthritis. Int J Behav Med 2019; 26:522-530. [PMID: 31313250 DOI: 10.1007/s12529-019-09806-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Most individuals with knee or hip osteoarthritis do not meet recommendations for physical activity. The Social Cognitive Theory suggests that the social environment (e.g., spouses/partners) may influence the physical activity of individuals with osteoarthritis. The purpose of this study was to examine whether the physical activity of insufficiently active, coupled adults with osteoarthritis was associated with received partner support for physical activity, partner's engagement in physical activity, and relationship satisfaction. METHODS Cross-sectional data from 169 couples were collected. Accelerometers estimated moderate-to-vigorous physical activity and daily steps for participants with osteoarthritis and their partners. Participants with osteoarthritis reported total received partner support for physical activity and relationship satisfaction. RESULTS Participants with osteoarthritis were on average 65 years old, 65% female, 86% non-Hispanic white, and 47% retired. Receiving total partner support more frequently was associated with more minutes of moderate-to-vigorous physical activity but not with steps. Relationship satisfaction moderated the association of partner's physical activity on the daily steps of individuals with osteoarthritis such that having a partner who accomplished more daily steps was associated with participants with osteoarthritis accomplishing more daily steps themselves when they reported greater relationship satisfaction. CONCLUSIONS Partners and relationship satisfaction may play an important role in the physical activity of individuals with osteoarthritis. Interventions seeking to increase physical activity in this population may be enhanced by promoting partner support. Additional research is needed to further explain these associations within the context of relationship satisfaction.
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Affiliation(s)
- Sandra H Soto
- Chapel Hill, School of Nursing, UNC, Carrington Hall, S Columbia St, Chapel Hill, NC, 27599, USA. .,Thurston Arthritis Research Center, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA.
| | - Leigh F Callahan
- Thurston Arthritis Research Center, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA.,Department of Medicine, UNC, 125 MacNider Hall, Campus Box #7005, Chapel Hill, NC, 27599, USA
| | - Stephanie Bahorski
- Thurston Arthritis Research Center, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA
| | - Mary Altpeter
- Thurston Arthritis Research Center, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA
| | - Derek P Hales
- Gillings School of Public Health, Department of Nutrition, UNC, 170 Rosenau Hall, CB#7400, Chapel Hill, NC, 27599, USA
| | - Ashley Phillips
- Division of Emergency Medicine, Duke University School of Medicine, 2301 Erwin Road, DUMC 3096, Durham, NC, 27710, USA
| | - Dana Carthron
- College of Nursing, Michigan State University, 1355 Bogue St, East Lansing, MI, 48824, USA
| | - Christine Rini
- John Theurer Cancer Center, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ, 07601, USA.,Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC, 20007, USA
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Liu SH, Morais SA, Lapane KL, Kay J. Physical activity and attitudes and perceptions towards physical activity in patients with spondyloarthritis: A systematic review. Semin Arthritis Rheum 2019; 50:289-302. [PMID: 31839210 DOI: 10.1016/j.semarthrit.2019.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/26/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To review systematically and synthesize qualitatively the literature about physical activity and perceptions and attitudes towards physical activity/exercise among patients with spondyloarthritis (SpA). METHODS PubMed, CINAHL and Scopus and reference lists were searched for quantitative and qualitative studies reporting on beliefs towards exercise in patients with SpA. Searches were limited to studies published from January 2000 through December 2018. The PRISMA guidelines were followed. Systematic searches identified 128 publications which underwent a title, abstract, or full-text review. Studies were excluded if articles were not in English or did not include original data. We summarized the methodologic quality using modified criteria for quantitative and qualitative studies. RESULTS Eight quantitative and three qualitative studies met eligibility criteria, with variable study quality. Based on self-reported data, 50% to 68% of patients with SpA met physical activity recommendations with walking, swimming/pool exercise, and cycling the most common forms reported. Intrinsic factors such as motivation and improvement in symptoms and health were commonly reported as facilitators associated with physical activity/exercise. Barriers included lack of time, fatigue, and symptoms such as pain. CONCLUSION One third to one half of patients with SpA do not meet physical activity recommendations. Given the potential for regular physical activity to reduce symptom burden in this patient population and the recommendation for regular physical activity as part of the management of these patients, more rigorous studies of physical activity behaviors and attitudes will be useful to inform interventions and promote exercise among individuals with SpA.
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Affiliation(s)
- Shao-Hsien Liu
- Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA; Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01605, USA.
| | - Stephen A Morais
- Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA.
| | - Kate L Lapane
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01605, USA.
| | - Jonathan Kay
- Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA; Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01605, USA.
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Thoma LM, Dunlop D, Song J, Lee J, Tudor-Locke C, Aguiar EJ, Master H, Christiansen MB, White DK. Are Older Adults With Symptomatic Knee Osteoarthritis Less Active Than the General Population? Analysis From the Osteoarthritis Initiative and the National Health and Nutrition Examination Survey. Arthritis Care Res (Hoboken) 2019; 70:1448-1454. [PMID: 29468844 DOI: 10.1002/acr.23511] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 01/02/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To compare objectively measured physical activity in older adults with symptomatic knee osteoarthritis (OA) with similarly aged adults without osteoarthritis (OA) or knee symptoms from the general population. METHODS We included people ages 50-85 years with symptomatic knee OA from the Osteoarthritis Initiative (OAI, n = 491), and ages 50-85 years from the general population using National Health and Nutrition Examination Survey (NHANES, n = 449) data. A uniaxial accelerometer was worn for ≥10 hours/day for ≥4 days in the NHANES group in 2003-2004 and in the OAI group in 2008-2010. We calculated time spent in moderate-to-vigorous physical activity (MVPA in minutes/day) and described differences in MVPA and demographic variables between the samples. We conducted matched-pairs sensitivity analyses to further evaluate the role of potential confounders. RESULTS Both cohorts had similarly low levels of physical activity in age- and sex-specific strata. Time in MVPA ranged from a median of 1-22 minutes/day in people with symptomatic knee OA, and from 1-24 minutes/day in the general population without OA or knee pain. These results were similar in sensitivity analyses. CONCLUSION Time spent in MVPA was similarly low in those with symptomatic knee OA as in older adults without knee pain or OA.
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Affiliation(s)
| | | | - Jing Song
- Northwestern University, Chicago, Illinois
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11
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Suh CH, Jung JY, Oh H, Boo S. Evaluation of factors affecting the levels of physical activity in patients with rheumatoid arthritis: a cross-sectional study. Clin Rheumatol 2019; 38:2483-2491. [DOI: 10.1007/s10067-019-04559-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/08/2019] [Accepted: 04/10/2019] [Indexed: 01/10/2023]
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12
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Tan XL, Pugh G, Humby F, Morrissey D. Factors associated with physical activity engagement among adults with rheumatoid arthritis: A cross-sectional study. Musculoskeletal Care 2019; 17:163-173. [PMID: 30729653 DOI: 10.1002/msc.1385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/21/2018] [Accepted: 12/23/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Physical activity (PA) has a number of benefits for rheumatoid arthritis (RA) patients. However, these patients are more physically inactive than the general population. The primary aim of this study was to investigate factors associated with PA engagement among RA patients. The secondary aim was to identify their preference for PA support. METHODS There were 96 participants, 76 of whom were female, with a mean age of 56.9 years (range = 34-72 years) and a median RA disease duration of 5 years (interquartile range = 2-12). All patients completed questionnaires assessing demographic status, health status (including cardiovascular disease [CVD] risk and RA disease profile), PA levels and preferences, alongside the perceived benefits of-and barriers to-PA. Hierarchical regressions were carried out to assess the relationship between reported PA levels and both engagement determinants and disease features. RESULTS Forty-five per cent (n = 44) had low levels (<600 metabolic equivalent-min/week) of PA. Low level of PA was significantly associated with: CVD risk profile (ηp 2 = 0.118, p < 0.002); functional disability (ηp 2 = 0.206, p < 0.032); pain (ηp 2 = 0.154, p < 0.028); general personal (ηp 2 = 0.190, p < 0.001) and arthritis-specific personal (ηp 2 = 0.170, p < 0.001) barriers to PA; age (ηp 2 = 0.076, p < 0.026); and sedentary behaviour (ηp 2 = 0.275, p < 0.001). Participants displayed a preference for unsupervised (n = 37, 38.5%), low-intensity (n = 45, 46.9%), indoor home (n = 50, 52.1%) exercises, with no preferences for the diversity of the exercise prescribed (n = 39, 40.6%) or for who provided the exercise counselling (n = 34, 35.4%). CONCLUSIONS These results suggest that CVD profile, disability, pain, and general and arthritis-specific personal barriers are associated with PA levels among RA patients. Intervention development should address these factors to facilitate an increase in PA uptake.
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Affiliation(s)
- Xiang Li Tan
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
| | - Gemma Pugh
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
| | - Frances Humby
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
| | - Dylan Morrissey
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK
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13
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Webber SC, Ripat JD, Pachu NS, Strachan SM. Exploring physical activity and sedentary behaviour: perspectives of individuals with osteoarthritis and knee arthroplasty. Disabil Rehabil 2019; 42:1971-1978. [DOI: 10.1080/09638288.2018.1543463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Sandra C. Webber
- Rady Faculty of Health Sciences, Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Jacquie D. Ripat
- Rady Faculty of Health Sciences, Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Navjot S. Pachu
- Applied Health Sciences Program, University of Manitoba, Winnipeg, Canada
| | - Shaelyn M. Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada
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14
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Abstract
Nurses have a central role in health education and promotion, particularly with regard to supporting individuals to optimise their nutritional intake and engage in healthy eating behaviours. However, high rates of obesity, unhealthy eating behaviours and low levels of physical activity have been found among nurses. Nursing is a challenging profession, and a high workload, a lack of resources and shift work may affect nurses' ability to adopt healthy lifestyles. Supporting nurses to improve aspects of their eating behaviours, such as the nutritional value, timing and frequency of meals, can have a positive effect on their health which, in turn, may enhance their ability to care for patients. Although there is much literature available on the benefits of healthy eating, there is a lack of practical guidance for nurses on how to enhance their nutritional intake. This article uses a case study to examine the occupational and personal factors that may affect nurses' ability to engage in healthy eating behaviours, and identifies how healthcare organisations and individual nurses can use a behavioural change approach to optimise nutritional intake.
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Affiliation(s)
- Brian Power
- Institute for Liver and Digestive Health, Royal Free Hospital Medical School, University College London, London, England; and honorary senior dietitian, University College London Hospitals NHS Foundation Trust, London, England
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15
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Sessford JD, Brawley LR, Cary MA, Flora PK, Blouin JE, Strachan SM, Gyurcsik NC. Facing Multiple Barriers to Exercise: Does Stronger Efficacy Help Individuals with Arthritis? Appl Psychol Health Well Being 2018; 11:59-79. [PMID: 30288964 DOI: 10.1111/aphw.12144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research about exercise adherence amongst adults with arthritis has been largely correlational, and theoretically based causal studies are needed. We used an experimental design to test the social cognitive theory premise that high self-efficacy helps to overcome challenging barriers to action. METHODS Exercising individuals (N = 86; female = 78%; M age = 53; BMI = 27) with differential self-regulatory efficacy for managing salient, non-disease barriers were randomly assigned to many or few barrier conditions. Individuals responded about the strength of their anticipated persistence to continue exercise, and their self-regulatory efficacy to use exercise-enabling coping strategies. RESULTS In the many barriers condition, higher barriers-efficacy individuals expressed (a) greater persistence (Cohen's d = 0.75 [-0.029, 1.79]) and (b) more confidence in their coping solutions (Cohen's d = 0.65 [-0.30, 1.60]) than lower barriers-efficacy counterparts. CONCLUSION Experimental support was obtained for the theoretical premise that when facing the greatest barrier challenge, individuals highest in self-regulatory efficacy still view exercise as possible. Findings suggest that identifying lower efficacy exercisers with arthritis to tailor their exercise to increase self-regulatory efficacy might also improve their adherence.
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Thomas R, Hewlett S, Swales C, Cramp F. Keeping physically active with rheumatoid arthritis: semi-structured interviews to explore patient perspectives, experiences and strategies. Physiotherapy 2018; 105:378-384. [PMID: 30318125 DOI: 10.1016/j.physio.2018.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Regular physical activity is safe and beneficial for people with rheumatoid arthritis (RA) but the majority of people with RA are less active than the general population and have a higher risk of co-morbidities. Exploring strategies used by physically active people with RA could inform effective methods to support those who are less active. OBJECTIVE To explore the perspectives, experiences and strategies employed by people with RA who successfully engage with regular physical activity. DESIGN Individual semi-structured interviews and thematic analysis. PARTICIPANTS A purposive sample of physically active people with RA. RESULTS Twelve females and three males participated (mean age 56, range 29 to 80; mean disease duration 13 years, range 10 months to 46 years). Analysis revealed eight constructs clustered into three themes. Theme 1: 'the individual' incorporated constructs of symptoms, feelings and role; theme 2: 'management' incorporated medical and self-management; theme 3: 'physical activity' incorporated constructs of type of physical activity, including barriers or facilitators. Participants reported a long history of physical activity prior to diagnosis and good support networks. All participants recognised that physical activity was key to their RA management, acknowledged the benefits from engaging in physical activity and were able to overcome barriers. Participants had strong beliefs that physical function would decline without regular physical activity. CONCLUSIONS People with RA who successfully maintain physical activity are motivated by a desire to manage symptoms, resist functional decline and maintain health and independence. These findings should be explored with a wider range of people with RA.
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Affiliation(s)
- R Thomas
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom.
| | - S Hewlett
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - C Swales
- Patient Research Partner, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - F Cramp
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
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17
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Chaleshgar-Kordasiabi M, Enjezab B, Akhlaghi M, Sabzmakan I. Barriers and reinforcing factors to self-management behaviour in rheumatoid arthritis patients: A qualitative study. Musculoskeletal Care 2018; 16:241-250. [PMID: 29314556 DOI: 10.1002/msc.1221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of the present study was to explore the view of rheumatoid arthritis (RA) patients about the barriers and reinforcing factors in practising self-management behaviour (SMB). METHODS This was a qualitative study based on directed content analysis of in-depth semi-structured interviews with 30 patients. The participants were selected using a purposeful sampling approach. The interviews continued until data saturation was reached. The study was conducted over 6 months in 2014-2015 at the Rheumatology Clinic of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. RESULTS Three main themes and 14 subthemes were extracted. The main themes included behavioural barriers, environmental barriers and reinforcing factors. The subthemes included lack of awareness; poor physician-patient relationship; lack of motivation; negative attitude and willingness; lack of time; cost; housing conditions and in-home equipment; negative social effects; social support; consequences of SMB; and comparing yourself with others. CONCLUSION Behavioural and environmental barriers, as well as social support and outcomes of SMB were the most important barriers and reinforcing factors of SMB. Therefore, considering these factors in patients may help in designing programmes that attempt to reduce barriers and increase reinforcing factors, which ultimately result in higher levels of SMB and quality of life among patients.
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Affiliation(s)
- M Chaleshgar-Kordasiabi
- Department of Public Health, Health Science Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - B Enjezab
- School of Nursing and Midwifery, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | - M Akhlaghi
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - I Sabzmakan
- Department of Health Education and Promotion, Alborz University of Medical Science, Karaj, Iran
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18
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Li LC, Sayre EC, Xie H, Falck RS, Best JR, Liu-Ambrose T, Grewal N, Hoens AM, Noonan G, Feehan LM. Efficacy of a Community-Based Technology-Enabled Physical Activity Counseling Program for People With Knee Osteoarthritis: Proof-of-Concept Study. J Med Internet Res 2018; 20:e159. [PMID: 29712630 PMCID: PMC5952118 DOI: 10.2196/jmir.8514] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 12/31/2022] Open
Abstract
Background Current practice guidelines emphasize the use of physical activity as the first-line treatment of knee osteoarthritis; however, up to 90% of people with osteoarthritis are inactive. Objective We aimed to assess the efficacy of a technology-enabled counseling intervention for improving physical activity in people with either a physician-confirmed diagnosis of knee osteoarthritis or having passed two validated criteria for early osteoarthritis. Methods We conducted a proof-of-concept randomized controlled trial. The immediate group received a brief education session by a physical therapist, a Fitbit Flex, and four biweekly phone calls for activity counseling. The delayed group received the same intervention 2 months later. Participants were assessed at baseline (T0) and at the end of 2 months (T1), 4 months (T2), and 6 months (T3). Outcomes included (1) mean time on moderate-to-vigorous physical activity (MVPA ≥3 metabolic equivalents [METs], primary outcome), (2) mean time on MVPA ≥4 METs, (3) mean daily steps, (4) mean time on sedentary activities, (5) Knee Injury and Osteoarthritis Outcome Score (KOOS), and (6) Partners in Health scale. Mixed-effects repeated measures analysis of variance was used to assess five planned contrasts of changes in outcome measures over measurement periods. The five contrasts were (1) immediate T1-T0 vs delayed T1-T0, (2) delayed T2-T1 vs delayed T1-T0, (3) mean of contrast 1 and contrast 2, (4) immediate T1-T0 vs delayed T2-T1, and (5) mean of immediate T2-T1 and delayed T3-T2. The first three contrasts estimate the between-group effects. The latter two contrasts estimate the effect of the 2-month intervention delay on outcomes. Results We recruited 61 participants (immediate: n=30; delayed: n=31). Both groups were similar in age (immediate: mean 61.3, SD 9.4 years; delayed: mean 62.1, SD 8.5 years) and body mass index (immediate: mean 29.2, SD 5.5 kg/m2; delayed: mean 29.2, SD 4.8 kg/m2). Contrast analyses revealed significant between-group effects in MVPA ≥3 METs (contrast 1 coefficient: 26.6, 95% CI 4.0-49.1, P=.02; contrast 3 coefficient: 26.0, 95% CI 3.1-49.0, P=.03), daily steps (contrast 1 coefficient: 1699.2, 95% CI 349.0-3049.4, P=.02; contrast 2 coefficient: 1601.8, 95% CI 38.7-3164.9, P=.045; contrast 3 coefficient: 1650.5, 95% CI 332.3-2968.7; P=.02), KOOS activity of daily living subscale (contrast 1 coefficient: 6.9, 95% CI 0.1-13.7, P=.047; contrast 3 coefficient: 7.2, 95% CI 0.8-13.6, P=.03), and KOOS quality of life subscale (contrast 1 coefficient: 7.4, 95% CI 0.0-14.7, P=.049; contrast 3 coefficient: 7.3, 95% CI 0.1-14.6, P=.048). We found no significant effect in any outcome measures due to the 2-month delay of the intervention. Conclusions Our counseling program improved MVPA ≥3 METs, daily steps, activity of daily living, and quality of life in people with knee osteoarthritis. These findings are important because an active lifestyle is an important component of successful self-management. Trial Registration ClinicalTrials.gov NCT02315664; https://clinicaltrials.gov/ct2/show/NCT02315664 (Archived by WebCite at http://www.webcitation.org/6ynSgUyUC)
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Affiliation(s)
- Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | | | - Hui Xie
- Arthritis Research Canada, Richmond, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Ryan S Falck
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - John R Best
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Navi Grewal
- Arthritis Research Canada, Richmond, BC, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Greg Noonan
- Mary Pack Arthritis Program, Vancouver General Hospital, Vancouver, BC, Canada
| | - Lynne M Feehan
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
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Östlund G, Björk M, Thyberg I, Valtersson E, Sverker A. Women's situation-specific strategies in managing participation restrictions due to early rheumatoid arthritis: A gender comparison. Musculoskeletal Care 2018; 16:251-259. [PMID: 29316201 DOI: 10.1002/msc.1225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 11/09/2017] [Accepted: 11/12/2017] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The present study explored how women describe their use of situation-specific strategies when managing rheumatoid arthritis (RA). The aim was also to compare women's strategies with those of men, and see the extent to which they used the same strategies. METHODS The data were collected using semi-structured interviews based on the critical incident technique. The sample consisted of women with early rheumatic arthritis (n = 34), and the results were compared with data reported in a previous study on men (n = 25) from the same cohort. The patient-described participation restrictions due to RA were firstly linked to the domains of the International Classification of Functioning, Disability and Health (ICF). The different strategies used were then categorized. The study was approved by the Research Ethics Committee of the Faculty of Health Sciences, Linköping University, Sweden. RESULTS The study found that women used four situation-specific strategies: adjustment, avoidance, interaction and acceptance. The same strategies had been found previously in interviews with men with RA. Women and men used these strategies to a similar extent in the ICF domains of mobility; major life arenas; domestic life; interpersonal interactions and relationships; and community, social and civic life. However, some differences were found, relating to the reported activities in self-care and domestic life, in which women reported using strategies to a greater extent than men. CONCLUSIONS Women and men used four types of situation-specific strategies in managing RA; adjustment, avoidance, interaction and acceptance. These situation-specific strategies provide useful knowledge, in terms of multidisciplinary rehabilitation and for patients' significant others.
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Affiliation(s)
- Gunnel Östlund
- Division of Social Work, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Mathilda Björk
- Department of Rheumatology and Department of Social and Welfare studies, Linköping University, Linköping, Sweden
| | - Ingrid Thyberg
- Departments of Rheumatology and Clinical & Experimental Medicine, Linköping University, Linköping, Sweden
| | - Eva Valtersson
- Departments of Activity and Health and Medical & Health Sciences, Linköping University, Linköping, Sweden
| | - Annette Sverker
- Departments of Activity and Health and Medical & Health Sciences, Linköping University, Linköping, Sweden
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20
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Flaherty LM, Schoeppe J, Kruse‐Jarres R, Konkle BA. Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study. Res Pract Thromb Haemost 2018; 2:147-154. [PMID: 30046715 PMCID: PMC6055559 DOI: 10.1002/rth2.12060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/12/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Prior research has established that falls are commonplace in adults with hemophilia, and advises that physical therapy and exercise are successful in fall prevention. Recognizing obstacles and catalysts to physical therapy and exercise in people with hemophilia may augment the efficacy of efforts to prevent falls in this population. OBJECTIVES To learn about the experiences and ideas of patients with hemophilia, especially associated with balance, falls, and exercise. METHODS Semi-structured interviews with 14 adult patients with hemophilia were performed. The interviews were coded for themes founded on the study aims. RESULTS Most subjects described difficulty with balance, often ascribed to joint problems. They believed that staying strong and fit could positively influence balance, but expressed concerns and fear related to falling. Those who exercised regularly did not view exercise as hazardous, while those who did not dependably exercise articulated worry that dangers of exercise may offset the benefits. The most common obstacle to exercise was pain and having someone to exercise with was often described as an enabler. Barriers to partaking in physical therapy included weak proof of its success and distrust in the therapist. Positive physical therapy experiences in the past and the connection with the therapist were reported as facilitators. CONCLUSIONS People with hemophilia describe some attitudes and experiences that are unique to hemophilia while others are found in the general population. Attending to fear, pain, and support for interventions, while encouraging a robust therapeutic alliance and a plan for routine exercise may aid fall prevention behaviors.
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Affiliation(s)
| | - Jennie Schoeppe
- Health Research InstituteKaiser Permanente Washington Health Research InstituteSeattleWAUSA
| | - Rebecca Kruse‐Jarres
- Washington Center for Bleeding DisordersBloodworks NorthwestSeattleWAUSA
- Division of HematologyUniversity of WashingtonSeattleWAUSA
| | - Barbara A. Konkle
- Washington Center for Bleeding DisordersBloodworks NorthwestSeattleWAUSA
- Division of HematologyUniversity of WashingtonSeattleWAUSA
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21
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Li LC, Feehan LM, Shaw C, Xie H, Sayre EC, Aviña-Zubeita A, Grewal N, Townsend AF, Gromala D, Noonan G, Backman CL. A technology-enabled Counselling program versus a delayed treatment control to support physical activity participation in people with inflammatory arthritis: study protocol for the OPAM-IA randomized controlled trial. BMC Rheumatol 2017; 1:6. [PMID: 30886950 PMCID: PMC6383592 DOI: 10.1186/s41927-017-0005-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/19/2017] [Indexed: 12/20/2022] Open
Abstract
Background Being physically active is an essential component of successful self-management for people with inflammatory arthritis; however, the vast majority of patients are inactive. This study aims to determine whether a technology-enabled counselling intervention can improve physical activity participation and patient outcomes. Methods The Effectiveness of Online Physical Activity Monitoring in Inflammatory Arthritis (OPAM-IA) project is a community-based randomized controlled trial with a delayed control design. We will recruit 130 people with rheumatoid arthritis or systemic lupus erythematosus, who can be physically active without health professional supervision. Randomization will be stratified by diagnosis. In Weeks 1-8, participants in the Immediate Group will: 1) receive education and counselling by a physical therapist (PT), 2) use a Fitbit and a new web-based application, FitViz, to track and obtain feedback about their physical activity, 3) receive 4 biweekly follow-up calls from the PT. Those in the Delayed Group will receive the same program in Week 10. We will interview a sample of participants about their experiences with the intervention. Participants will be assessed at baseline, and Weeks 9, 18 and 27. The primary outcome measure is time spent in moderate/vigorous physical activity in bouts of ≥ 10 min, measured with a portable multi-sensor device in the free-living environment. Secondary outcomes include step count, time in sedentary behaviour, pain, fatigue, mood, self-management capacity, and habitual behaviour. Discussion A limitation of this study is that participants, who also administer the outcome measures, will not be blinded. Nonetheless, by customizing existing self-monitoring technologies in a patient-centred manner, individuals can be coached to engage in an active lifestyle and monitor their performance. The results will determine if this intervention improves physical activity participation. The qualitative interviews will also provide insight into a paradigm to integrate this program to support self-management. Trial registration Date of last update in ClinicalTrials.gov: September 18, 2015. ClinicalTrials.gov Identifier: NCT02554474.
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Affiliation(s)
- Linda C Li
- 1Department of Physical Therapy, University of British Columbia, Friedman Building, 2177 Wesbrook Mall, Vancouver, BC Canada.,Arthritis Research Canada, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC V6X 2C7 Canada
| | - Lynne M Feehan
- 1Department of Physical Therapy, University of British Columbia, Friedman Building, 2177 Wesbrook Mall, Vancouver, BC Canada
| | - Chris Shaw
- 3School of Interactive Arts and Technology, Simon Fraser University, 250-13450 102 Avenue, Surrey, BC V3T 0A3 Canada
| | - Hui Xie
- Arthritis Research Canada, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC V6X 2C7 Canada.,4Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC Canada
| | - Eric C Sayre
- Arthritis Research Canada, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC V6X 2C7 Canada
| | - Antonio Aviña-Zubeita
- Arthritis Research Canada, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC V6X 2C7 Canada.,5Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, BC V5Z 1M9 Canada
| | - Navi Grewal
- Arthritis Research Canada, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC V6X 2C7 Canada
| | - Anne F Townsend
- Arthritis Research Canada, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC V6X 2C7 Canada.,6Medical School, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Diane Gromala
- 3School of Interactive Arts and Technology, Simon Fraser University, 250-13450 102 Avenue, Surrey, BC V3T 0A3 Canada
| | - Greg Noonan
- 7Mary Pack Arthritis Program, Vancouver General Hospital, 895 W 10th Avenue, Vancouver, BC Canada
| | - Catherine L Backman
- Arthritis Research Canada, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC V6X 2C7 Canada.,8Department of Occupational Therapy and Occupational Science, University of British Columbia, 2211 Wesbrook Mall T325, Vancouver, BC V6T 2B5 Canada
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Sessford JD, Brawley LR, Cary MA, Flora PK, Blouin JE, Meade L, Strachan SM, Gyurcsik NC. Self-Regulatory Efficacy Encourages Exercise Persistence Despite Arthritis Flare Symptoms. Appl Psychol Health Well Being 2017; 9:285-302. [DOI: 10.1111/aphw.12092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Li LC, Sayre EC, Xie H, Clayton C, Feehan LM. A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study. JMIR Mhealth Uhealth 2017; 5:e86. [PMID: 28652228 PMCID: PMC5504340 DOI: 10.2196/mhealth.7863] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/22/2017] [Accepted: 05/26/2017] [Indexed: 01/02/2023] Open
Abstract
Background Physical activity can improve health outcomes in people with knee osteoarthritis (OA); however, participation in physical activity is very low in this population. Objective The objective of our study was to assess the feasibility and preliminary efficacy of the use of wearables (Fitbit Flex) and telephone counselling by a physical therapist (PT) for improving physical activity in people with a physician-confirmed diagnosis of knee OA, or who have passed 2 validated criteria for early OA. Methods We conducted a community-based feasibility randomized controlled trial. The immediate group (n=17) received a brief education session by a physical therapist, a Fitbit Flex activity tracker, and a weekly telephone call for activity counselling with the physical therapist. The delayed group (n=17) received the same intervention 1 month later. All participants were assessed at baseline (T0), and the end of 1 month (T1) and 2 months (T2). Outcomes were (1) mean moderate to vigorous physical activity time, (2) mean time spent on sedentary behavior, (3) Knee Injury and Osteoarthritis Outcome Score (KOOS), and (4) Partners in Health Scale. Feasibility data were summarized with descriptive statistics. We used analysis of covariance to evaluate the effect of the group type on the outcome measures at T1 and T2, after adjusting for blocking and T0. We assessed planned contrasts of changes in outcome measures over measurement periods. Results We identified 46 eligible individuals; of those, 34 (74%) enrolled and no one dropped out. All but 1 participant adhered to the intervention protocol. We found a significant effect, with the immediate intervention group having improved in the moderate to vigorous physical activity time and in the Partners in Health Scale at T0 to T1 compared with the delayed intervention group. The planned contrast of the immediate intervention group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in the sedentary time and the KOOS symptoms subscale, favoring the delayed group. Conclusions This study demonstrated the feasibility of a behavioral intervention, supported by the use of a wearable device, to promote physical activity among people with knee OA. Trial Registration ClinicalTrials.gov NCT02313506; https://clinicaltrials.gov/ct2/show/NCT02313506 (Archived by WebCite at http://www.webcitation.org/6r4P3Bub0)
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Affiliation(s)
- Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | | | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Cam Clayton
- Arthritis Research Canada, Richmond, BC, Canada
| | - Lynne M Feehan
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Rehabilitation Program, Fraser Health, Surrey, BC, Canada
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Cary MA, Brittain DR, Gyurcsik NC. Differences in psychosocial responses to pain between sufficiently and insufficiently active adults with arthritis. Psychol Health 2017; 32:765-780. [PMID: 28276735 DOI: 10.1080/08870446.2017.1300258] [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] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Adults with arthritis struggle to meet the physical activity recommendation for disease self-management. Identifying psychosocial factors that differentiate adults who meet (sufficiently active) or do not meet (insufficiently active) the recommendation is needed. This study sought to examine differences in psychosocial responses to arthritis pain among adults who were sufficiently or insufficiently active. DESIGN This prospective study included adults with medically diagnosed arthritis (N = 136, Mage = 49.75 ± 13.88 years) who completed two online surveys: (1) baseline: pain and psychosocial responses to pain and (2) two weeks later: physical activity. MAIN OUTCOME MEASURES Psychosocial responses examined in this study were psychological flexibility in response to pain, pain anxiety and maladaptive responses to pain anxiety. RESULTS A between-groups MANCOVA comparing sufficiently active (n = 87) to insufficiently active (n = 49) participants on psychosocial responses, after controlling for pain intensity, was significant (p = .005). Follow-up ANOVA's revealed that sufficiently active participants reported significantly higher psychological flexibility and used maladaptive responses less often compared to insufficiently active participants (p's < .05). CONCLUSIONS These findings provide preliminary insight into the psychosocial profile of adults at risk for nonadherence due to their responses to arthritis pain.
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Affiliation(s)
- Miranda A Cary
- a College of Kinesiology, University of Saskatchewan , Saskatoon , Canada
| | - Danielle R Brittain
- b Community Health Program , Colorado School of Public Health, University of Northern Colorado , Greeley , CO , United States
| | - Nancy C Gyurcsik
- a College of Kinesiology, University of Saskatchewan , Saskatoon , Canada
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Geuens J, Swinnen TW, Westhovens R, de Vlam K, Geurts L, Vanden Abeele V. A Review of Persuasive Principles in Mobile Apps for Chronic Arthritis Patients: Opportunities for Improvement. JMIR Mhealth Uhealth 2016; 4:e118. [PMID: 27742604 PMCID: PMC5083846 DOI: 10.2196/mhealth.6286] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/22/2016] [Accepted: 09/07/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic arthritis (CA), an umbrella term for inflammatory rheumatic and other musculoskeletal diseases, is highly prevalent. Effective disease-modifying antirheumatic drugs for CA are available, with the exception of osteoarthritis, but require a long-term commitment of patients to comply with the medication regimen and management program as well as a tight follow-up by the treating physician and health professionals. Additionally, patients are advised to participate in physical exercise programs. Adherence to exercises and physical activity programs is often very low. Patients would benefit from support to increase medication compliance as well as compliance to the physical exercise programs. To address these shortcomings, health apps for CA patients have been created. These mobile apps assist patients in self-management of overall health measures, health prevention, and disease management. By including persuasive principles designed to reinforce, change, or shape attitudes or behaviors, health apps can transform into support tools that motivate and stimulate users to achieve or keep up with target behavior, also called persuasive systems. However, the extent to which health apps for CA patients consciously and successfully employ such persuasive principles remains unknown. OBJECTIVE The objective of this study was to evaluate the number and type of persuasive principles present in current health apps for CA patients. METHODS A review of apps for arthritis patients was conducted across the three major app stores (Google Play, Apple App Store, and Windows Phone Store). Collected apps were coded according to 37 persuasive principles, based on an altered version of the Persuasive System Design taxonomy of Oinas-Kukkonen and Harjuma and the taxonomy of Behavior Change Techniques of Michie and Abraham. In addition, user ratings, number of installs, and price of the apps were also coded. RESULTS We coded 28 apps. On average, 5.8 out of 37 persuasive principles were used in each app. The most used category of persuasive principles was System Credibility with an average of 2.6 principles. Task Support was the second most used, with an average of 2.3 persuasive principles. Next was Dialogue Support with an average of 0.5 principles. Social Support was last with an average of 0.01 persuasive principles only. CONCLUSIONS Current health apps for CA patients would benefit from adding Social Support techniques (eg, social media, user fora) and extending Dialogue Support techniques (eg, rewards, praise). The addition of automated tracking of health-related parameters (eg, physical activity, step count) could further reduce the effort for CA patients to manage their disease and thus increase Task Support. Finally, apps for health could benefit from a more evidence-based approach, both in developing the app as well as ensuring that content can be verified as scientifically proven, which will result in enhanced System Credibility.
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Plow M, Mangal S, Geither K, Golding M. A Scoping Review of Tailored Self-management Interventions among Adults with Mobility Impairing Neurological and Musculoskeletal Conditions. Front Public Health 2016; 4:165. [PMID: 27672633 PMCID: PMC5018478 DOI: 10.3389/fpubh.2016.00165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 07/28/2016] [Indexed: 11/29/2022] Open
Abstract
A critical public health objective is to optimize and disseminate self-management interventions for the 56.7 million adults living with chronic disabling conditions in the United States. A possible strategy to optimize the effectiveness of self-management interventions is to understand how best to tailor self-management interventions to the needs and circumstances of each participant. Thus, the purpose of this scoping review was to describe randomized controlled trials (RCTs) of tailored self-management interventions in adults with neurological and musculoskeletal conditions that characteristically result in mobility impairments. The 13 RCTs included in the scoping review typically compared tailored interventions to non-tailored interventions or usual care among adults with chronic pain, stroke, and/or arthritis. The tailored interventions were diverse in their delivery formats, dosing, behavior change techniques, and tailoring strategies. We identified 13 personal characteristics (e.g., preferences and theoretical constructs) and 4 types of assessment formats (i.e., oral history, self-report questionnaires, provider-reported assessments, and medical records) that were used to tailor the self-management interventions. It was common to tailor intervention content using self-report questionnaires that assessed personal characteristics pertaining to impairments and preferences. Content was matched to personal characteristics using clinical judgment or computer algorithms. However, few studies adequately described the decision rules for matching content. To advance the science of tailoring self-management interventions, we recommend conducting comparative effectiveness research and further developing a taxonomy to standardize descriptions of tailoring. We discuss the opportunities that are now coalescing to optimize tailored self-management. We also provide examples of how to merge concepts from the self-management literature with conceptual frameworks of tailoring from the health communication literature.
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Affiliation(s)
- Matthew Plow
- Frances Payne Bolton School of Nursing, Case Western Reserve University , Cleveland, OH , USA
| | - Sabrina Mangal
- Frances Payne Bolton School of Nursing, Case Western Reserve University , Cleveland, OH , USA
| | - Kathryn Geither
- Frances Payne Bolton School of Nursing, Case Western Reserve University , Cleveland, OH , USA
| | - Meghan Golding
- Frances Payne Bolton School of Nursing, Case Western Reserve University , Cleveland, OH , USA
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Cary MA, Brittain DR, Dinger MK, Ford ML, Cain M, Sharp TA. Barriers to Physical Activity Among Gay Men. Am J Mens Health 2016; 10:408-17. [DOI: 10.1177/1557988315569297] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Gay men may not be physically active at recommended levels to achieve health benefits. Thus, a need exists to identify general (i.e., common across populations) and population-specific barriers that hinder or stop gay men from participating in physical activity (PA). Salient barriers may be identified through the extent each barrier limits PA (i.e., barrier limitation) and the level of one’s confidence to overcome barriers and engage in PA (i.e., self-regulatory efficacy). The purposes of this study were to (1) provide a description of general and population-specific barriers to PA among sufficiently and insufficiently active gay men, (2) identify barrier limitation and self-regulatory efficacy for the reported barriers, and (3) examine the associations between meeting the current PA recommendation, barrier limitation, and self-regulatory efficacy. Participants were 108 self-identified gay males aged 21 to 64 years who completed a web-based survey. A total of 35 general barriers and no population-specific barriers were identified by the sufficiently and insufficiently active groups. The sufficiently active group reported higher self-regulatory efficacy and lower barrier limitation for nearly all reported barriers. A binary logistic regression used to examine the associations between PA, barrier limitation, and self-regulatory efficacy was statistically significant, χ2(2, N = 108) = 19.26, p < .0001, R2 = .16. Only barrier limitation significantly contributed to the model. Future research should continue to examine barriers to PA among gay men to determine whether an intervention needs to be designed specifically for gay men or whether a one-size-fits-all intervention would be effective in helping all men overcome common barriers to engaging in PA.
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Affiliation(s)
| | | | | | | | - Meagan Cain
- University of Northern Colorado, Greeley, CO, USA
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Perceived Barriers, Facilitators and Benefits for Regular Physical Activity and Exercise in Patients with Rheumatoid Arthritis: A Review of the Literature. Sports Med 2016. [PMID: 26219268 PMCID: PMC4579262 DOI: 10.1007/s40279-015-0363-2] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease, which not only affects the joints but can also impact on general well-being and risk for cardiovascular disease. Regular physical activity and exercise in patients with RA have numerous health benefits. Nevertheless, the majority of patients with RA are physically inactive. This indicates that people with RA might experience additional or more severe barriers to physical activity or exercise than the general population. This narrative review provides an overview of perceived barriers, benefits and facilitators of physical activity and exercise in RA. Databases were searched for articles published until September 2014 using the terms 'rheumatoid arthritis', 'physical activity', 'exercise', 'barriers', 'facilitators', 'benefits', 'motivation', 'motivators' and 'enablers'. Similarities were found between disease-specific barriers and benefits of physical activity and exercise, e.g. pain and fatigue are frequently mentioned as barriers, but reductions in pain and fatigue are perceived benefits of physical activity and exercise. Even though exercise does not influence the existence of barriers, physically active patients appear to be more capable of overcoming them. Therefore, exercise programmes should enhance self-efficacy for exercise in order to achieve long-term physical activity and exercise behaviour. Encouragement from health professionals and friends/family are facilitators for physical activity and exercise. There is a need for interventions that support RA patients in overcoming barriers to physical activity and exercise and help sustain this important health behaviour.
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Spink KS, Brawley LR, Gyurcsik NC. Perceived success/failure and attributions associated with self-regulatory efficacy to meet physical activity recommendations for women with arthritis. Women Health 2015; 56:767-83. [PMID: 26624884 DOI: 10.1080/03630242.2015.1118730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The relationship between attributional dimensions women assign to the cause of their perceived success or failure at meeting the recommended physical activity dose and self-regulatory efficacy for future physical activity was examined among women with arthritis. Women (N = 117) aged 18-84 years, with self-reported medically-diagnosed arthritis, completed on-line questions in the fall of 2013 assessing endurance physical activity, perceived outcome for meeting the recommended levels of endurance activity, attributions for one's success or failure in meeting the recommendations, and self-regulatory efficacy to schedule/plan endurance activity over the next month. The main theoretically-driven finding revealed that the interaction of the stability dimension with perceived success/failure was significantly related to self-regulatory efficacy for scheduling and planning future physical activity (β = 0.35, p = .002). Outcomes attributed to more versus less stable factors accentuated differences in self-regulatory efficacy beliefs following perceived success and failure at being active. It appears that attributional dimensions were associated with self-regulatory efficacy in women with arthritis. This suggests that rather than objectively observed past mastery experience, women's subjective perceptions and explanations of their past experiences were related to efficacy beliefs, especially following a failure experience.
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Affiliation(s)
- Kevin S Spink
- a College of Kinesiology , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Lawrence R Brawley
- a College of Kinesiology , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Nancy C Gyurcsik
- a College of Kinesiology , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
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Flora PK, Brawley LR, Sessford JD, Cary MA, Gyurcsik NC. Predicting planned physical activity of individuals with arthritis: A self-regulatory perspective. J Health Psychol 2015; 21:2684-2694. [PMID: 25967945 DOI: 10.1177/1359105315583370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Few individuals with arthritis are sufficiently active. We surveyed a convenience sample of exercisers ( N = 134) to examine the utility of social cognitive theory variables, namely, self-regulatory efficacy, negative outcome expectations, and pain acceptance for predicting planned physical activity according to Weinstein's two prediction suggestions. Logistic regression revealed, after controlling for pain intensity, self-regulatory efficacy, negative outcome expectations, and pain acceptance distinguished groups achieving/not achieving planned physical activity, p < 0.001 (28% variance). A second model adding past physical activity also predicted the groups, p < 0.001 (57% variance). This is one of the first arthritis studies examining planned physical activity relative to Weinstein's recommendations.
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Gyurcsik NC, Cary MA, Sessford JD, Flora PK, Brawley LR. Pain, anxiety, and negative outcome expectations for activity: do negative psychological profiles differ between the inactive and active? Arthritis Care Res (Hoboken) 2015; 67:58-64. [PMID: 25073450 DOI: 10.1002/acr.22421] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 07/22/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Adherence to physical activity at ≥150 minutes/week has proven to offer disease management and health-promoting benefits among adults with arthritis. While highly active people seem undaunted by arthritis pain and are differentiated from the moderately active by adherence-related psychological factors, knowledge about inactive individuals is lacking. This knowledge may identify what to change in order to help inactive people begin and maintain physical activity. The present study examined the planned, self-regulated activity of high, moderate, and inactive individuals to determine if differences existed in negative psychological factors. METHODS Adults with a medical diagnosis of arthritis completed online measures of physical activity, perceived pain intensity, pain anxiety, and negative disease-related outcome expectations from being active. High active (n = 94), moderately active (n = 77), and inactive (n = 104) groups were identified. RESULTS A significant multivariate analysis of covariance revealed group differences (P < 0.001). Followup analyses indicated that inactive participants had the most negative psychological profile. Inactive participants reported that negative disease-related outcomes expectancies were more distressing and likely to occur than either group of active participants and expressed greater pain intensity and pain anxiety than the highly active participants (P < 0.05 for all). CONCLUSION Identifying differences in negative psychological factors aids in the understanding of differential adherence between activity groups and highlights possible factors to change in future intervention and research.
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Cary MA, Gyurcsik NC, Brawley LR. Prediction of adaptive self-regulatory responses to arthritis pain anxiety in exercising adults: does pain acceptance matter? Pain Res Manag 2015; 20:67-74. [PMID: 25621990 PMCID: PMC4391441 DOI: 10.1155/2015/853961] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Exercising for ≥ 150 min/week is a recommended strategy for self-managing arthritis. However, exercise nonadherence is a problem. Arthritis pain anxiety may interfere with regular exercise. According to the fear-avoidance model, individuals may confront their pain anxiety by using adaptive self-regulatory responses (eg, changing exercise type or duration). Furthermore, the anxiety-self-regulatory responses relationship may vary as a function of individuals' pain acceptance levels. OBJECTIVES To investigate pain acceptance as a moderator of the pain anxiety-adaptive self-regulatory responses relationship. The secondary objective was to examine whether groups of patients who differed in meeting exercise recommendations also differed in pain-related and self-regulatory responses. METHODS Adults (mean [± SD] age 49.75 ± 13.88 years) with medically diagnosed arthritis completed online measures of arthritis pain-related variables and self-regulatory responses at baseline, and exercise participation two weeks later. Individuals meeting (n=87) and not meeting (n=49) exercise recommendations were identified. RESULTS Hierarchical multiple regression analysis revealed that pain acceptance moderated the anxiety-adaptive self-regulatory responses relationship. When pain anxiety was lower, greater pain acceptance was associated with less frequent use of adaptive responses. When anxiety was higher, adaptive responses were used regardless of pain acceptance level. MANOVA findings revealed that participants meeting the recommended exercise dose reported significantly lower pain and pain anxiety, and greater pain acceptance (P<0.05) than those not meeting the dose. CONCLUSIONS Greater pain acceptance may help individuals to focus their efforts to adapt to their pain anxiety only when it is higher, leaving self-regulatory capacity to cope with additional challenges to exercise adherence (eg, busy schedule).
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Affiliation(s)
- Miranda A Cary
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Nancy C Gyurcsik
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Lawrence R Brawley
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan
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Marks R. Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care. Health Psychol Open 2014; 1:2055102914564582. [PMID: 28070346 PMCID: PMC5193269 DOI: 10.1177/2055102914564582] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Self-efficacy, denoting the degree of confidence an individual has in carrying out a specific activity, was initially discussed in the 1970s as a potential correlate of disease outcomes. Drawn from 35 years of related research, this review provides an updated understanding of the concept of self-efficacy and its relevance for arthritis management. There is a consistent link between self-efficacy, arthritis pain and disability, and adherence to recommended therapeutic strategies. A wide variety of intervention strategies improve arthritis self-efficacy, as well as outcomes. Steps to assess and intervene thoughtfully to maximize self-efficacy beliefs are likely to impact arthritis disability outcomes quite favorably and significantly, regardless of disease type, duration, or sociodemographic factors.
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Affiliation(s)
- Ray Marks
- The City University of New York, USA; Columbia University, USA
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Abstract
Inactivity leads to frailty and loss of function for older adults. Most older adults are sedentary. Participating in a regular routine of physical activity is recommended for maintaining physical function required to sustain quality of life and independence for older adults. Annual screening for level of physical activity is required to determine changes from year to year. Research shows older adults are more likely to initiate a regular routine of physical activity when a health care provider writes a prescription for physical activity including the type, frequency, and specific duration of physical activity sessions.
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Affiliation(s)
- Carol E Rogers
- Department of Nursing, Donald W Reynolds Center of Geriatric Nursing Excellence, College of Nursing, University of Oklahoma Health Sciences Center, 1100 North Stonewall Avenue, Office 410, Oklahoma City, OK 73120, USA.
| | - Maria Cordeiro
- Department of Nursing, Reynolds Center of Geriatric Nursing Excellence, College of Nursing, University of Oklahoma Health Sciences Center, 1300 Olde North Place, Edmond, OK 73034, USA
| | - Erica Perryman
- Department of Nursing, Reynolds Center of Geriatric Nursing Excellence, College of Nursing, University of Oklahoma Health Sciences Center, 1100 North Stonewall Avenue, Office 472, Oklahoma City, OK 73117, USA
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Knittle K, De Gucht V, Hurkmans E, Peeters A, Ronday K, Maes S, Vlieland TV. Targeting motivation and self-regulation to increase physical activity among patients with rheumatoid arthritis: a randomised controlled trial. Clin Rheumatol 2013; 34:231-8. [DOI: 10.1007/s10067-013-2425-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 10/22/2013] [Indexed: 11/29/2022]
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Loeppenthin K, Esbensen BA, Ostergaard M, Jennum P, Thomsen T, Midtgaard J. Physical activity maintenance in patients with rheumatoid arthritis: a qualitative study. Clin Rehabil 2013; 28:289-99. [DOI: 10.1177/0269215513501526] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: To describe the experience of physical activity maintenance in patients with rheumatoid arthritis. Design: A qualitative salutogenic-oriented interview study. Setting: A rheumatology outpatient clinic. Subjects: A purposive sample of 16 physically active patients (mean age 50, range 37–67) diagnosed with rheumatoid arthritis on average 21 years previously (range 4–46 years). Methods: In-depth interviews were conducted using a semi-structured interview guide to illuminate how the phenomenon ‘physical activity maintenance’ was experienced by patients with rheumatoid arthritis. The interviews were analysed using systematic text condensation, inspired by Giorgi’s descriptive phenomenological methodology. Results: The analysis revealed three categories: (1) knowing and enjoying the body; (2) responsibility and challenges; (3) autonomy and social belonging. On the basis of these categories, the essential meaning of the phenomenon of physical activity maintenance for patients with rheumatoid arthritis was summarized into ‘striving for a transparent body and participation’, pointing to experiences of sensations of wellbeing, liberation from restrictions and social participation on equal terms with non-arthritis populations. Conclusion: This study demonstrates that physical activity in patients with rheumatoid arthritis may be understood as a resource to resist disability and to feel and stay healthy while creating and sustaining meaningfulness in life.
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Affiliation(s)
- K Loeppenthin
- Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Denmark
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
| | - BA Esbensen
- Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Denmark
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
- Department of Public Health, University of Copenhagen, Denmark
| | - M Ostergaard
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - P Jennum
- Department of Clinical Medicine, University of Copenhagen, Denmark
- Danish Centre for Sleep Medicine, Glostrup Hospital, Copenhagen University, Denmark
| | - T Thomsen
- Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Denmark
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
| | - J Midtgaard
- Department of Clinical Medicine, University of Copenhagen, Denmark
- University Hospitals Centre for Health Care Research, Rigshospitalet, Denmark
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Li LC, Lineker S, Cibere J, Crooks VA, Jones CA, Kopec JA, Lear SA, Pencharz J, Rhodes RE, Esdaile JM. Capitalizing on the teachable moment: osteoarthritis physical activity and exercise net for improving physical activity in early knee osteoarthritis. JMIR Res Protoc 2013; 2:e17. [PMID: 23659903 PMCID: PMC3650932 DOI: 10.2196/resprot.2553] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/27/2013] [Accepted: 04/11/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Practice guidelines emphasize the use of exercise and weight reduction as the first line of management for knee osteoarthritis (OA). However, less than half of the people with mild OA participate in moderate intensity physical activity. Given that physical activities have been shown to reduce pain, improve quality of life, and have the potential to reduce the progression of joint damage, many people with OA are missing the benefits of this inexpensive intervention. OBJECTIVE The objectives of this study are (1) to develop a behavioral theory-informed Internet intervention called Osteoarthritis Physical Activity & Exercise Net (OPEN) for people with previously undiagnosed knee OA, and (2) to assess the efficacy of the OPEN website for improving physical activity participation through a proof-of-concept study. METHODS OPEN was developed based on the theory of planned behavior. Efficacy of this online intervention is being assessed by an ongoing proof-of-concept, single-blind randomized controlled trial in British Columbia, Canada. We are currently recruiting participants and plan to recruit a total of 252 sedentary people with previously undiagnosed knee OA using a set of validated criteria. Half of the participants will be randomized to use OPEN and receive an OA education pamphlet. The other half only will receive the pamphlet. Participants will complete an online questionnaire at baseline, 3 months, and 6 months about their participation in physical activities, health-related quality of life, and motivational outcomes. In addition, we will perform an aerobic fitness test in a sub-sample of participants (n=20 per study arm). In the primary analysis, we will use logistic regression to compare the proportion of participants reporting being physically active at or above the recommended level in the 2 groups, adjusting for baseline measurement, age, and sex. RESULTS This study evaluates a theory-informed behavioral intervention at a time when people affected with OA tend to be more motivated to adopt an active lifestyle (ie, at the early stage of OA). Our approach, which consisted of the identification of early knee OA followed immediately by an online intervention that directly targets physical inactivity, can be easily implemented across communities. CONCLUSIONS Our online intervention directly targets physical inactivity at a time when the joint damage tends to be mild. If OPEN is found to be effective in changing long-term physical activity behaviors, it opens further opportunities to promote early diagnosis and to implement lifestyle interventions. TRIAL REGISTRATION Clinicaltrial.gov: NCT01608282; http://clinicaltrials.gov/ct2/show/NCT01608282 (Archived by WebCite at http://www.webcitation.org/6G7sBBayI).
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Affiliation(s)
- Linda C Li
- Arthritis Research Centre of Canada, Richmond, BC, Canada.
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Burton E, Lewin G, Boldy D. Barriers and Motivators to Being Physically Active for Older Home Care Clients. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2012. [DOI: 10.3109/02703181.2012.751474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Law RJ, Markland DA, Jones JG, Maddison PJ, Thom JM. Perceptions of issues relating to exercise and joint health in rheumatoid arthritis: a UK-based questionnaire study. Musculoskeletal Care 2012; 11:147-58. [PMID: 23125122 DOI: 10.1002/msc.1037] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This questionnaire study investigated the perceptions of rheumatoid arthritis (RA) patients across the UK in relation to exercise and joint health. The validity of the measure was also assessed. METHODS Members of the National Rheumatoid Arthritis Society (NRAS) with self-reported RA completed the questionnaire online. Items related to five factors that emerged from previous qualitative research. Participants responded using a five-point Likert-style scale (strongly disagree to strongly agree). The International Physical Activity Questionnaire (IPAQ) assessed physical activity. The model was tested using confirmatory factor analysis (LISREL 8.8); statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS). RESULTS A total of 247 responses were collected over 47 days (88% females; age: 18-77 years; disease duration: <1-51 years). Acceptable factorial validity was revealed (Satorra-Bentler χ(2) = 774.47, df = 454, p < 0.001, root mean squared error of approximation (RMSEA) = 0.05, 90% confidence interval RMSEA = 0.05-0.06, comparative fit index = 0.94, standardized root mean square residual = 0.09), with the following factor endorsements: 'Health professionals show exercise knowledge' (19%); 'Knowing what exercise should be done' (43%); 'Having to exercise because it is helpful' (72%); 'Worry about causing harm to joints' (44%); and 'Not wanting to exercise as joints hurt' (52%). Patient concerns about joint pain, joint harm and how to exercise were significantly associated with lower physical activity (p < 0.05). CONCLUSIONS These results confirm that patients perceive exercise as beneficial. However, concerns about how to exercise, joint pain, causing harm to joints and a perceived lack of exercise knowledge among health professionals remain. Addressing these concerns may have implications for increasing physical activity within the RA population.
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Vervloesem N, Van Gils N, Ovaere L, Westhovens R, Van Assche D. Are personal characteristics associated with exercise participation in patients with rheumatoid arthritis? A cross-sectional explorative survey. Musculoskeletal Care 2012; 10:90-100. [PMID: 22351523 DOI: 10.1002/msc.1003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Organized exercise programs for patients with rheumatoid arthritis (RA) are useful to enhance physical activity and fitness. However, participation and adherence rates of these programs are low. This study aimed to identify demographic, personal and disease-related factors interfering with implementing an exercise program for RA. METHODS A random sample of ambulatory RA patients from a single centre was divided into two groups, depending on their willingness to participate in an exercise program. Subsequently, demographic data (gender, age, disease duration and educational level) and disease-related and personal factors were obtained (Disease Activity Score; Short Form 36 [SF-36]; Health Assessment Questionnaire; Global Disease Activity; and also the Utrecht Coping List [UCL], Illness Cognition Questionnaire; TAMPA scale and modified Baecke questionnaire). RESULTS Of the 154 people completing the survey, 113 (73%) indicated that they were willing to participate in an exercise program. These positive responders (PR) were more often female (p<0.05), and had a higher educational level (p<0.05). In the negative responders (NR), higher scores were found in the general health perception (54.7; [SD 18.3] versus 47.4; [SD 20.8]) and vitality (61.6 [SD 19.8] versus 53.7 [SD 20.1] sections of the SF-36, and a lower score was found on the reassuring thoughts subscale of the UCL (11.9 [SD 2.7] versus 12.9 [SD 2.7]) compared with the PR (all p<0.05). CONCLUSIONS Although few differences were found between the groups, some insights regarding pitfalls in implementing an exercise program were highlighted. Further insights into external and personal motivators for patients are needed.
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Affiliation(s)
- Nele Vervloesem
- Department of Rheumatology, University Hospital Leuven, Leuven, Belgium
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Abstract
BACKGROUND Low back pain affects a substantial number of adults each year and is persistent or recurrent for many. Self-efficacy is an important predictor of functional recovery. OBJECTIVE The purpose of this investigation was to assess the preliminary reliability and validity of the Low Back Activity Confidence Scale (LoBACS) for individuals with histories of low back pain or lumbar surgery. DESIGN Two overlapping samples of patients who had undergone a microdiskectomy participated: a test-retest sample of 21 individuals and a validity sample of 53 individuals. METHODS Low Back Activity Confidence Scale items pertaining to self-efficacy for functional activities (FnSE subscale), self-regulation of back health (Self-RegSE subscale), and regular exercise (ExSE subscale) were generated from existing literature and clinical observations. The test-retest sample completed the LoBACS twice, approximately 10 days apart. The validity sample completed the LoBACS and measures of functional performance, self-reported leisure and occupational physical activity, pain, fear beliefs, disability, and quality of life. RESULTS The FnSE, Self-RegSE, and ExSE subscale scores and LoBACS total score had excellent to acceptable test-retest reliability (intraclass correlation coefficients of .924, .634, .710, and .850, respectively) and internal consistency (Cronbach α coefficients of .924, .804, .941, and .911, respectively). The LoBACS subscales were correlated in expected directions with physical performance, physical activity, pain, fear beliefs, disability, and quality of life, providing initial evidence of concurrent validity. CONCLUSIONS The findings provide preliminary content and concurrent validity and interrater and internal consistency reliability for the LoBACS measure of self-efficacy for individuals with histories of low back pain and lumbar microdiskectomy.
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Arnold CM, Faulkner RA, Gyurcsik NC. The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis. Physiother Can 2011; 63:41-420. [PMID: 22942514 DOI: 10.3138/ptc.2010-29] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. METHOD Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. RESULTS EE participants with low baseline falls efficacy demonstrated significantly (p<0.05) greater improvement in balance and falls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (p<0.05) correlated with positive balance and falls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). CONCLUSIONS Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes.
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Affiliation(s)
- C M Arnold
- School of Physical Therapy, College of Medicine, University of Saskatchewan
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43
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Balance dysfunction and falls in people with lower limb arthritis: factors contributing to risk and effectiveness of exercise interventions. Eur Rev Aging Phys Act 2011. [DOI: 10.1007/s11556-011-0086-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Abstract
Chronic musculoskeletal conditions in the lower extremities, particularly arthritis, and the chronic pain associated with them, are independent risk factors for falls, with approximately 50% of people with arthritis reporting one or more falls. Despite this, few studies have specifically addressed balance dysfunction, falls risk and falls incidence in people with arthritis. This review aimed to identify potential factors contributing to the increased risk of falls in people with lower limb osteoarthritis or rheumatoid arthritis and to summarise the evidence base for effective exercise interventions targeted to reduce their risk of falls. A systematic search of the literature was conducted in February 2010 and included the following databases: MEDLINE (Ovid), EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Cochrane Library and PsycINFO. Only three studies that investigated exercise programmes for people with lower limb arthritis met all inclusion criteria, but none used falls as an outcome measure. To broaden the review, systematic reviews that assessed the effectiveness of exercise interventions for fall prevention in older people were also included. The presence of any form of lower limb arthritis and the associated consequences including pain, balance impairment, reduced muscle strength and reduced function are all associated with increased risk of falling. Due to the link between musculoskeletal pain and the increased risk of falls, further research needs to investigate which type of exercise programme will be effective in reducing the risk of falls in populations with arthritis in the lower limbs.
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44
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Cooney JK, Law RJ, Matschke V, Lemmey AB, Moore JP, Ahmad Y, Jones JG, Maddison P, Thom JM. Benefits of exercise in rheumatoid arthritis. J Aging Res 2011; 2011:681640. [PMID: 21403833 PMCID: PMC3042669 DOI: 10.4061/2011/681640] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 12/15/2010] [Indexed: 11/20/2022] Open
Abstract
This paper aims to highlight the importance of exercise in patients with rheumatoid arthritis (RA) and to demonstrate the multitude of beneficial effects that properly designed exercise training has in this population. RA is a chronic, systemic, autoimmune disease characterised by decrements to joint health including joint pain and inflammation, fatigue, increased incidence and progression of cardiovascular disease, and accelerated loss of muscle mass, that is, “rheumatoid cachexia”. These factors contribute to functional limitation, disability, comorbidities, and reduced quality of life. Exercise training for RA patients has been shown to be efficacious in reversing cachexia and substantially improving function without exacerbating disease activity and is likely to reduce cardiovascular risk. Thus, all RA patients should be encouraged to include aerobic and resistance exercise training as part of routine care. Understanding the perceptions of RA patients and health professionals to exercise is key to patients initiating and adhering to effective exercise training.
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Affiliation(s)
- Jennifer K Cooney
- School of Sport, Health and Exercise Sciences, Bangor University, George Building, Holyhead Road, Bangor, Gwynedd LL57 2PZ, UK
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45
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Gyurcsik NC, Brawley LR, Spink KS, Glazebrook KE, Anderson TJ. Is level of pain acceptance differentially related to social cognitions and behavior? The case of active women with arthritis. J Health Psychol 2011; 16:530-9. [PMID: 21224336 DOI: 10.1177/1359105310394229] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Pain from arthritis is a barrier to physical activity (PA), yet some people still manage to be active. This study examined whether women with greater or weaker arthritis pain acceptance were distinguished by social cognitions (self-regulatory efficacy to overcome barriers; outcome expectations of PA) and whether PA differences existed. Women with arthritis (N = 118) completed two surveys. After controlling for pain, a hierarchical discriminant function analysis discriminated pain acceptance groups in terms of the social cognitions. Greater pain acceptance participants were also significantly more active. Findings contribute new insight on the combination of a disease-related factor (pain acceptance) and social cognitions important for adherence.
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46
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Brittain DR, Gyurcsik NC, McElroy M, Hillard SA. General and Arthritis-Specific Barriers to Moderate Physical Activity in Women With Arthritis. Womens Health Issues 2011; 21:57-63. [DOI: 10.1016/j.whi.2010.07.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 07/23/2010] [Accepted: 07/26/2010] [Indexed: 10/19/2022]
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47
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Pickering G, Leplege A. Herpes Zoster Pain, Postherpetic Neuralgia, and Quality of Life in the Elderly. Pain Pract 2010; 11:397-402. [DOI: 10.1111/j.1533-2500.2010.00432.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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48
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Mancuso CA, Perna M, Sargent AB, Salmon JE. Perceptions and measurements of physical activity in patients with systemic lupus erythematosus. Lupus 2010; 20:231-42. [DOI: 10.1177/0961203310383737] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Promoting physical activity should be a priority for patients with systemic lupus erythematosus (SLE) because a sedentary lifestyle compounds patients’ already disproportionately high risk for cardiovascular events and other adverse health outcomes. The objectives of this pilot study were to assess physical activity in 50 patients with SLE and to compare activity levels with clinical and psychosocial variables, such as fatigue, depressive symptoms, and social support and stress. Patients were asked open-ended questions about physical activity, and responses were coded according to Grounded Theory. Patients then completed the Paffenbarger Physical Activity and Exercise Index, a survey of lifestyle energy expenditure reported in kilocalories/week, performed a 2-minute walk test according to a standard protocol, and completed questionnaires measuring fatigue, depressive symptoms and social support and stress. Most patients (92%) were women, had a mean age of 45 years, and did not have extensive SLE. In response to open-ended questions, patients reported they avoided physical activity because they did not want to exacerbate SLE in the short term. However, if they could overcome initial hurdles, 46 patients (92%) thought physical activity ultimately would improve SLE symptoms. Walking was the preferred activity and 45 (90%) thought they could walk more. According to the Paffenbarger Index, mean energy expenditure was 1466 ± 1366 kilocalories/week and mean time spent in moderate-intensity activity was 132 ± 222 min/week. In total, 18 patients (36%) and 14 patients (28%) met physical activity goals for these values, respectively. Mean distance walked during the 2-minute test was 149 ± 28 m, equivalent to two blocks, which is similar to reports for stable patients with other chronic diseases. Patients with more social stress and more fatigue reported less physical activity. We conclude that the proportion of patients meeting physical activity goals was low; however, patients performed well on a standard walking test. Most patients believed physical activity provided long-term benefits for SLE and that they could be more physically active.
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Affiliation(s)
- CA Mancuso
- Research Division and Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - M Perna
- Research Division, Hospital for Special Surgery, New York, USA
| | - AB Sargent
- Research Division, Hospital for Special Surgery, New York, USA
| | - JE Salmon
- Research Division and Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
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49
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Law RJ, Breslin A, Oliver EJ, Mawn L, Markland DA, Maddison P, Thom JM. Perceptions of the effects of exercise on joint health in rheumatoid arthritis patients. Rheumatology (Oxford) 2010; 49:2444-51. [PMID: 20871130 DOI: 10.1093/rheumatology/keq299] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Exercise is important in RA management. However, RA patients are less active than the general population. This qualitative study explores the perceptions of patients regarding the effects of exercise on joint health. METHODS A purposive sample of 12 female and 6 male RA outpatients [age: 23-76 years; disease duration: 2.5 months to 33 years; HAQ score: 0-2.13] participated in four moderated focus groups. The main questions addressed were: (i) How do you feel exercise affects your joints?; and (ii) What affects your exercise behaviour? Transcriptions were independently analysed with 455 meaning units identified. An inductive, thematic analysis was conducted using established techniques. Discussion with a third analyst contributed to consensus validation. RESULTS Sixteen constructs emerged, clustering into five themes, reflecting the issues relating to exercise and joint health in RA patients. Emergent themes were: 'health professionals showing a lack of exercise knowledge', 'not knowing what exercise should be done', 'worry about causing harm to joints', 'not wanting to exercise as joints hurt' and 'having to exercise because it is helpful'. CONCLUSIONS RA patients demonstrated awareness of the advantages of exercise for their joints, both experientially and through education. However, they perceived that health professionals lacked certainty and clarity regarding specific exercise recommendations and the occurrence of joint damage. Thus, to enhance patient-centred exercise prescription in the RA population, uncertainties surrounding joint health, pain symptoms and exercise specificity need to be addressed, alongside continual emphasis of exercise benefits.
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Affiliation(s)
- Rebecca-Jane Law
- School of Sport, Health and Exercise Sciences, Bangor University, George Building, Holyhead Road, Bangor, Gwynedd LL57 2PZ, UK.
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