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Price EJ, Benjamin S, Bombardieri M, Bowman S, Carty S, Ciurtin C, Crampton B, Dawson A, Fisher BA, Giles I, Glennon P, Gupta M, Hackett KL, Larkin G, Ng WF, Ramanan AV, Rassam S, Rauz S, Smith G, Sutcliffe N, Tappuni A, Walsh SB. British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease. Rheumatology (Oxford) 2024:keae152. [PMID: 38621708 DOI: 10.1093/rheumatology/keae152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/02/2024] [Indexed: 04/17/2024] Open
Abstract
Sjögren disease (SD) is a chronic, autoimmune disease of unknown aetiology with significant impact on quality of life. Although dryness (sicca) of the eyes and mouth are the classically described features, dryness of other mucosal surfaces and systemic manifestations are common. The key management aim should be to empower the individual to manage their condition-conserving, replacing and stimulating secretions; and preventing damage and suppressing systemic disease activity. This guideline builds on and widens the recommendations developed for the first guideline published in 2017. We have included advice on the management of children and adolescents where appropriate to provide a comprehensive guideline for UK-based rheumatology teams.
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Affiliation(s)
- Elizabeth J Price
- Department of Rheumatology, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Stuart Benjamin
- The Academy Library and Information Service, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Michele Bombardieri
- Department of Rheumatology, Barts and The London School of Medicine and Dentistry, Barts Health NHS Trust, London, UK
- Centre for Experimental Medicine and Rheumatology, The William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Simon Bowman
- Department of Rheumatology, Milton Keynes University Hospital, Milton Keynes, UK
- Department of Rheumatology, University Hospitals Birmingham NHSFT, Birmingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Sara Carty
- Department of Rheumatology, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Coziana Ciurtin
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Bridget Crampton
- Patient Representative, Sjogren's UK Helpline Lead, Sjogren's UK (British Sjögren's Syndrome Association), Birmingham, UK
| | - Annabel Dawson
- Patient Representative, Sjogren's UK (British Sjögren's Syndrome Association), Birmingham, UK
| | - Benjamin A Fisher
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre and Department of Rheumatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Peter Glennon
- General Practice, NHS Staffordshire & Stoke on Trent ICB, Stafford, UK
| | - Monica Gupta
- Department of Rheumatology, Gartnavel General Hospital, Glasgow, UK
| | - Katie L Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | | | - Wan-Fai Ng
- Translational and Clinical Research Institute & Newcastle NIHR Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Department of Rheumatology, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Athimalaipet V Ramanan
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- Translational Health Sciences, University of Bristol, Bristol, UK
| | - Saad Rassam
- Haematology and Haemato-Oncology, KIMS Hospital, Maidstone, Kent, UK
| | - Saaeha Rauz
- Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Guy Smith
- Department of Ophthalmology, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | | | - Anwar Tappuni
- Institute of Dentistry, Queen Mary University of London, London, UK
| | - Stephen B Walsh
- London Tubular Centre, University College London, London, UK
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Zhang YF, Liu XQ. Using ChatGPT to promote college students' participation in physical activities and its effect on mental health. World J Psychiatry 2024; 14:330-333. [PMID: 38464770 PMCID: PMC10921293 DOI: 10.5498/wjp.v14.i2.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/19/2023] [Accepted: 01/23/2024] [Indexed: 02/04/2024] Open
Abstract
As one of the most famous large language models, ChatGPT has great potential for application in physical education. It can provide personalized exercise plans, a variety of exercise options, and interactive support. The integration of ChatGPT into the teaching process can promote college students' participation in physical activities and improve their mental health while expanding the traditional teaching environment and promoting the reform of traditional teaching methods. However, the application of ChatGPT faces challenges and obstacles in physical education. To make full use of ChatGPT in physical education, it can be combined with wearable devices and sports equipment to enhance the efficiency of interactions with users. Relevant policies are urgently needed to avoid the improper use of users' data.
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Affiliation(s)
- Yi-Fan Zhang
- School of Education, Tianjin University, Tianjin 300350, China
| | - Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
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Jacobi M, van der Schuur L, Seves BL, Brandenbarg P, Dekker R, Hettinga FJ, Hoekstra F, Krops LA, van der Woude LHV, Hoekstra T. Exploring experiences of people with stroke and health professionals on post-stroke fatigue guidance: getting the right people to the right care at the right time. Disabil Rehabil 2023:1-9. [PMID: 37950406 DOI: 10.1080/09638288.2023.2277398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE This focus group study aimed to explore experiences and perceptions on post-stroke fatigue guidance in Dutch rehabilitation and follow-up care among people/patients with stroke and health professionals. METHODS Ten persons with stroke and twelve health professionals with different professions within stroke rehabilitation or follow-up care in the Netherlands were purposively sampled and included. Eight online focus group interviews were conducted. We analysed the data using reflexive thematic analysis. RESULTS Three themes were identified. Guidance in fatigue management did not always match the needs of people/patients with stroke. Professionals were positive about the provided fatigue guidance (e.g. advice on activity pacing), but found it could be better tailored to the situation of people/patients with stroke. Professionals believe the right time for post-stroke fatigue guidance is when people/patients with stroke are motivated to change physical activity behaviour to manage fatigue - mostly several months after stroke - while people/patients with stroke preferred information on post-stroke fatigue well before discharge. Follow-up care and suggestions for improvement described that follow-up support after rehabilitation by a stroke coach is not implemented nationwide, while people/patients with stroke and professionals expressed a need for it. CONCLUSIONS The study findings will help guide improvement of fatigue guidance in stroke rehabilitation programmes and stroke follow-up care aiming to improve physical activity, functioning, participation, and health.
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Affiliation(s)
- M Jacobi
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L van der Schuur
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - B L Seves
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - F J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - F Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - L A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - L H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T Hoekstra
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Barakou I, Hackett KL, Finch T, Hettinga FJ. Self-regulation of effort for a better health-related quality of life: a multidimensional activity pacing model for chronic pain and fatigue management. Ann Med 2023; 55:2270688. [PMID: 37871249 PMCID: PMC10595396 DOI: 10.1080/07853890.2023.2270688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
PURPOSE To propose a comprehensive multidimensional model of activity pacing that improves health-related quality of life and promotes sustained physical activity engagement among adults with chronic conditions. MATERIALS AND METHODS A narrative review was conducted to examine the existing literature on activity pacing, health-related quality of life, pain and fatigue management, and physical activity promotion in chronic conditions. RESULTS The literature revealed a lack of a cohesive approach towards a multidimensional model for using activity pacing to improve health-related quality of life. A comprehensive multidimensional model of activity pacing was proposed, emphasizing the importance of considering all aspects of pacing for sustained physical activity engagement and improved health-related quality of life. The model incorporates elements such as rest breaks, self-regulatory skills, environmental factors, and effective coping strategies for depression/anxiety. It takes into account physical, psychological, and environmental factors, all of which contribute significantly to the enhancement of health-related quality of life, physical function, and overall well-being, reflecting a holistic approach. CONCLUSIONS The model offers guidance to researchers and clinicians in effectively educating patients on activity pacing acquisition and in developing effective interventions to enhance physical activity engagement and health outcomes among adults with chronic conditions. Additionally, it serves as a tool towards facilitating discussions on sustained physical activity and a healthy lifestyle for patients, which can eventually lead to improved quality of life.
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Affiliation(s)
- Ioulia Barakou
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | - Katie L. Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
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5
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Barakou I, Sakalidis KE, Abonie US, Finch T, Hackett KL, Hettinga FJ. Effectiveness of physical activity interventions on reducing perceived fatigue among adults with chronic conditions: a systematic review and meta-analysis of randomised controlled trials. Sci Rep 2023; 13:14582. [PMID: 37666869 PMCID: PMC10477297 DOI: 10.1038/s41598-023-41075-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023] Open
Abstract
Fatigue is barrier of physical activity participation in adults with chronic conditions. However, physical activity alleviates fatigue symptoms. This systematic review and meta-analysis aimed to (1) synthesise evidence from randomised controlled trials (RCTs) exploring the effects of physical activity interventions on fatigue reduction and (2) evaluate their effectiveness. Medline/CINAHL/EMBASE/Web of Science and Scopus were searched up to June 24th, 2023. Two reviewers independently conducted study screening and selection (RCTs), extracted data and assessed risk of bias (RoB2). Outcome was the standardised mean difference (SMD) with 95% confidence intervals in fatigue between experimental and control groups. 38 articles met the inclusion criteria. Overall, physical activity interventions moderately reduced fatigue (SMD = 0.54, p < 0.0001). Interventions lasting 2-6 weeks demonstrated a larger effect on fatigue reduction (SMD = 0.86, p < 0.00001). Interventions with 18-24 sessions showed a large effect on fatigue reduction (SMD = 0.97, p < 0.00001). Aerobic cycling and combination training interventions had a large to moderate effect (SMD = 0.66, p = 0.0005; SMD = 0.60, p = 0.0010, respectively). No long-term effects were found during follow-up. Physical activity interventions moderately reduced fatigue among adults with chronic conditions. Duration, total sessions, and mode of physical activity were identified as key factors in intervention effectiveness. Further research is needed to explore the impact of physical activity interventions on fatigue.
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Affiliation(s)
- Ioulia Barakou
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, NE7 7XA, UK
| | - Kandianos Emmanouil Sakalidis
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumberland Building, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Ulric Sena Abonie
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumberland Building, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, NE7 7XA, UK
| | - Katie L Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Florentina Johanna Hettinga
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumberland Building, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
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Rabady S, Hoffmann K, Aigner M, Altenberger J, Brose M, Costa U, Denk-Linnert DM, Gruber S, Götzinger F, Helbok R, Hüfner K, Koczulla R, Kurz K, Lamprecht B, Leis S, Löffler J, Müller CA, Rittmannsberger H, Rommer PS, Sator P, Strenger V, Struhal W, Untersmayr E, Vonbank K, Wancata J, Weber T, Wendler M, Zwick RH. [S1 guidelines for the management of postviral conditions using the example of post-COVID-19]. Wien Klin Wochenschr 2023; 135:525-598. [PMID: 37555900 PMCID: PMC10504206 DOI: 10.1007/s00508-023-02242-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 08/10/2023]
Abstract
These S1 guidelines are an updated and expanded version of the S1 guidelines on long COVID differential diagnostic and management strategies. They summarize the state of knowledge on postviral conditions like long/post COVID at the time of writing. Due to the dynamic nature of knowledge development, they are intended to be "living guidelines". The focus is on practical applicability at the level of primary care, which is understood to be the appropriate place for initial access and for primary care and treatment. The guidelines provide recommendations on the course of treatment, differential diagnostics of the most common symptoms that can result from infections like with SARS-CoV-2, treatment options, patient management and care, reintegration and rehabilitation. The guidelines have been developed through an interdisciplinary and interprofessional process and provide recommendations on interfaces and possibilities for collaboration.
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Affiliation(s)
- Susanne Rabady
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich.
| | - Kathryn Hoffmann
- Leiterin der Abteilung Primary Care Medicine, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Martin Aigner
- Abteilung für Psychiatrie und psychotherapeutische Medizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich
| | - Johann Altenberger
- Pensionsversicherungsanstalt, Rehabilitationszentrum Großgmain, Salzburger Str. 520, 5084, Großgmain, Österreich
| | - Markus Brose
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich
| | - Ursula Costa
- Ergotherapie und Handlungswissenschaft, fhg - Zentrum für Gesundheitsberufe Tirol GmbH/fh, Innrain 98, 6020, Innsbruck, Österreich
| | - Doris-Maria Denk-Linnert
- Klinische Abteilung für Allgemeine Hals‑, Nasen- und Ohrenkrankheiten, Klin. Abteilung Phoniatrie-Logopädie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Samuel Gruber
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich
| | - Florian Götzinger
- Abteilung für Kinderheilkunde, Klinik Ottakring, Montleartstr. 37, 1160, Wien, Österreich
| | - Raimund Helbok
- Universitätsklinik für Neurologie, Johannes Kepler Universität Linz, Standort Neuromed Campus & Med Campus Kepler Universitätsklinikum GmbH, 4020, Linz, Österreich
| | - Katharina Hüfner
- Dep. für Psychiatrie, Psychotherapie, Psychosomatik und Medizinische Psychologie, Universitätsklinik für Psychiatrie II, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - Rembert Koczulla
- Fachbereich Medizin, Klinik für Pneumologie Marburg, Baldingerstr., 35035, Marburg, Deutschland
| | - Katharina Kurz
- Innere Medizin II, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - Bernd Lamprecht
- Universitätsklinik für Innere Medizin mit Schwerpunkt Pneumologie, Kepler Universitätsklinikum, 4020, Linz, Österreich
| | - Stefan Leis
- Universitätsklinik für Neurologie der PMU, MME Universitätsklinikum Salzburg Christian-Doppler-Klinik, Ignaz-Harrer-Str. 79, 5020, Salzburg, Österreich
| | - Judith Löffler
- Innere Medizin II, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - Christian A Müller
- Klinische Abteilung für Allgemeine Hals‑, Nasen- und Ohrenkrankheiten, Klin. Abteilung für Allgemeine HNO, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | | | - Paulus S Rommer
- Universitätsklinik für Neurologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Paul Sator
- Dermatologische Abteilung, Klinik Hietzing, Wolkersbergenstr. 1, 1130, Wien, Österreich
| | - Volker Strenger
- Klinische Abteilung für Allgemeinpädiatrie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, 8036, Graz, Österreich
| | - Walter Struhal
- Klinische Abteilung für Neurologie, Universitätsklinikum Tulln, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Alter Ziegelweg 10, 3430, Tulln an der Donau, Österreich
| | - Eva Untersmayr
- Institut für Pathophysiologie und Allergieforschung Zentrum für Pathophysiologie, Infektiologie und Immunologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Karin Vonbank
- Klinische Abteilung für Pulmologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Johannes Wancata
- Klinische Abteilung für Sozialpsychiatrie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Thomas Weber
- Kardiologische Abteilung Klinikum Wels-Grieskirchen, Grieskirchnerstr. 42, 4600, Wels, Österreich
| | | | - Ralf-Harun Zwick
- Ludwig Boltzmann Institute for Rehabilitation Research, Kurbadstr. 14, 1100, Wien, Österreich
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Sakalidis KE, Menting SGP, Hettinga FJ. The Role of Cognition and Social Factors in Competition: How Do People with Intellectual Disabilities Respond to Opponents? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2670. [PMID: 36768036 PMCID: PMC9914994 DOI: 10.3390/ijerph20032670] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Exploring pacing behaviour in people with intellectual disabilities (ID) in competition will help to better understand the impact of cognition and social environment in sports, providing support for the shaping of proper inclusive sports environments. The present experimental study aimed to (1) compare the pacing behaviour and performance between people with and without ID who are inexperienced in cycling and (2) investigate how these are influenced by an opponent. Participants with (n = 8) and without ID (n = 10) performed two randomised 4-km maximal cycling trials, alone and against an opponent. Non-parametric tests for repeated measures data (p ≤ 0.05) revealed that people with ID cycled slower, but with higher inter-individual variation (both conditions) and paced themselves differently compared to people without ID when competing against an opponent. In contrast to the previous literature in athletes without ID, the presence of a faster opponent resulted in a decrease in the performance in the participants with ID. The negative influence of the opponent highlights the potential difficulties people with ID experience to adequately use their opponents to enhance their self-regulatory processes and optimize their pacing and performance in maximal exercise trials. Coaches who want to offer inclusive sports environments for people with ID could take these findings into consideration.
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Affiliation(s)
- Kandianos Emmanouil Sakalidis
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Stein Gerrit Paul Menting
- Department of Human Movement Sciences, University Medical Centre Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
| | - Florentina Johanna Hettinga
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
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8
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Antcliff D, Keenan AM, Keeley P, Woby S, McGowan L. Testing a newly developed activity pacing framework for chronic pain/fatigue: a feasibility study. BMJ Open 2021; 11:e045398. [PMID: 34880007 PMCID: PMC8655535 DOI: 10.1136/bmjopen-2020-045398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To test the feasibility of using a new activity pacing framework to standardise healthcare professionals' instructions of pacing, and explore whether measures of activity pacing/symptoms detected changes following treatment. DESIGN Single-arm, repeated measures study. SETTING One National Health Service (NHS) Pain Service in Northern England, UK. PARTICIPANTS Adult patients with chronic pain/fatigue, including chronic low back pain, chronic widespread pain, fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis. INTERVENTIONS Six-week rehabilitation programme, standardised using the activity pacing framework. OUTCOME MEASURES Feasibility was explored via patients' recruitment/attrition rates, adherence and satisfaction, and healthcare professionals' fidelity. Questionnaire data were collected from patients at the start and end of the programme (T1 and T2, respectively) and 3 months' follow-up (T3). Questionnaires included measures of activity pacing, current/usual pain, physical/mental fatigue, depression, anxiety, self-efficacy, avoidance, physical/mental function and quality of life. Mean changes in activity pacing and symptoms between T1-T2, T2-T3 and T1-T3 were estimated. RESULTS Of the 139 eligible patients, 107 patients consented (recruitment rate=77%); 65 patients completed T2 (T1-T2 attrition rate=39%), and 52 patients completed T3 (T1-T3 attrition rate=51%). At T2, patients' satisfaction ratings averaged 9/10, and 89% attended ≥5 rehabilitation programme sessions. Activity pacing and all symptoms improved between T1 and T2, with smaller improvements maintained at T3. CONCLUSION The activity pacing framework was feasible to implement and patients' ability to pace and manage their symptoms improved. Future work will employ a suitable comparison group and test the framework across wider settings to explore the effects of activity pacing in a randomised controlled trial. TRIAL REGISTRATION NUMBER NCT03497585.
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Affiliation(s)
- Deborah Antcliff
- Department of Physiotherapy, Fairfield General Hospital, Northern Care Alliance NHS Group, Bury, UK
- School of Healthcare, University of Leeds, Leeds, UK
| | - Anne-Maree Keenan
- School of Healthcare, University of Leeds, Leeds, UK
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Philip Keeley
- School of Nursing and Midwifery, Keele University, Staffordshire, UK
| | - Steve Woby
- Department of Research and Innovation, Northern Care Alliance NHS Group, Salford, UK
- School of Health and Society, University of Salford, Salford, UK
| | - Linda McGowan
- School of Healthcare, University of Leeds, Leeds, UK
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9
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Abonie US, Saxton J, Baker K, Hettinga FJ. Objectively-assessed physical activity and self-reported activity pacing in adults with multiple sclerosis: A pilot study. Clin Rehabil 2021; 35:1781-1788. [PMID: 34132109 PMCID: PMC8552369 DOI: 10.1177/02692155211024135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the association between self-reported activity pacing (a strategy to manage fatigue symptoms) and objectively-measured physical activity behaviours in adults with multiple sclerosis. DESIGN Single cross-sectional study. SETTING Multiple sclerosis rehabilitation centre in Colchester, United Kingdom. SUBJECTS Twenty-one adults (59 ± 9 years) with multiple sclerosis. MAIN MEASURES Physical activity behaviours (activity level: activity counts per minute; activity variability: highest activity counts per minute each day divided by activity counts per minute on that day) were measured with accelerometers. Self-reported activity pacing (Activity Pacing and Risk of Overactivity Questionnaire), fatigue severity (Fatigue Severity Scale) and health-related quality of life (RAND-12-Item Short-Form Health Survey) were measured. Scatter plots were used to explore associations between measures. RESULTS Activity level was 258 ± 133 counts per minutes, activity variability was 4 ± 1, self-reported activity pacing was 3 ± 1, fatigue severity was 5 ± 2 and health-related quality of life was 43 ± 8. Increased self-reported activity pacing was associated with lower activity levels and less variability in daily activities. CONCLUSION This investigation suggests that people with multiple sclerosis who have low physical activity levels could be inappropriately using activity pacing as a reactionary response to their multiple sclerosis symptoms.
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Affiliation(s)
- Ulric S Abonie
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ghana
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester, UK
| | - John Saxton
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Katherine Baker
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Florentina J Hettinga
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester, UK
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
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10
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Rabady S, Altenberger J, Brose M, Denk-Linnert DM, Fertl E, Götzinger F, de la Cruz Gomez Pellin M, Hofbaur B, Hoffmann K, Hoffmann-Dorninger R, Koczulla R, Lammel O, Lamprecht B, Löffler-Ragg J, Müller CA, Poggenburg S, Rittmannsberger H, Sator P, Strenger V, Vonbank K, Wancata J, Weber T, Weber J, Weiss G, Wendler M, Zwick RH. [Guideline S1: Long COVID: Diagnostics and treatment strategies]. Wien Klin Wochenschr 2021; 133:237-278. [PMID: 34851455 PMCID: PMC8633909 DOI: 10.1007/s00508-021-01974-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 02/07/2023]
Abstract
This guideline comprises the state of science at the time of the editorial deadline. In view of the high turnover of knowledge the guideline is designed as a living guideline. The main objective was to provide a tool for the use in primary care, being considered well suited as a first point of entry and for the provision of care. The guideline gives recommendations on the differential diagnosis of symptoms following SARS-CoV‑2 infection, on their therapeutic options, as well as for guidance and care of the patients concerned. It also offers advice concerning return to daily life and rehabilitation. Long COVID being a very variable condition, we chose an interdisciplinary approach.
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Affiliation(s)
- Susanne Rabady
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.
| | - Johann Altenberger
- Pensionsversicherungsanstalt, Rehabilitationszentrum Großgmain, Großgmain, Österreich
| | - Markus Brose
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich
| | - Doris-Maria Denk-Linnert
- Klinische Abteilung Phoniatrie-Logopädie, Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Wien, Österreich
| | - Elisabeth Fertl
- Neurologische Abteilung, Klinik Landstraße, Wiener Gesundheitsverbund, Wien, Österreich
| | - Florian Götzinger
- Abteilung für Kinder- und Jugendheilkunde, Klinik Ottakring, Wiener Gesundheitsverbund, Wien, Österreich
| | - Maria de la Cruz Gomez Pellin
- Unit Versorgungsforschung in der Primärversorgung, Zentrum für Public Health, Medizinische Universität Wien, Wien, Österreich
| | | | - Kathryn Hoffmann
- Unit Health Services Research and Telemedicine in Primary Care, Department of Preventive- and Social Medicine, Center for Public Health, Medical University of Vienna, Wien, Österreich
| | | | - Rembert Koczulla
- Abteilung für Pneumologische Rehabilitation, Philipps Universität Marburg, Marburg, Deutschland
| | - Oliver Lammel
- Praxis Dr Oliver Lammel, Ramsau am Dachstein, Österreich
| | - Bernd Lamprecht
- Klinik für Lungenheilkunde, Kepler Universitätsklinikum, Linz, Österreich
| | | | - Christian A Müller
- Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Wien, Österreich
| | | | - Hans Rittmannsberger
- Abteilung Psychiatrie und Psychotherapie, Pyhrn-Eisenwurzen-Klinikum, Steyr, Österreich
| | - Paul Sator
- Dermatologische Abteilung, Klinik Hietzing, Wiener Gesundheitsverbund, Wien, Österreich
| | - Volker Strenger
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Karin Vonbank
- Klinische Abteilung für Pulmologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Wien, Österreich
| | - Johannes Wancata
- Klinische Abteilung für Sozialpsychiatrie, Medizinische Universität Wien, Wien, Österreich
| | - Thomas Weber
- Abteilung für Innere Medizin 2 (Kardiologie, Intensivmedizin), Klinikum Wels-Grieskirchen, Wels, Österreich
| | - Jörg Weber
- Klinikum Klagenfurt, Feschnigstraße 11, 9020, Klagenfurt, Österreich
| | - Günter Weiss
- Univ.-Klinik für Innere Medizin II, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Maria Wendler
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich
| | - Ralf-Harun Zwick
- Ambulante internistische Rehabilitation, Therme Wien Med, Wien, Österreich
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11
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Abonie US, Seves BL, Hoekstra F, Hoekstra T, van der Woude LH, Dekker R, Hettinga FJ. Assessment of Activity Pacing in Relation to Physical Activity and Health-Related Quality of Life in Adults with Multiple Sclerosis: A Foundation for Further Intervention Development. Int J MS Care 2021; 23:207-212. [PMID: 34720760 PMCID: PMC8550481 DOI: 10.7224/1537-2073.2020-047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Activity pacing is a behavioral strategy for coping with fatigue, optimizing physical activity (PA) levels, and achieving a paced approach to lifestyle and sustainable self-regulated exercise practice to optimize health and well-being. Yet little is known about how activity pacing affects PA and health-related quality of life (HRQOL) while controlling for fatigue and demographic characteristics over time in adults with multiple sclerosis (MS). This study examined the natural use of activity pacing and how it is associated with PA and HRQOL over time in adults with MS. METHODS Sixty-eight adults with MS (mean ± SD age, 45.2 ± 10.9 years) completed questionnaires on their activity pacing, fatigue, PA, and HRQOL 14, 33, and 52 weeks after rehabilitation. Associations between the variables were examined using multilevel models. RESULTS No associations were found between activity pacing and PA (β = -0.01, P = .89) or between activity pacing and HRQOL (β = -0.15, P = .09). CONCLUSIONS This study provides an initial understanding of how activity pacing relates to PA and HRQOL in people with MS over time and indicates that there is no clear strategy among adults with MS that is successful in improving PA and HRQOL in the short or long term. Persons with MS may benefit from goal-directed activity pacing interventions to improve longitudinal engagement in PA, and the present study provides a foundation for further intervention development.
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Affiliation(s)
- Ulric S. Abonie
- From the Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Ghana (USA)
- School of Sport, Rehabilitation, and Exercise Science, University of Essex, Colchester, UK (USA)
| | - Bregje L. Seves
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Femke Hoekstra
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Rehabilitation (FH, LHVvdW, RD), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Trynke Hoekstra
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Health Sciences and Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands (TH)
| | - Lucas H.V. van der Woude
- Center for Human Movement Sciences (BLS, FH, TH, LHVvdW), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Rehabilitation (FH, LHVvdW, RD), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rienk Dekker
- Department of Rehabilitation (FH, LHVvdW, RD), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Florentina J. Hettinga
- Department of Sport, Exercise, and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK (FJH)
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12
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Xu H. SCIENTIFIC PHYSICAL TRAINING ON THE CLINICAL RECOVERY OF CHRONIC FATIGUE INJURY. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127082021_0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Chronic fatigue syndrome is also called chronic fatigue and immune dysfunction syndrome. This disease has now become a common disease in modern medicine. Objective: To explore and analyze the effect of exercise therapy on chronic fatigue syndrome. Methods: We selected 70 patients with chronic fatigue syndrome for the experiment. The exercise group performed gradual exercise, and the control group was inactive. Results: Appropriate and regular exercise can achieve ideal results in the treatment of chronic fatigue syndrome. Conclusion: Studying methods to prevent and recover from fatigue syndrome will help in understanding and focusing attention on the topic of fatigue, as well as being aware of the methods of self-prevention of fatigue syndrome. Level of evidence II; Therapeutic studies - investigation of treatment results.
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13
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Solvang PK, Heiaas I, Romsland G, Søberg HL. The unexpected other: Challenges and strategies after acquired impairment. Health (London) 2021; 27:345-361. [PMID: 34075795 DOI: 10.1177/13634593211021482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
People experiencing traumatic brain injury or multitrauma will often live with problems in functioning for a profound period in life. A situation of great complexity emerges involving both the experience of an impaired body and the experience of a changed social position. This article addresses the intricate relations between the altered body, personal ambitions, and social surroundings in the first 2-3 years after an injury. The conceptual framework centers around the process of change, applying concepts such as the unexpected other and biographical reconstruction. Twenty-one people of working age were interviewed two times. All interviewees had experienced traumatic brain injury or multitrauma. A thematic narrative analysis was applied. Consequences of the injury took place at a carnal level where fatigue is something completely different from becoming exhausted and where elimination of body waste takes place through practices novel to the injured person. Living with impairment also took place at the level of social interaction. Here, family relations, shame, and establishing a new identity seemed profoundly important. This article makes two novel contributions. First, it emphasizes more than previous studies do that the daily management of altered body functions is more important for independence and wellbeing. Second, the article identifies the narrative about the accident as an important issue for injured people to settle.
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Affiliation(s)
| | - Ida Heiaas
- Oslo Metropolitan University, Norway.,Norwegian Women's Public Health Association, Norway
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14
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Antcliff D, Keenan AM, Keeley P, Woby S, McGowan L. "Pacing does help you get your life back": The acceptability of a newly developed activity pacing framework for chronic pain/fatigue. Musculoskeletal Care 2021; 20:99-110. [PMID: 33955642 DOI: 10.1002/msc.1557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We have developed and feasibility tested an activity pacing framework for clinicians to standardise their recommendations of activity pacing to patients with chronic pain/fatigue. This study aimed to explore the acceptability and fidelity to this framework in preparation for a future trial of activity pacing. DESIGN Acceptability and fidelity were explored using semi-structured interviews. Data were analysed using framework analysis. PARTICIPANTS Patients who attended a rehabilitation programme for chronic pain/fatigue underpinned by the framework, and clinicians (physiotherapists and psychological wellbeing practitioners) who led the programmes. RESULTS Seventeen interviews were conducted, involving 12 patients with chronic pain/fatigue and five clinicians. The framework analysis revealed four deductive themes: (1) Acceptability of the activity pacing framework, (2) Acceptability of the feasibility study methods, (3) Processes of change and (4) Barriers and facilitators to activity pacing; and one inductive theme: (5) Perspectives of patients and clinicians. CONCLUSIONS The activity pacing framework appeared acceptable to patients and clinicians, and adherence to the framework was demonstrated. Processes of behaviour change included patients' regulation of activities through activity pacing. Barriers to pacing included work/social commitments and facilitators included identifying the benefits of pacing on symptoms. Different perspectives emerged between clinicians and patients regarding interpretations of symptom-contingent and quota-contingent strategies. The framework recognises fluctuations in symptoms of chronic pain/fatigue and encourages a quota-contingent approach with flexibility. Future work will develop a patient friendly guide ahead of a clinical trial to explore the effects of pacing.
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Affiliation(s)
- Deborah Antcliff
- Physiotherapy Department, Bury Care Organisation, Northern Care Alliance NHS Group, Bury, England, UK.,School of Healthcare, University of Leeds, Leeds, England, UK
| | - Anne-Maree Keenan
- School of Healthcare, University of Leeds, Leeds, England, UK.,NIHR Leeds Biomedical Research Centre, Leeds, England, UK
| | - Philip Keeley
- School of Nursing and Midwifery, Keele University, Keele, England, UK
| | - Steve Woby
- Research and Innovation Department, Northern Care Alliance NHS Group, Salford, England, UK.,School of Health and Society, University of Salford, Salford, England, UK.,Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, England, UK
| | - Linda McGowan
- School of Healthcare, University of Leeds, Leeds, England, UK
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15
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Edwards AM, Abonie US, Hettinga FJ, Pyne DB, Oh TM, Polman RCJ. Practical and Clinical Approaches Using Pacing to Improve Selfregulation in Special Populations such as Children and People with Mental Health or Learning Disabilities. JOURNAL OF REHABILITATION MEDICINE - CLINICAL COMMUNICATIONS 2021; 4:1000058. [PMID: 33968335 PMCID: PMC8101060 DOI: 10.2340/20030711-1000058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 11/16/2022]
Abstract
For special populations such as people with a mental health issue or learning disability, a disconnect between the ability to accurately monitor and regulate exercise behaviour can lead to reduced levels of physical activity, which, in turn, is associated with additional physical or mental health problems. Activity pacing is a strategy used in clinical settings to address issues of pain amelioration, while self-pacing research is now well addressed in sport and exercise science literature. It has been proposed recently that these overlapping areas of investigation collectively support the development of self-regulatory, lifestyle exercise skills across broad population groups. Activity pacing appears to have substantial application in numerous development and rehabilitation settings and, therefore, the purpose of this short communication is to articulate how an activity pacing approach could be utilized among population groups in whom self-regulatory skills may require development. This paper provides specific examples of exercise practice across 2 discrete populations: children, and people with mental health and learning difficulties. In these cases, homeostatic regulatory processes may either be altered, or the individual may require extrinsic support to appropriately self-regulate exercise performance. A support-based exercise environment or approach such as programmatic activity (lifestyle) pacing would be beneficial to facilitate supervised and education-based self-regulation until such time as fully self-regulated exercise is feasible.
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Affiliation(s)
- Andrew M Edwards
- School of Psychology & Life Sciences, Canterbury Christ Church University, Canterbury, UK!
| | - Ulric S Abonie
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Volta Region, Ghana
| | - Florentina J Hettinga
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - David B Pyne
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, Australia
| | - Tomasina M Oh
- Faculty of Health: Medicine, Dentistry & Human Sciences, University of Plymouth, Plymouth, UK
| | - Remco C J Polman
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
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16
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Abonie US, Hettinga FJ. Effect of a Tailored Activity Pacing Intervention on Fatigue and Physical Activity Behaviours in Adults with Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E17. [PMID: 33375123 PMCID: PMC7792946 DOI: 10.3390/ijerph18010017] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
Tailored activity pacing could help manage fatigue and improve physical activity. However, little is known about how to tailor activity pacing for people with multiple sclerosis. This study aims to evaluate the effect of a tailored activity pacing intervention on fatigue and physical activity behaviours in adults with multiple sclerosis. Twenty-one adults with multiple sclerosis, stratified by age and gender, are randomly allocated to either a tailored pacing or control group. Participants wear an accelerometer for seven days that measures physical activity behaviours, and self-report fatigue at the baseline and four-week follow-up. Physical activity behaviours are assessed by examining activity level (seven-day average activity counts per minute) and activity variability (seven-day average highest activity counts each day divided by activity counts on that day). The intervention improves activity levels (Mean difference = 40.91; 95% Confidence Interval [CI] (3.84-77.96); p = 0.03) and lessens activity variability (Mean difference = -0.63; 95% CI (-1.25-0.02); p = 0.04). No significant effect is found for fatigue (Mean difference = -0.36; 95% CI (-1.02-0.30); p = 0.27). This investigation shows that tailoring activity pacing based on physical activity behaviours and fatigue is effective in improving physical activity levels, without exacerbating fatigue symptoms.
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Affiliation(s)
- Ulric S. Abonie
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Volta Region PMB 31, Ghana;
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
| | - Florentina J. Hettinga
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
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17
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Seves BL, Hoekstra F, Schoenmakers JW, Brandenbarg P, Hoekstra T, Hettinga FJ, Dekker R, van der Woude LH, van der Schans CP. Test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities. J Sports Sci 2020; 39:875-886. [DOI: 10.1080/02640414.2020.1850983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Bregje L. Seves
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - Femke Hoekstra
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Jorrit W.A. Schoenmakers
- University of Groningen, University Medical Center Groningen, Department of Orthopedics, Groningen, The Netherlands
| | - Pim Brandenbarg
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Trynke Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Lucas H.V. van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise & Health Sciences, Loughborough University, UK
| | - Cees P. van der Schans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
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18
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Albergoni A, Hettinga FJ, Stut W, Sartor F. Factors Influencing Walking and Exercise Adherence in Healthy Older Adults Using Monitoring and Interfacing Technology: Preliminary Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6142. [PMID: 32846988 PMCID: PMC7503601 DOI: 10.3390/ijerph17176142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Monitoring and interfacing technologies may increase physical activity (PA) program adherence in older adults, but they should account for aspects influencing older adults' PA behavior. This study aimed at gathering preliminary wrist-based PA adherence data in free-living and relate these to the influencing factors. METHODS Ten healthy older adults (4 females, aged 70-78 years) provided health, fatigue, activity levels, attitude towards pacing, and self-efficacy information and performed a 6 min-walk test to assess their fitness. After a baseline week they followed a two-week walking and exercise intervention. Participants saw their progress via a purposely designed mobile application. RESULTS Walking and exercise adherence did not increase during the intervention (p = 0.38, p = 0.65). Self-efficacy decreased (p = 0.024). The baseline physical component of the Short Form Health Survey was the most predictive variable of walking adherence. Baseline perceived risk of over-activity and resting heart rate (HRrest) were the most predictive variables of exercise adherence. When the latter two were used to cluster participants according to their exercise adherence, the fitness gap between exercise-adherent and non-adherent increased after the intervention (p = 0.004). CONCLUSIONS Risk of over-activity and HRrest profiled short-term exercise adherence in older adults. If confirmed in a larger and longer study, these could personalize interventions aimed at increasing adherence.
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Affiliation(s)
- Andrea Albergoni
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Centro Polifunzionale di Scienze Motorie, University of Genoa, 16132 Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, 16148 Genoa, Italy
- Department of Patient Care and Measurements, Philips Research, 5656AE Eindhoven, The Netherlands
| | - Florentina J. Hettinga
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle NE1 8ST, UK
| | - Wim Stut
- Department of Chronic Disease Management, Philips Research, 5656AE Eindhoven, The Netherlands;
| | - Francesco Sartor
- Department of Patient Care and Measurements, Philips Research, 5656AE Eindhoven, The Netherlands
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
- College of Health and Behavioural Science, Bangor University, Bangor LL57 2EF, UK
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19
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Abonie US, Hoekstra F, Seves BL, van der Woude LHV, Dekker R, Hettinga FJ. Associations between Activity Pacing, Fatigue, and Physical Activity in Adults with Multiple Sclerosis: A Cross Sectional Study. J Funct Morphol Kinesiol 2020; 5:jfmk5020043. [PMID: 33467259 PMCID: PMC7739300 DOI: 10.3390/jfmk5020043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 01/09/2023] Open
Abstract
Fatigue is common in people with multiple sclerosis (MS). Activity pacing is a behavioral way to cope with fatigue and limited energy resources. However, little is known about how people with MS naturally pace activities to manage their fatigue and optimize daily activities. This study explored how activity pacing relates to fatigue and physical activity in people with MS. Participants were 80 individuals (60 females, 20 males) with a diagnosis of MS. The participants filled in questionnaires on their activity pacing, fatigue, physical activity, and health-related quality of life, 3-6 weeks before discharge from rehabilitation. The relationships between the variables were examined using hierarchical regression. After controlling for demographics, health-related quality of life, and perceived risk of overactivity, no associations were found between activity pacing and fatigue (β = 0.20; t = 1.43, p = 0.16) or between activity pacing and physical activity (β = -0.24; t = -1.61, p = 0.12). The lack of significant associations between activity pacing and fatigue or physical activity suggests that without interventions, there appears to be no clear strategy amongst people with MS to manage fatigue and improve physical activity. People with MS may benefit from interventions to manage fatigue and optimize engagement in physical activity.
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Affiliation(s)
- Ulric S. Abonie
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho PMB 31 Volta Region, Ghana;
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, Essex, UK
| | - Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, PO Box 72, 9700 AB Groningen, The Netherlands; (F.H.); (B.L.S.); (L.H.V.v.d.W.)
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, PO Box 72, 9700 AB Groningen, The Netherlands;
| | - Bregje L. Seves
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, PO Box 72, 9700 AB Groningen, The Netherlands; (F.H.); (B.L.S.); (L.H.V.v.d.W.)
| | - Lucas H. V. van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, PO Box 72, 9700 AB Groningen, The Netherlands; (F.H.); (B.L.S.); (L.H.V.v.d.W.)
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, PO Box 72, 9700 AB Groningen, The Netherlands;
| | - Rienk Dekker
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, PO Box 72, 9700 AB Groningen, The Netherlands;
| | - Florentina J. Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne NE1 8SB, UK
- Correspondence: ; Tel.: +44-77-648-853-76
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