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Uemura K, Kamitani T, Watanabe A, Okamoto H, Saho K, Yamada M. Active Learning Through Video Conferencing to Maintain Physical Activity Among Older Adults: A Pilot Randomized Controlled Trial. J Aging Phys Act 2024:1-9. [PMID: 38830609 DOI: 10.1123/japa.2023-0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/12/2024] [Accepted: 04/27/2024] [Indexed: 06/05/2024]
Abstract
This randomized pilot trial investigated the feasibility of an active learning physical activity intervention through video conferencing and its preliminary effects. Participants comprised community-dwelling older adults who could use e-mail. The intervention group underwent a 12-week active learning intervention via video conferencing to promote a healthy lifestyle, particularly physical activity. The control group received information via e-mail once per week. The amount of physical activity and sedentary behavior was measured using an accelerometer at baseline, postintervention, and 24-week postintervention (36 weeks). Of the 31 participants, 29 were eligible and randomized into two groups (15 for the intervention and 14 for the control). Adherence to the intervention was 83%-100% (mean, 97%). Compared with the control group, the intervention group showed moderate maintenance effects on total physical activity and sedentary behavior at 36 weeks. Active learning physical activity intervention through video conferencing was found to be feasible and contributed to the prevention of physical activity decline in older adults.
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Affiliation(s)
- Kazuki Uemura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino-City, Japan
| | - Tsukasa Kamitani
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Atsuya Watanabe
- Faculty of Engineering, Center for Liberal Arts and Sciences, Toyama Prefectural University, Imizu, Japan
| | - Hiroshi Okamoto
- Faculty of Engineering, Center for Liberal Arts and Sciences, Toyama Prefectural University, Imizu, Japan
| | - Kenshi Saho
- Department of Electronic and Computer Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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Lorenzo-Villarreal D, Monforte J, Úbeda-Colomer J, Albiñana N, Pérez-Samaniego V. "I needed something to hook me." A narrative study on adherence to Pilates. J Bodyw Mov Ther 2024; 38:534-540. [PMID: 38763604 DOI: 10.1016/j.jbmt.2024.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/18/2023] [Accepted: 03/15/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Exercise adherence is necessary for achieving long-term benefits. Along with other elements, stories and narratives can play a role in understanding and promoting adherence. The aim of the present study was to explore how stories and narratives may affect adherence to Pilates. METHOD 8 Pilates practitioners who had been participating in a Pilates program for 6 or more years were interviewed. Data obtained were analysed using thematic narrative analysis, (focusing on the whats of stories) and holistic narrative analysis (examining how narratives acted on adherence). RESULTS AND DISCUSSION Results highlight pain, Pilates as a health-related method, and the social relations as characters, plots and scenarios of stories enhancing long-term participation in Pilates. Exercise is medicine and eudaimonic well-being are presented as narratives articulating the coherence to practitioners' adherence. They act for participants subjectivizing their Pilates practice into a serious commitment to health. CONCLUSION Stories and narratives are relevant to give meaning and sense to the adherence to Pilates. A focus on stories can be added as a strategy to promote adherence to Pilates.
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Ambrens M, Macniven R, Perram A, Andrews S, Hawley-Hague H, Razee H, Todd C, Valenzuela T, Delbaere K. How Perceptions of Aging Influence Physical Activity and Exercise in Older Age: Exploring the Behavior of People Aged 70+ Years Engaged in Fall Prevention Activities. J Appl Gerontol 2024:7334648241238315. [PMID: 38475694 DOI: 10.1177/07334648241238315] [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: 03/14/2024] Open
Abstract
For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity and reducing falls. Nested within a randomized controlled trial, this study reports on the factors influencing the physical activity behavior of people, aged between 70 and 90 years, engaged in StandingTall, a home-based balance exercise program proven to reduce falls in the community. The perception of aging, physical activity in older age, and the delivery of exercise were identified as major themes, with the perception of aging an overarching theme influencing both preferences for physical activity in older age and exercise delivery. Findings demonstrate the importance of considering the role of aging, the influence aging has on physical activity and exercise behavior, and how aging influences the delivery and design of exercise programs including falls prevention activities for older people.
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Affiliation(s)
- Meghan Ambrens
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Amy Perram
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Sophie Andrews
- Neuroscience Research Australia, Randwick, NSW, Australia
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
- School of Psychology, UNSW, Sydney, NSW, Australia
| | - Helen Hawley-Hague
- School of Health Sciences, The University of Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, The University of Manchester, UK
| | - Husna Razee
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Chris Todd
- School of Health Sciences, The University of Manchester, Manchester, UK
- Manchester Institute for Collaborative Research on Ageing, The University of Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Trinidad Valenzuela
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences Universidad Andres Bello, Santiago, Chile
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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Letton ME, Macdonald ER, Thom JM, Ward RE. Classical Ballet for Women Aged Over 50 Years: Investigating Balance, Strength, and Range of Motion. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:171-182. [PMID: 37036402 DOI: 10.1080/02701367.2023.2169236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 01/11/2023] [Indexed: 06/19/2023]
Abstract
Background: Regular exercise can mitigate the loss of strength, balance, and flexibility that contribute to age-related decline in physical function and mobility. However, traditional exercise interventions often report poor adherence rates. There is growing interest in classical ballet as an enjoyable exercise modality for adults in middle to late age. Classical ballet requires muscular strength, coordination, and flexibility. The current study investigated a classical ballet intervention on the balance, physical function, and range of motion of women aged over 50 years. Methods: Twenty-two healthy female participants (aged 56.2 (4.5) years (mean (SD)) completed a 10-week ballet intervention. Results: This single-arm study showed significant improvements (p<.05) in lower limb strength (measured by 5 times sit-to-stand and forward leap) and high adherence rates (95% adherence for participants who completed the intervention). No adverse events were reported. Improvements in balance were reported in the left leg only (as measured by center of pressure ellipse area in the parallel retiré condition). Conclusions: These results allude to the positive effects of ballet training on strength and balance in adults aged 50 years and over. High adherence rates suggest that ballet training was enjoyed and may thus be a long-term exercise modality for this population. Although this study was a single-arm design, it suggests promising results for future research wishing to evaluate the effectiveness of classical ballet training using randomized controlled trial designs.
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Affiliation(s)
| | | | - Jeanette M Thom
- University of New South Wales
- Neuroscience Research Australia (NeuRA)
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Ikeda T, Toyama S, Harada T, Noma K, Hamada M, Kitagawa T. Effectiveness of prehabilitation during neoadjuvant therapy for patients with esophageal or gastroesophageal junction cancer: a systematic review. Esophagus 2024:10.1007/s10388-024-01049-9. [PMID: 38411724 DOI: 10.1007/s10388-024-01049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024]
Abstract
Progression of the physical weakness during neoadjuvant therapy (NAT) in patients with esophageal or gastroesophageal junction cancer is a serious problem; however, prehabilitation during NAT has the potential to overcome the unmet need. Nevertheless, systematic reviews on this topic have not been summarized. Therefore, this systematic review aimed to determine prehabilitation's effectiveness, acceptability, and safety during NAT for patients with esophageal or gastroesophageal junction cancer. An electronic search was performed in the MEDLINE, Web of Science, CENTRAL, CINAHL, and PEDro databases. A meta-analysis was conducted to assess the effectiveness of prehabilitation during NAT, along with a descriptive analysis of acceptance and safety. This study analyzed data from three randomized controlled trials (RCTs) and nine non-RCTs involving 664 patients. The meta-analysis of two RCTs demonstrated that prehabilitation during NAT may be more effective than usual care in enhancing tolerance to NAT and grip strength; moreover, one RCT and three non-RCTs revealed that prehabilitation may reduce the risk of postoperative complications. The adherence rates for exercise programs in two RCTs and seven non-RCTs were 55-76%. Additionally, two studies reported a 76% adherence rate for multimodal prehabilitation programs, including exercise, dietary, and psychological care. Six studies reported no serious prehabilitation-related adverse events during NAT. Prehabilitation during NAT may be a safe and beneficial intervention strategy for patients with esophageal or gastroesophageal junction cancer. However, the investigation of strategies to enhance adherence is essential. Furthermore, additional high-quality RCTs are needed to examine the effect of prehabilitation during NAT.
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Affiliation(s)
- Tomohiro Ikeda
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan.
| | - Shusuke Toyama
- Department of Rehabilitation, Tagami Hospital, 2-14-15 tagami, Nagasaki, Japan
| | - Tsuyoshi Harada
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwa, Chiba, Japan
- Department of Rehabilitation Medicine, Keio University Graduate School, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Kazuhiro Noma
- Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama, Japan
| | - Masanori Hamada
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan
| | - Takashi Kitagawa
- Department of Physical Therapy, School of Health Sciences, Shinshu University, 3‑1‑1 Asahi, Matsumoto, Nagano, Japan
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Osuka Y, Kojima N, Daimaru K, Ono R, Sugie M, Omura T, Motokawa K, Ueda T, Maruo K, Aoyama T, Inoue S, Sasai H. Effects of Radio-Taiso on Health-Related Quality of Life in Older Adults with Frailty: A Randomized Controlled Trial. J Epidemiol 2024:JE20230317. [PMID: 38403689 DOI: 10.2188/jea.je20230317] [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: 02/27/2024] Open
Abstract
BACKGROUND Radio-Taiso could be a sustainable public health strategy for maintaining quality of life (QoL) in older adults with frailty. This study aimed to investigate whether Radio-Taiso provided greater benefits for health-related quality of life (HR-QoL) and to identify the mechanisms underlying the effectiveness in this population. METHODS A 12-week randomized controlled trial enrolled 226 older Japanese adults with pre-frailty or frailty, assessed using the modified frailty phenotype. Participants were randomly allocated to the intervention (Radio-Taiso + nutrition program) or control (nutrition program) groups. The Radio-Taiso program comprised five 60-min group sessions and daily practice at the participants' homes. The primary outcome was the change in the mental domain of HR-QoL, assessed using the SF-36®. The secondary outcomes included six physical fitness items and exercise self-efficacy. RESULTS Overall, 104 and 105 participants in the intervention and control groups, respectively, were analyzed based on the intention-to-treat principle. The median (interquartile range) daily practice rate of Radio-Taiso was 94.1% (73.2-98.8%). Although general linear models adjusted for baseline values and allocation stratification factors showed that the intervention group obtained greater benefits (adjusted mean differences [95% confidence intervals]) in the up-and-go (0.3 [0.1, 0.6] s), 2-min step-in-place (-3.2 [-6.2, -0.2] steps) tests, and exercise self-efficacy scale (-1.4 [-2.6, -0.1] points) than the control group, there were no group differences in changes in the mental domain score of HR-QoL. CONCLUSIONS Radio-Taiso provided greater benefits for agility/dynamic balance, aerobic endurance, and exercise self-efficacy in older adults with frailty; however, these changes do not improve HR-QoL.
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology
| | - Kaori Daimaru
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology
| | - Risa Ono
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology
- Japan Radio-Taiso Federation
| | - Masamitsu Sugie
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology
| | - Takuya Omura
- Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology
- Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology
| | - Takuya Ueda
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology
| | - Kazushi Maruo
- Department of Biostatistics, Institute of Medicine, University of Tsukuba
| | | | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology
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Charters E, Loy J, Wu R, Cheng K, Dunn M, Davies S, Clark J. Pilot Study of Intensive Trismus Intervention Using Restorabite™ During Unilateral Adjuvant Radiation for Head and Neck Cancer. Dysphagia 2024:10.1007/s00455-024-10668-4. [PMID: 38366084 DOI: 10.1007/s00455-024-10668-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/02/2024] [Indexed: 02/18/2024]
Abstract
Trismus commonly arises after surgery for head and neck cancer (HNC) and its severity is potentiated by postoperative radiotherapy. While the benefit of trismus rehabilitation after surgery and radiotherapy is well established, the evidence during radiotherapy is less clear. This may be due to poor adherence to trismus exercises secondary to acute mucositis. This study assessed the feasibility of using a novel trismus device during adjuvant radiotherapy for HNC in patients with acute postoperative trismus. Prospective single-arm cohort feasibility study. Eligible patients had undergone surgery with curative intent for HNC, planned for adjuvant radiotherapy, and were suitable for trismus rehabilitation. Participants completed a 10-week exercise program using a novel jaw stretching device. Study outcomes were adherence, maximal incisal opening (MIO), and trismus-related function and quality of life scores, assessed at baseline, 10 weeks, and 6 months after commencing exercises. Nine patients diagnosed with trismus after primary surgery were recruited. The mean increase in MIO at 10 weeks was 7.8 mm (range -4 to 15 mm, p = 0.03), and at 6 months was 10.6 mm (range 1-26 mm, p = 0.03). Significant improvements were observed in trismus-related quality of life (Gothenburg Trismus Questionnaire; p = 0.04). Adherence to the exercises was 100% in week 1-2, 67% in weeks 3-6, and 100% at 10 weeks (1 month post radiation). This study demonstrates the feasibility of using a novel jaw stretching device during adjuvant radiotherapy. Further evaluation is warranted to assess the effectiveness of early intervention and prevention of trismus during HNC radiotherapy.Level of Evidence: IV.
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Affiliation(s)
- Emma Charters
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Sydney, NSW, 2050, Australia.
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Jamie Loy
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Sydney, NSW, 2050, Australia
| | - Raymond Wu
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Kai Cheng
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Sydney, NSW, 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, NSW, Australia
| | - Masako Dunn
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Sydney, NSW, 2050, Australia
| | - Sarah Davies
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Sydney, NSW, 2050, Australia
| | - Jonathan Clark
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Sydney, NSW, 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW, Australia
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H Fosstveit S, Lohne-Seiler H, Feron J, Lucas SJE, Ivarsson A, Berntsen S. The intensity paradox: A systematic review and meta-analysis of its impact on the cardiorespiratory fitness of older adults. Scand J Med Sci Sports 2024; 34:e14573. [PMID: 38389140 DOI: 10.1111/sms.14573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/24/2024]
Abstract
AIM The present systematic review and meta-analysis aimed to compare the effect of moderate- versus high-intensity aerobic exercise on cardiorespiratory fitness (CRF) in older adults, taking into account the volume of exercise completed. METHODS The databases MEDLINE (Ovid), EMBASE (Ovid), and CENTRAL (Cochrane Library) were searched to identify randomized controlled trials (RCTs). Two reviewers extracted data and assessed bias. Comprehensive Meta-Analysis software calculated overall effect size, intensity differences, and performed meta-regression analyses using pre-to-post intervention or change scores of peak oxygen uptake (V̇O2 peak). The review included 23 RCTs with 1332 older adults (intervention group: n = 932; control group: n = 400), divided into moderate-intensity (435 older adults) and high-intensity (476 older adults) groups. RESULTS Meta-regression analysis showed a moderate, but not significant, relationship between exercise intensity and improvements in V̇O2 peak after accounting for the completed exercise volume (β = 0.31, 95% CI = [-0.04; 0.67]). Additionally, studies comparing moderate- versus high-intensity revealed a small, but not significant, effect in favor of high-intensity (Hedges' g = 0.20, 95% CI = [-0.02; 0.41]). Finally, no significant differences in V̇O2 peak improvements were found across exercise groups employing various methods, modalities, and intensity monitoring strategies. CONCLUSION Findings challenge the notion that high-intensity exercise is inherently superior and indicate that regular aerobic exercise, irrespective of the specific approach and intensity, provides the primary benefits to CRF in older adults. Future RCTs should prioritize valid and reliable methodologies for monitoring and reporting exercise volume and adherence among older adults.
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Affiliation(s)
- Sindre H Fosstveit
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Hilde Lohne-Seiler
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Jack Feron
- School of Sport, Exercise and Rehabilitation Sciences and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Andreas Ivarsson
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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Goldschmidt S, Schmidt ME, Rosenberger F, Wiskemann J, Steindorf K. Patterns and influencing factors of exercise attendance of breast cancer patients during neoadjuvant chemotherapy. Support Care Cancer 2024; 32:79. [PMID: 38170301 PMCID: PMC10764381 DOI: 10.1007/s00520-023-08269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Performing 2-3 exercise sessions/week may relieve therapy-related side effects of breast cancer patients (BRCA) and improve their quality of life. However, attendance to the exercise sessions is often impaired. Thus, we investigated patterns and possible influencing factors of attendance to an aerobic (AT) or resistance training (RT) intervention in BRCA during neoadjuvant chemotherapy. METHODS BRCA (N = 122) were randomly allocated to supervised AT or RT twice weekly during neoadjuvant chemotherapy (18 ± 4 weeks). Attendance was calculated individually and group-wise per training week as the percentage of the performed sessions out of the prescribed sessions. Possible influencing factors were investigated using multiple regression analyses. RESULTS Mean individual attendance was 44.1% ± 29.3% with no significant differences between the groups. Group-wise attendance was highest in the first 6 weeks of training with ≥ 60% for AT and ≥ 50% for RT, but decreased over the course of the intervention accompanying chemotherapy. Significantly higher attendance was associated with not having vs. having nausea (ß = - 14.57; p = 0.007) and not having vs. having pain (ß = - 12.07; p = 0.12), whereas fatigue did not show any association (ß = - 0.006; p = 0.96). Having been randomized into a preferred intervention group (48.8%) showed no association with attendance. Yet, patients' rating of the exercise intervention as "good"/ "very good" (58.7%) was significantly associated with higher attendance (p = 0.01). CONCLUSION For both exercise interventions, group-wise attendance/training week decreased during chemotherapy despite good intervention ratings. While some patients never started, others trained almost constantly twice weekly. The study revealed that patients who are nauseous or experience pain may need more support to attend more exercise sessions. Trial Registration Clinicaltrials.gov: NCT02999074 from May 6, 2016.
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Affiliation(s)
- Siri Goldschmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT), Heidelberg, a partnership between DKFZ and University Medical Center, Heidelberg, Germany
- Medical Faculty of the University of Heidelberg, Heidelberg, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT), Heidelberg, a partnership between DKFZ and University Medical Center, Heidelberg, Germany
| | - Friederike Rosenberger
- Department of Medical Oncology, University Medical Center, and National Center for Tumor Diseases (NCT), Heidelberg, a partnership between DKFZ and University Medical Center, Heidelberg, Germany
| | - Joachim Wiskemann
- Department of Medical Oncology, University Medical Center, and National Center for Tumor Diseases (NCT), Heidelberg, a partnership between DKFZ and University Medical Center, Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT), Heidelberg, a partnership between DKFZ and University Medical Center, Heidelberg, Germany.
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Cristini J, Potvin-Desrochers A, Seo F, Dagher A, Postuma RB, Rosa-Neto P, Carrier J, Amara AW, Steib S, Paquette C, Roig M. The Effect of Different Types of Exercise on Sleep Quality and Architecture in Parkinson Disease: A Single-Blinded Randomized Clinical Trial Protocol. Phys Ther 2024; 104:pzad073. [PMID: 37354450 PMCID: PMC10776310 DOI: 10.1093/ptj/pzad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/17/2023] [Accepted: 05/18/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES The purpose of this trial is to (1) determine the best exercise modality to improve sleep quality and sleep architecture in people with Parkinson disease (PD); (2) investigate whether exercise-induced improvements in sleep mediate enhancements in motor and cognitive function as well as other non-motor symptoms of PD; and (3) explore if changes in systemic inflammation after exercise mediate improvements in sleep. METHODS This is a multi-site, superiority, single-blinded randomized controlled trial. One hundred fifty persons with PD and sleep problems will be recruited and randomly allocated into 4 intervention arms. Participants will be allocated into 12 weeks of either cardiovascular training, resistance training, multimodal training, or a waiting list control intervention. Assessments will be conducted at baseline, immediately after each intervention, and 8 weeks after each intervention by blinded assessors. Objective sleep quality and sleep architecture will be measured with polysomnography and electroencephalography. Motor and cognitive function will be assessed with the Unified PD Rating Scale and the Scale for Outcomes in PD-Cognition, respectively. Subjective sleep quality, fatigue, psychosocial functioning, and quality of life will be assessed with questionnaires. The concentration of inflammatory biomarkers in blood serum will be assessed with enzyme-linked immunosorbent assays. IMPACT This study will investigate the effect of different types of exercise on sleep quality and architecture in PD, exploring interactions between changes in sleep quality and architecture with motor and cognitive function and other non-motor symptoms of the disease as well as mechanistic interactions between systemic inflammation and sleep. The results will provide important practical information to guide physical therapists and other rehabilitation professionals in the selection of exercise and the design of more personalized exercise-based treatments aimed at optimizing sleep, motor, and cognitive function in people with PD.
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Affiliation(s)
- Jacopo Cristini
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, Québec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Québec, Canada
| | - Alexandra Potvin-Desrochers
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Québec, Canada
- Department of Kinesiology & Physical Education, McGill University, Montreal, Québec, Canada
- Human Brain Control of Locomotion Laboratory, McGill University, Montreal, Québec, Canada
| | - Freddie Seo
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, Québec, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Québec, Canada
| | - Alain Dagher
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal, Québec, Canada
| | - Ronald B Postuma
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal, Québec, Canada
| | - Pedro Rosa-Neto
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal, Québec, Canada
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Québec, Canada
| | - Julie Carrier
- Département de Psychologie, Université de Montréal, Montreal, Québec, Canada
- Centre d'Études Avancées en Médecine du Sommeil (CÉAMS), Hôpital du Sacré-Cœur de Montréal, Montreal, Québec, Canada
| | - Amy W Amara
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Simon Steib
- Department of Exercise, Training and Active Aging, Institute of Sport and Sport Science, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Caroline Paquette
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Québec, Canada
- Department of Kinesiology & Physical Education, McGill University, Montreal, Québec, Canada
- Human Brain Control of Locomotion Laboratory, McGill University, Montreal, Québec, Canada
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, Québec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Québec, Canada
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11
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Pérez-Maletzki J, Dominguez-Navarro F, Hernández-Guillen D, Roig-Casasús S, Blasco JM. Effectiveness of strategies to improve adherence to physical therapy in patients with knee and hip osteoarthritis: a systematic review and meta-analysis. Disabil Rehabil 2023:1-16. [PMID: 38059584 DOI: 10.1080/09638288.2023.2288678] [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: 04/25/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE To determine the effectiveness of current strategies oriented to increase adherence to physical therapy in subjects with knee and hip osteoarthritis (OA). MATERIAL AND METHODS A systematic review of electronic databases was conducted from inception until March 2023. Studies with experimental interventions using strategies to increase adherence to physical therapy programs in subjects with knee or hip OA were included. A meta-analysis compared the effects of such interventions with usual care for adherence-related measures (primary outcome), and functional and pain outcomes, using standardized mean differences (SMD) with a 95% confidence interval (CI). GRADE was used to determine the strength of the resultant evidence and the external validity of the findings. RESULTS Fifteen articles, assessing 1,818 participants, were included. The interventions included cognitive-behavior strategies, telephone calls, internet-based interventions, communication technologies, and booster sessions. A meta-analysis revealed that the experimental interventions increased adherence over usual care with a moderate effect size of SMD = 0.39 (95%CI = 0.08-0.71) and moderate certainty in this evidence. CONCLUSION Overall, this review supports that the strategies to promote adherence to physical therapy in individuals with knee and hip OA are effective. However, the positive impact on adherence rates does not always translate into improved clinical outcomes.
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Affiliation(s)
- José Pérez-Maletzki
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Faculty of Health Sciences, Universidad Europea de Valencia, València, Spain
| | - Fernando Dominguez-Navarro
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Faculty of Health Sciences, Universidad Europea de Valencia, València, Spain
| | - David Hernández-Guillen
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Departament de Fisioterapia. Facultad de Fisioterapia, Universitat de València, València, Spain
| | - Sergio Roig-Casasús
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Hospital Universitari i Politècnic La Fe de València, València, Spain
| | - José-María Blasco
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Departament de Fisioterapia. Facultad de Fisioterapia, Universitat de València, València, Spain
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12
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Teng B, Gomersall SR, Hatton AL, Khan A, Brauer SG. Predictors of real-world adherence to prescribed home exercise in older patients with a risk of falling: A prospective observational study. Aging Med (Milton) 2023; 6:361-369. [PMID: 38239715 PMCID: PMC10792326 DOI: 10.1002/agm2.12270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/22/2023] [Accepted: 08/27/2023] [Indexed: 01/22/2024] Open
Abstract
Objectives Using a multi-ethnic Asian population, this study assessed adherence to prescribed home exercise programs, explored factors predicting adherence, and evaluated whether home exercise adherence was associated with physical activity. Methods A prospective cohort study was conducted in 68 older adults (aged ≥65 years) from two geriatric outpatient clinics in Singapore, who were receiving tailored home exercises while undergoing 6 weeks of outpatient physical therapy for falls prevention. Adherence was measured as the percentage of prescribed sessions completed. Predictor variables included sociodemographic factors, clinical characteristics, intervention-specific factors, and physical and psychosocial measures. Multivariable linear regressions were performed to develop a model that best predicted adherence to prescribed exercise. Physical activity levels, measured by accelerometry, were analyzed by cross-sectional univariate analysis at 6 weeks. Results The mean adherence rate was 65% (SD 34.3%). In the regression model, the number of medications [B = 0.360, 95% CI (0.098-0.630)], social support for exercising [B = 0.080, 95% CI (0.015-0.145)], and self-efficacy for exercising [B = -0.034, 95% CI (-0.068-0.000)] significantly explained 31% (R 2 = 0.312) of the variance in exercise adherence. Older adults with better adherence took more steps/day at 6 weeks [B = 0.001, 95% CI (0.000-0.001)]. Conclusions Low adherence to home exercise programs among older adults in Singapore, emphasizing the need for improvement. Counterintuitively, older adults with more medications, lower exercise self-efficacy, but with greater social support demonstrated higher adherence. Addressing unmet social support needs is crucial for enhancing adherence rates and reducing fall risks.
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Affiliation(s)
- Bernadine Teng
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
- Health and Social Sciences clusterSingapore Institute of TechnologySingaporeSingapore
| | - Sjaan R. Gomersall
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Anna L. Hatton
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Sandra G. Brauer
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
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13
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Zilmer CK, Kristensen MT, Magnusson SP, Bährentz IB, Jensen TG, Zoffmann SØ, Palm H, Bieler T. Intensified acute in-hospital physiotherapy for patients after hip fracture surgery: a pragmatic, randomized, controlled feasibility trial. Disabil Rehabil 2023:1-10. [PMID: 38037849 DOI: 10.1080/09638288.2023.2288672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE Intensified acute in-hospital physiotherapy (IP) after hip fracture (HF) may enhance patient's ability to regain basic mobility at discharge. The primary objective was to assess the feasibility of IP. Secondary to estimate the effect of IP on regained basic mobility at discharge. MATERIALS AND METHODS In a pragmatic, randomized, unblinded feasibility trial, 60 patients (mean age 79 years, 41 women) with HF and an independent pre-fracture basic mobility level were randomized (2:1) to IP with two daily sessions on weekdays focusing on functional training and weight-bearing activities (n = 40) versus usual care (UC) physiotherapy once daily (n = 20). Feasibility outcomes included physiotherapy completion rates, reasons for non-successful completion, and adverse events. The primary effect outcome was recovery of basic mobility (Cumulated Ambulation Score (CAS)). RESULTS Eighty-two percent of the sessions in the IP group were successfully- or partially completed versus 94% of the sessions in the UC group. No adverse events occurred. The main reason for not completing physiotherapy was fatigue. At discharge (median 7 days), 50% in the IP group had regained their pre-fracture basic mobility level (CAS = 6) versus 16% in the UC group; odds ratio = 5.33, 95%CI [1.3;21.5]. CONCLUSIONS IP seems feasible for patients after HF surgery, and it may enhance recovery. Fatigue was the primary obstacle to completing IP.
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Affiliation(s)
- Camilla Kampp Zilmer
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Morten Tange Kristensen
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - S Peter Magnusson
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Orthopedic Surgery M, Institute of Sports Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Inger Birgitte Bährentz
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Thomas Giver Jensen
- Department of Orthopedic Surgery, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Signe Østergaard Zoffmann
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Henrik Palm
- Department of Orthopedic Surgery, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Theresa Bieler
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
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14
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Gu X, Shen X, Chu JH, Fang TT, Jiang L. Frailty, Illness Perception and Lung Functional Exercise Adherence in Lung Cancer Patients After Thoracoscopic Surgery. Patient Prefer Adherence 2023; 17:2773-2787. [PMID: 37936716 PMCID: PMC10627072 DOI: 10.2147/ppa.s435944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023] Open
Abstract
Background Lung cancer patients will have lung damage after surgery, need rehabilitation exercise. Common-sense model has shown the impact of patients' perception of illness on health behaviors. However, for patients with lung cancer after thoracoscopic surgery, there has been no relevant exploration of disease perception. Objective The purpose of this study was to investigate the clinical status of patients with lung cancer patients who have undergone thoracoscopic surgery, and to explore the correlation between frailty, disease perception, and lung functional exercise compliance. Methods The cross-sectional study included 218 patients with lung cancer after thoracoscopic surgery. We collected participants' frailty, disease perception, exercise adherence, and relevant clinical information. T-test, Chi-square, Linear regression, Pearson's correlation, and mediation analysis were used for statistical analysis of patient data. Results We analyzed the data by disease perception with high and low median scores and found significant differences in lymphatic dissection, stool within three days, pain, thoracic drainage tube placement time. Linear regression results show that, after controlling for confounding factors, frailty and disease perception were significantly associated with pulmonary function exercise compliance. The higher the frailty score, the worse the compliance, and the higher the disease perception negative score, the less exercise. Illness perception played a partially mediating role in the association between frailty and lung functional exercise adherence. Conclusion Frailty and disease perception have an impact on exercise adherence, therefore, we need to consider these factors in the intervention to improve exercise compliance after thoracoscopic surgery for lung cancer.
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Affiliation(s)
- Xue Gu
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Xia Shen
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Jiang-Hui Chu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China
| | - Ting-Ting Fang
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China
| | - Lei Jiang
- Department of Radiology, Huadong Sanatorium, Wuxi, People’s Republic of China
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15
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Nah MFK, Pereira MJ, Hemaavathi M, Wong SW, Lim CJ, Tan BY. Study on proximal humerus evaluation of effective treatment (SPHEER) - what is the effect of rehabilitation compliance on clinical outcomes of proximal humerus fractures. BMC Musculoskelet Disord 2023; 24:778. [PMID: 37784126 PMCID: PMC10544385 DOI: 10.1186/s12891-023-06894-w] [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: 04/24/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023] Open
Abstract
INTRODUCTION Proximal humeral fractures (PHFs) are 3rd commonest fragility fractures and cause significant functional impairment. This paper sought to determine impact of rehabilitation compliance on the clinical outcomes for non-surgically managed PHFs, while ascertaining reasons for non-compliance which can be addressed to improve compliance. METHODS Prospective cohort study of patients undergoing non-surgical treatment for PHFs from August 2017 to April 2020 in a tertiary trauma centre was performed. Data was collected via questionnaire: patient demographic data, PHF injury details, clinical outcome measures, therapist-reported (Sport Injury Rehabilitation Adherence Scale [SIRAS]) and patient-reported (subjective compliance, frequency of exercise) rehabilitation compliance measures. Data was analysed using multiple linear regression model to account for confounding variables. RESULTS 107 participants attended physical therapy follow-up for mean 137.8 days. 6-week SIRAS strongly predicted 3-month Constant score (p = 0.023; 95%CI = 0.265,3.423), OSS (p = 0.038; 95%CI = 0.049,1.634), flexion ROM (p < 0.001; 95%CI = 2.872,8.982), extension ROM (p = 0.035; 95%CI = 0.097,2.614), abduction ROM (p = 0.002;95%CI = 1.995,8.466) and achievement of functional active ROM at 3-months (p = 0.049; 95%CI = 1.001,1.638). Pain was the top reason impairing rehabilitation compliance from therapist (43.9% at 6-weeks and 20.6% at 3-months) and patient-perspective (33.6% at 6-weeks, 24.3% at 3-months). Author-developed patient-reported compliance measures had good correlation with validated SIRAS score (subjective compliance: p < 0.001 frequency of exercise: p = 0.001). CONCLUSION Rehabilitation compliance predicts short-term clinical outcomes up to 3-months and potentially 1-year outcomes. Pain control should be optimised to maximise rehabilitation compliance and improve PHF outcomes. There is lack of consensus definition for rehabilitation compliance measures; patient-reported measures used have good correlation to existing validated measures and could serve as a steppingstone for further research. LEVEL OF EVIDENCE II, cohort study.
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Affiliation(s)
- Ming Foo Kenneth Nah
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
| | | | | | - Shiyun Winnie Wong
- Department of Occupational Therapy, Tan Tock Seng Hospital, Singapore, Singapore
| | - Chien Joo Lim
- Medical Statistician (Research), Woodlands Health, Singapore, Singapore
| | - Bryan Yijia Tan
- Department of Orthopedic Surgery, Woodlands Health, Singapore, Singapore
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16
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Alhusayni AI, Cowey ES, Coulter E, Barber M, Paul L. Personalised Online Upper-Limb Physiotherapy for Stroke Survivors during the Inpatient Phase: A Feasibility Study. Healthcare (Basel) 2023; 11:2582. [PMID: 37761779 PMCID: PMC10531470 DOI: 10.3390/healthcare11182582] [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: 08/05/2023] [Revised: 09/07/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND After a stroke, inpatients often receive less than the recommended dose of therapy. Telerehabilitation may assist by providing personalised rehabilitation programmes without face-to-face therapy time. This study aimed to evaluate the acceptability and feasibility of an individualised programme of upper-limb rehabilitation that is delivered via an online rehabilitation platform for inpatient stroke survivors. METHODS Stroke survivors were recruited from three stroke units in one NHS Board in Scotland and randomised to the intervention (personalised upper-limb exercise programme delivered via an online physiotherapy platform for four weeks, up to 30 min five times per week, in addition to usual care) or the control group (usual care). The main outcomes are related to recruitment, attrition, adherence and safety. The clinical measures were the Action Research Arm Test, Trunk Impairment Scale and Modified Ashworth Scale. The intervention participants, their carers and physiotherapists completed questionnaires on the acceptability of the intervention. RESULTS Twenty-six participants, 42% males, were recruited around three weeks post-stroke, on average. There were 13 participants in each group, with a mean age of 69 years (SD of 12) and 67 years (SD of 11) for the control and intervention groups, respectively. Overall, 47% of those screened for eligibility were randomised, and attrition was 23% in the intervention group mainly due to discharge before the end of the intervention. Participants who adhered to their programme (completed more than two-thirds), generally those with an engaged carer, demonstrated a trend toward improved clinical outcomes. Overall, the patients, carers and physiotherapists were positive regarding the intervention. There was a total of five reported adverse events, none of which were related to the study. CONCLUSION An upper-limb unsupervised exercise intervention using an online physiotherapy platform for inpatient stroke survivors is feasible, safe and acceptable to patients, carers and physiotherapists. A fully powered RCT is warranted to investigate the clinical- and cost-effectiveness of such interventions for this patient group.
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Affiliation(s)
| | | | - Elaine Coulter
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK; (E.C.); (L.P.)
| | | | - Lorna Paul
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK; (E.C.); (L.P.)
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17
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Zou L, Herold F, Ludyga S, Kamijo K, Müller NG, Pontifex MB, Heath M, Kuwamizu R, Soya H, Hillman CH, Ando S, Alderman BL, Cheval B, Kramer AF. Look into my eyes: What can eye-based measures tell us about the relationship between physical activity and cognitive performance? JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:568-591. [PMID: 37148971 PMCID: PMC10466196 DOI: 10.1016/j.jshs.2023.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND There is a growing interest to understand the neurobiological mechanisms that drive the positive associations of physical activity and fitness with measures of cognitive performance. To better understand those mechanisms, several studies have employed eye-based measures (e.g., eye movement measures such as saccades, pupillary measures such as pupil dilation, and vascular measures such as retinal vessel diameter) deemed to be proxies for specific neurobiological mechanisms. However, there is currently no systematic review providing a comprehensive overview of these studies in the field of exercise-cognition science. Thus, this review aimed to address that gap in the literature. METHODS To identify eligible studies, we searched 5 electronic databases on October 23, 2022. Two researchers independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX scale, for interventional studies) and the critical appraisal tool from the Joanna Briggs Institute (for cross-sectional studies). RESULTS Our systematic review (n = 35 studies) offers the following main findings: (a) there is insufficient evidence available to draw solid conclusions concerning gaze-fixation-based measures; (b) the evidence that pupillometric measures, which are a proxy for the noradrenergic system, can explain the positive effect of acute exercise and cardiorespiratory fitness on cognitive performance is mixed; (c) physical training- or fitness-related changes of the cerebrovascular system (operationalized via changes in retinal vasculature) are, in general, positively associated with cognitive performance improvements; (d) acute and chronic physical exercises show a positive effect based on an oculomotor-based measure of executive function (operationalized via antisaccade tasks); and (e) the positive association between cardiorespiratory fitness and cognitive performance is partly mediated by the dopaminergic system (operationalized via spontaneous eye-blink rate). CONCLUSION This systematic review offers confirmation that eye-based measures can provide valuable insight into the neurobiological mechanisms that may drive positive associations between physical activity and fitness and measures of cognitive performance. However, due to the limited number of studies utilizing specific methods for obtaining eye-based measures (e.g., pupillometry, retinal vessel analysis, spontaneous eye blink rate) or investigating a possible dose-response relationship, further research is necessary before more nuanced conclusions can be drawn. Given that eye-based measures are economical and non-invasive, we hope this review will foster the future application of eye-based measures in the field of exercise-cognition science.
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Affiliation(s)
- Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China; Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany.
| | - Fabian Herold
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China; Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany
| | - Sebastian Ludyga
- Department of Sport, Exercise, and Health, University of Basel, Basel 4052, Switzerland
| | - Keita Kamijo
- Faculty of Liberal Arts and Sciences, Chukyo University, Nagoya 466-8666, Japan
| | - Notger G Müller
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China; Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany
| | - Matthew B Pontifex
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
| | - Matthew Heath
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London ON N6A 3K7, Canada; Canadian Centre for Activity and Aging, University of Western Ontario, London ON, N6A 3K7, Canada; Graduate Program in Neuroscience, University of Western Ontario, London ON, N6A 3K7, Canada
| | - Ryuta Kuwamizu
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-0006, Japan
| | - Hideaki Soya
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-0006, Japan; Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-0006, Japan
| | - Charles H Hillman
- Center for Cognitive and Brain Health, Department of Psychology, Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA 02115, USA
| | - Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo 182-8585, Japan
| | - Brandon L Alderman
- Department of Kinesiology and Health, Rutgers University-New Brunswick, New Brunswick, NJ 08854, USA
| | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva 1205, Switzerland; Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Geneva 1205, Switzerland
| | - Arthur F Kramer
- Department of Psychology, Center for Cognitive and Brain Health, Northeastern University, Boston, MA 02115, USA; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
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18
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Espin A, Irazusta J, Segovia Celaya I, Mosquera Lajas Á, González-Templado V, Rodriguez-Larrad A. Effects of a videoconference-based therapeutic exercise intervention on the musculoskeletal pain of eldercare workers: protocol for the ReViEEW randomized controlled trial. BMC Musculoskelet Disord 2023; 24:463. [PMID: 37280584 DOI: 10.1186/s12891-023-06584-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Prevalence of musculoskeletal pain is high among eldercare workers, and therapeutic exercise has shown to be effective for its management. Although telerehabilitation is an increasingly used alternative for delivering therapeutic exercise, no studies have assessed synchronous group telerehabilitation interventions for the management of musculoskeletal disorders. Thus, the aim of this article is to describe the protocol of a randomized controlled trial that will assess the effects of a videoconference-based group therapeutic exercise intervention on the musculoskeletal pain of eldercare workers. METHODS This multicenter trial will randomly assign 130 eldercare workers to either a control or experimental group. Participants in the control group will not receive any intervention, and participants in the experimental group will take part in a 12-week remote supervised videoconference-based intervention, consisting of 2 weekly 45-min group sessions. Each session will include 4 sets of 6 progressive resistance exercises for the lower limbs, upper limbs and trunk, performed with bodyweight and elastic bands at moderate-high intensity. Following the 12 weeks, participants in the experimental group will be provided with material for autonomously carry on the therapeutic exercises and advised to continue performing 2 weekly sessions on their own until a 48-week follow-up. Assessments will be performed at baseline, 12 and 48 weeks. Primary outcome will be average pain intensity in the low back during the last 7 days, measured by the 0-10 Numerical Rating Scale. Secondary outcomes will include additional measures of musculoskeletal pain, psycho-affective state, work-related variables, and physical fitness. DISCUSSION This will be the first trial, to our knowledge, assessing whether a remote delivery of a group therapeutic exercise intervention via videoconference is effective for reducing the musculoskeletal pain, improving the psycho-affective state and physical fitness, and enhancing the work-related parameters in eldercare workers. If successful, this study will provide innovative tools for implementing effective, scalable and affordable interventions to tackle musculoskeletal disorders in the workplace. It will also highlight the utility of telehealth, and address the importance of therapeutic exercise to manage musculoskeletal pain in a critical population for the future of the aging societies as it is the eldercare workers. TRIAL REGISTRATION The study protocol was prospectively registered at ClinicalTrials.gov (registration number: NCT05050526) on September 20, 2021.
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Affiliation(s)
- Ander Espin
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain.
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.
| | - Jon Irazusta
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | | | | | | | - Ana Rodriguez-Larrad
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
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19
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Ferrando-Terradez I, Dueñas L, Parčina I, Ćopić N, Petronijević S, Beltrami G, Pezzoni F, San Martín-Valenzuela C, Gijssel M, Moliterni S, Papageorgiou P, Rodríguez-Carrasco Y. Women's Involvement in Steady Exercise (WISE): Study Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2023; 11:1279. [PMID: 37174821 PMCID: PMC10177760 DOI: 10.3390/healthcare11091279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Physical inactivity is a serious public health problem for people of all ages and is currently the fourth highest global risk factor for mortality. The transition period from adolescence to adulthood coincides with a marked reduction in participation in physical activity, with more than 50% (and up to 80%) of young adults stopping physical activity. This decrease in physical activity is more evident in women than in men. Despite efforts, existing programs face challenges in effectively initiating and maintaining physical activity among individuals, particularly women, for extended durations. To address these limitations, the Women's Involvement in Steady Exercise (WISE) randomized controlled trial (RCT) seeks to assess the efficacy of a digital high-intensity training intervention complemented by nutritional plans and other health-related advice. METHODS The study will be a three-center, randomized (1:1), controlled, parallel-group trial with a six-month intervention period. A total of 300 participants will be recruited at three study sites in Spain, Serbia and Italy. The participants will be randomized to one of the two groups and will follow a six-month program. The primary outcome of the study is the daily step count. Self-reported physical activity, the adherence to the exercise program, body composition, physical activity enjoyment, quality of sleep and physical capacities will also be evaluated.
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Affiliation(s)
| | - Lirios Dueñas
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Physiotherapy in Motion, Multi-Specialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Ivana Parčina
- Faculty of Sport, University “Union—Nikola Tesla”, 11000 Belgrade, Serbia
| | - Nemanja Ćopić
- Faculty of Sport, University “Union—Nikola Tesla”, 11000 Belgrade, Serbia
| | | | | | | | - Constanza San Martín-Valenzuela
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Unit of Personal Autonomy, Dependency and Mental Disorder Assessment, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maarten Gijssel
- Kinetic Analysis, Jheronimus Academy of Data Science, 5211 DA ‘s-Hertogenbosh, The Netherlands
| | | | | | - Yelko Rodríguez-Carrasco
- Department of Food Science and Toxicology, Faculty of Pharmacy, University of Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
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20
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LoRusso SM, Parry SL, Yahner TP, Wonders KY. Patient Comments on a Hospital- and University-Based Exercise Oncology Program. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:639-645. [PMID: 35438414 DOI: 10.1007/s13187-022-02168-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/09/2022] [Indexed: 05/20/2023]
Abstract
The purpose of this study was to identify referral source and patient-reported factors that promoted follow-through and participation in exercise oncology rehabilitation programs. A three question open-ended survey was administered to patients enrolled in trainer-supervised, hospital-based (n = 101), or university-based (n = 17) cancer rehabilitation program that provided 12 weeks of individualized one on one aerobic and resistance training 1-3 days per week. Significant themes for each question were as follows: Question #1. Who referred you to the program/facility? Oncology team (Χ2 = 145.814 P ≤ 0.001); Question #2. What convinced you to follow through with the referral? Health, fatigue, and need for supervision (Χ2 = 74.814 P ≤ 0.001); and Question #3. What motivates you to continue in the program? Personal results, getting healthy, and the trainer (Χ2 = 108.729 P ≤ 0.001). In this study, oncology team referral confirms previous work. Patient follow-through and continuation appear largely self-motivated as patients' health and the attainment of health through personal results are primary motivators for continuation in the program. Question #3 responses note the importance of the trainer in maintaining continuation in an exercise oncology rehabilitation program.
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Affiliation(s)
- Stephen M LoRusso
- Department of Physical Therapy, Saint Francis University, Loretto, PA, USA.
- Program in Exercise Physiology, Saint Francis University, Loretto, PA, USA.
- Cancer Care Program, Saint Francis University, Loretto, PA, 15940, USA.
| | - Shaelyn L Parry
- Program in Exercise Physiology, Saint Francis University, Loretto, PA, USA
| | - Travis P Yahner
- Cancer Care Program, Saint Francis University, Loretto, PA, 15940, USA
| | - Karen Y Wonders
- Exercise Science Program, Wright State University, Dayton, OH, USA
- Maple Tree Cancer Alliance, Dayton, OH, USA
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21
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Kenny M, Ranabahu T, Vallance P, Zhang Y, Gurr J, Färnqvist K, Rathi S, Cridland K, Munteanu SE, Malliaras P. Exercise adherence in trials of therapeutic exercise interventions for common musculoskeletal conditions: A scoping review. Musculoskelet Sci Pract 2023; 65:102748. [PMID: 37030090 DOI: 10.1016/j.msksp.2023.102748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 04/10/2023]
Abstract
OBJECTIVE The aims of the scoping review were to: (1) evaluate how commonly trialists assess and report adherence to exercise intervention for common musculoskeletal conditions and (2) report the levels of adherence to exercise for musculoskeletal conditions and whether this was influenced by variables of interest. METHODS Medline, Cinahl, Embase, Emcare, and SPORTDiscus databases were searched using predefined terms. Published randomised controlled trials were included. Trials were included if they investigated the effectiveness of an exercise intervention for low back pain, shoulder pain, Achilles tendinopathy and knee osteoarthritis (we selected a priori as indicative common musculoskeletal conditions). Data extraction was performed independently by teams of two reviewers. Descriptive consolidation and qualitative synthesis were performed. RESULTS 321 trials were included; less than half (46.7%, 150/321) measured adherence. When adherence was assessed, 21% (31/150) of trials did not report the results. Adherence levels were greater when people were supervised. Reporting adherence was more common in registered trials. Adherence was measured most frequently via self-report (47.3%, 71/150) followed by supervised sessions (32.0%, 48/150) or combination of both (20.7%, 31/150). The majority of trials (97.0%, 97/100) reported the level of adherence in terms of a frequency. CONCLUSIONS A majority of trials investigating exercise interventions for common musculoskeletal conditions do not assess exercise adherence. Trials that were registered reported exercise adherence more frequently. The majority of trials measure adherence via self-report with reliance on only one dimension of exercise adherence (frequency).
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Affiliation(s)
- Matthew Kenny
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia.
| | | | - Patrick Vallance
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia
| | - Yuxin Zhang
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | | | - Kenneth Färnqvist
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Instituet, Sweden
| | | | - Kate Cridland
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Peter Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia
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22
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Natalucci V, Ferri Marini C, De Santi M, Annibalini G, Lucertini F, Vallorani L, Panico AR, Sisti D, Saltarelli R, Donati Zeppa S, Agostini D, Gervasi M, Baldelli G, Grassi E, Nart A, Rossato M, Biancalana V, Piccoli G, Benelli P, Villarini A, Somaini M, Catalano V, Guarino S, Pietrelli A, Monaldi S, Sarti D, Barocci S, Flori M, Rocchi MBL, Brandi G, Stocchi V, Emili R, Barbieri E. Movement and health beyond care, MoviS: study protocol for a randomized clinical trial on nutrition and exercise educational programs for breast cancer survivors. Trials 2023; 24:134. [PMID: 36814313 PMCID: PMC9946288 DOI: 10.1186/s13063-023-07153-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common invasive cancer in women, and exercise can significantly improve the outcomes of BC survivors. MoviS (Movement and Health Beyond Care) is a randomized controlled trial aimed to evaluate the potential health benefits of exercise and proper nutritional habits. This study aims to assess the efficacy of aerobic exercise training in improving quality of life (QoL) and health-related factors in high-risk BC. METHODS One hundred seventy-two BC survivor women, aged 30-70 years, non-metastatic, stage 0-III, non-physically active, 6-12 months post-surgery, and post chemo- or radiotherapy, will be recruited in this study. Women will be randomly allocated to the intervention arm (lifestyle recommendations and MoviS Training) or control arm (lifestyle recommendations). The MoviS training consists of 12 weeks of aerobic exercise training (2 days/week of supervised and 1 day/week of unsupervised exercise) with a progressive increase in exercise intensity (40-70% of heart rate reserve) and duration (20-60 min). Both arms will receive counseling on healthy lifestyle habits (nutrition and exercise) based on the World Cancer Research Fund International (WCRF) 2018 guidelines. The primary outcome is the improvement of the QoL. The secondary outcomes are improvement of health-related parameters such as Mediterranean diet adherence, physical activity level, flexibility, muscular fitness, fatigue, cardiorespiratory fitness (estimated maximal oxygen uptake), echocardiographic parameters, heart rate variability (average of the standard deviations of all 5 min normal to normal intervals (ASDNN/5 min) and 24 h very low and low frequency), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein). DISCUSSION This trial aims to evaluate if supervised exercise may improve QoL and health-related factors of BC survivors with a high risk of recurrence. Findings from this project could provide knowledge improvement in the field of exercise oncology through the participation of a multidisciplinary team that will provide a coordinated program of cancer care to improve healthcare quality, improve prognosis, increase survival times and QoL, and reduce the risk of BC recurrence. TRIAL REGISTRATION ClinicalTrials.gov NCT04818359 . Retrospectively registered on March 26, 2021.
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Affiliation(s)
- Valentina Natalucci
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Carlo Ferri Marini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Mauro De Santi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Francesco Lucertini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Luciana Vallorani
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Andrea Rocco Panico
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Davide Sisti
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Roberta Saltarelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Sabrina Donati Zeppa
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Deborah Agostini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Gervasi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giulia Baldelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Eugenio Grassi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Alessandra Nart
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Massimo Rossato
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vincenzo Biancalana
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giovanni Piccoli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Piero Benelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Anna Villarini
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Matteo Somaini
- grid.4708.b0000 0004 1757 2822School of Specialization in Nutrition Science, University of Milano, Milan, Italy
| | - Vincenzo Catalano
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Stefania Guarino
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Alice Pietrelli
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Silvia Monaldi
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Donatella Sarti
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Simone Barocci
- Clinical Pathology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Marco Flori
- Cardiology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Marco Bruno Luigi Rocchi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giorgio Brandi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132 Rome, Italy
| | - Rita Emili
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Elena Barbieri
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
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23
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Adherence to mHealth and Paper-Based Versions of Lifestyle-Integrated Functional Exercise: A Secondary Analysis of Data From the PreventIT Feasibility Randomized Controlled Trial. J Aging Phys Act 2023; 31:18-25. [PMID: 35508304 DOI: 10.1123/japa.2021-0239] [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: 06/20/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/08/2023]
Abstract
The European Commission Horizon 2020 project-PreventIT-evaluated two approaches to delivering Lifestyle-Integrated Functional Exercise (LiFE) programs for maintaining older adults' physical function: the paper-based adapted LiFE and mobile health device delivered enhanced LiFE. A self-reported method was used to measure users' monthly adherence over 12 months. This analysis aimed to explore young seniors' adherence patterns between enhanced LiFE and adapted LiFE groups. Results showed that adherence level decreased with time in both groups. The enhanced LiFE group had slightly higher adherence than the adapted LiFE group during most of the 12 months. However, the overall adherence levels were not significantly different during either intervention or follow-up periods. Monthly self-reported adherence measurement can help to understand users' adherence comprehensively. The comparable adherence levels between both groups indicate mobile health could be an alternative to delivering home-based physical activity for young seniors. However, this feasibility study was not powered to detect differences between groups.
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24
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Lee JH, Shin KH, Lee GB, Son S, Jang KM. Comparison of Functional Outcomes between Supervised Rehabilitation and Telerehabilitation in Female Patients with Patellofemoral Pain Syndrome during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2233. [PMID: 36767600 PMCID: PMC9915527 DOI: 10.3390/ijerph20032233] [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: 12/30/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Patellofemoral pain syndrome (PFPS) is a common cause of anterior knee pain, and therapeutic exercises are recommended. During the COVID-19 pandemic, despite recommendations on the importance of telerehabilitation, insufficient studies have investigated functional outcomes between supervised rehabilitation and telerehabilitation in patients with PFPS. This study aimed to compare the muscle strength, muscle activation time, and patient-reported outcomes between supervised rehabilitation and telerehabilitation in female patients with PFPS. A total of 61 patients (supervised, n = 30; telerehabilitation, n = 31) participated. Muscle strength and activation time of the quadriceps and hamstrings were measured using an isokinetic device. Hip muscle strength was evaluated using a hand-held dynamometer. Patient-reported outcomes were measured using the visual analog scale (VAS) for pain, Kujala Anterior Knee Pain Scale (AKPS) for functional ability, and Tampa scale for kinesiophobia (TSK-11). No significant differences were found in muscle strength, muscle activation time, or patient-reported outcomes of the involved knees between the two groups (p > 0.05). In addition, the rate of change in all parameters did not significantly differ between the two groups (p > 0.05). Telerehabilitation, such as a home-exercise program supervised by physical therapists, may be as effective as supervised rehabilitation in improving functional outcomes in female patients with PFPS.
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Affiliation(s)
- Jin Hyuck Lee
- Department of Sports Medical Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Ki Hun Shin
- Department of Sports Medical Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Gyu Bin Lee
- Department of Sports Medical Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Seiwook Son
- Department of Orthopaedic Surgery, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Ki-Mo Jang
- Department of Sports Medical Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
- Department of Orthopaedic Surgery, Korea University College of Medicine, Seoul 02841, Republic of Korea
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25
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Mahmood A, Nayak P, Deshmukh A, English C, N M, Solomon M J, B U. Measurement, determinants, barriers, and interventions for exercise adherence: A scoping review. J Bodyw Mov Ther 2023; 33:95-105. [PMID: 36775533 DOI: 10.1016/j.jbmt.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 05/21/2022] [Accepted: 09/18/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Adherence to exercise interventions is the cornerstone of a successful rehabilitation program. However, there is limited evidence on multifaceted components of exercise adherence. Therefore, we aimed to summarize the existing literature on measurement, determinants, barriers, theoretical frameworks, and evidence-based interventions that support exercise adherence. METHODS We conducted a scoping review based on the PRISMA extension for scoping reviews guidelines and searched the literature in PubMed, Cochrane Databases of Systematic Reviews, ScienceDirect, and Web of Science. Two reviewers independently screened articles. The included articles were subjected to data extraction and qualitative synthesis. RESULTS A total of 72 articles were included for this review. Data synthesis showed that there are no gold standard methods of measuring exercise adherence; however, questionnaires and daily logs are commonly used tools. The determinants of adherence are personal, disease-related, therapy-related, provider-related, and health system-related. The common barriers to adherence are the absence of a caregiver, low health literacy, poor communication by healthcare providers, cost, and lack of access to health facilities. Few evidence-based interventions used for supporting adherence are behavioral strategies, improving self-efficacy, motivational therapy, and mHealth or multimedia. CONCLUSION Non-adherence to exercises is a challenge for healthcare providers. There are no standard guidelines for the evaluation and management of non-adherence to exercises. Future studies should aim at developing objective measures of exercise adherence and investigate the long-term effects of adherence strategies in different disease populations. It is an under-researched area and requires multipronged strategies to improve adherence levels among patients.
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Affiliation(s)
- Amreen Mahmood
- Department of Health Professions, Manchester Metropolitan University, Birley Fields Campus, Bonsall Street, M15 6GX, Manchester, United Kingdom.
| | - Pradeepa Nayak
- Department of Health Professions, Manchester Metropolitan University, Birley Fields Campus, Bonsall Street, M15 6GX, Manchester, United Kingdom.
| | - Anagha Deshmukh
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
| | - Coralie English
- School of Health Sciences and Priority Research, Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia.
| | - Manikandan N
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
| | - John Solomon M
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
| | - Unnikrishnan B
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
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26
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Weiner DE, Liu CK, Miao S, Fielding R, Katzel LI, Giffuni J, Well A, Seliger SL. Effect of Long-term Exercise Training on Physical Performance and Cardiorespiratory Function in Adults With CKD: A Randomized Controlled Trial. Am J Kidney Dis 2023; 81:59-66. [PMID: 35944747 PMCID: PMC9780154 DOI: 10.1053/j.ajkd.2022.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/22/2022] [Indexed: 12/25/2022]
Abstract
RATIONALE & OBJECTIVE The safety and efficacy of long-term exercise training in reducing physical functional loss in older adults with advanced CKD and comorbidity is uncertain. STUDY DESIGN Multicenter, parallel group, randomized controlled trial. SETTINGS & PARTICIPANTS Adults 55 years and older with estimated glomerular filtration rate (eGFR) of 15 to <45 mL/min/1.73 m2 enrolled from centers in Baltimore and Boston. INTERVENTION Twelve months of in-center supervised exercise training incorporating majority aerobic but also muscle strengthening activities or a group health education control intervention, randomly assigned in 1:1 ratio. OUTCOME Primary outcomes were cardiorespiratory fitness and submaximal gait at 6 and 12 months quantified by peak oxygen consumption (Vo2peak) on graded exercise treadmill test and distance walked on the 6-minute walk test, respectively. Secondary outcomes were changes in lower extremity function, eGFR, albuminuria, glycemia, blood pressure, and body mass index. RESULTS Among 99 participants, the mean age was 68 years, 62% were African American, and the mean eGFR was 33 mL/min/1.73 m2; 59% had diabetes, and 29% had coronary artery disease. Among those randomized to exercise, 59% of exercise sessions were attended in the initial 6 months. Exercise was well tolerated without excess occurrence of adverse events. At 6 months, aerobic capacity was higher among exercise participants (17.9 ± 5.5 vs 15.9 ± 7.0 mL/kg/min, P = 0.03), but the differences were not sustained at 12 months. The 6-minute walk distance improved more in the exercise group (adjusted difference: 98 feet [P = 0.02; P = 0.03 for treatment-by-time interaction]). The exercise group had greater improvements on the Timed Up and Go Test (P = 0.04) but not the Short Physical Performance Battery (P = 0.8). LIMITATIONS Planned sample size was not reached. Loss to follow-up and dropout were greater than anticipated. CONCLUSIONS Among adults aged ≥55 years with CKD stages 3b-4 and a high level of medical comorbidity, a 12-month program of in-center aerobic and resistance exercise training was safe and associated with improvements in physical functioning. FUNDING Government grants (National Institutes of Health). TRIAL REGISTRATION Registered at ClinicalTrials.gov with study number NCT01462097.
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Affiliation(s)
- Daniel E Weiner
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Christine K Liu
- Section of Geriatric Medicine, Division of Primary Care and Population Health, Stanford University, Stanford, California; Geriatric Research and Education Clinical Center, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
| | - Shiyuan Miao
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Roger Fielding
- Department of Medicine, School of Medicine, Tufts University, Boston, Massachusetts; Jean Mayer Human Nutrition Research Center on Aging, US Department of Agriculture, Boston, Massachusetts
| | - Leslie I Katzel
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland; Geriatric Research and Education Clinical Center, VA Maryland Healthcare System, Baltimore, Maryland
| | - Jamie Giffuni
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Andrew Well
- Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Stephen L Seliger
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland; Geriatric Research and Education Clinical Center, VA Maryland Healthcare System, Baltimore, Maryland.
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27
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Osuka Y, Sasai H, Kojima N, Sugie M, Motokawa K, Maruo K, Ono R, Aoyama T, Inoue S, Kim H. Adherence, safety and potential effectiveness of a home-based Radio-Taiso exercise program in older adults with frailty: A pilot randomized controlled trial. Geriatr Gerontol Int 2023; 23:32-37. [PMID: 36426763 PMCID: PMC10100027 DOI: 10.1111/ggi.14511] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/21/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022]
Abstract
AIM Radio-Taiso, a traditional exercise program in Japan, may serve as a coping strategy for older adults with frailty during the COVID-19 pandemic. This phase II trial tested program adherence and safety and explored the potential effectiveness of a home-based Radio-Taiso. METHODS This assessor-blind parallel randomized controlled trial included community-dwelling Jolder Japanese adults with frailty and pre-frailty. Fifty-eight eligible participants were randomly allocated to intervention and control groups. Intervention participants performed 3-5-min sessions of Radio-Taiso one to four times per day for 12 weeks. Feasibility criteria were set at practice and retention rates of ≥75%. Safety was monitored by assessing all adverse events reported by participants during the intervention period, irrespective of causality. Potential effectiveness was exploratorily assessed using items that allow clinical interpretation of changes: mobility and health-related quality of life (HR-QoL), assessed using the modified short physical performance battery (SPPB) and the SF-36, respectively. RESULTS Both practice (83%) and retention rates (100%) met the predetermined feasibility criteria. Eleven adverse events were reported but were supposedly unrelated to the intervention. In the intention-to-treat analysis, there was no clinically significant difference in the change in SPPB score between groups (-0.4 points, 95% confidence interval [CI], -1.2, 0.3); however, the intervention group scored higher in the mental component of HR-QoL than did the control group (3.4 points, 95% CI: -1.1, 7.8). CONCLUSIONS The preliminary data indicate that a phase III trial is feasible, focusing on the mental aspect of HR-QoL as the primary outcome. Geriatr Gerontol Int 2023; 23: 32-37.
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Masamitsu Sugie
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Risa Ono
- Japan Radio-Taiso Federation, Chiyoda-ku, Japan
| | | | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjyuku-ku, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
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28
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Zougar M, Todd C, McGarrigle L, Stanmore E. MIRA Rehab Exergames for Older Male Residents in a Care Home Center in Saudi Arabia: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e39148. [PMID: 36538360 PMCID: PMC9812269 DOI: 10.2196/39148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/29/2022] [Accepted: 09/05/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Physical activity leads to improvements in morbidity, mortality, and quality of life, especially when it is progressive, challenging, and regular. There is strong evidence that strength and balance exercises decrease the risk of falling. However, traditional exercises may be tedious and not very motivating for participants. Exergames have been found to increase engagement and enjoyment for older users. OBJECTIVE This study will conduct a feasibility randomized controlled trial (RCT) on the use of MIRA Rehab Exergames among older male residents in a care home setting in Saudi Arabia. A sample of 30 eligible participants will be recruited to meet feasibility study requirements. METHODS We will recruit 38 residents in the care home who will be randomly allocated to either an intervention or a control group. The intervention participants will perform gamified exercises using the MIRA telerehabilitation platform (30 minutes 3 times per week for 6 weeks). The control group will receive educational advice based on booklets of the Otago exercise program and be encouraged to exercise (30 minutes 3 times per week for 6 weeks). Participants will be assessed at weeks 0, 6, and 12. Assessments will include feasibility measures (eligibility, recruitment and attrition rates, and practicalities of data collection methods) and participant outcome measures (balance, strength, mobility, adherence, quality of life, fear of falling, depression, acceptability, and usability). RESULTS Data collection started in November 2021 and ended in March 2022. The study is currently in the data analysis stage, which commenced in May 2022. The findings from this feasibility RCT will be used to design a definitive RCT to test whether the MIRA Rehab Exergame program benefits older people in Saudi Arabia who may not like participating in traditional exercise programs and may be unwilling or unable to leave their homes. CONCLUSIONS This study will contribute to our understanding of how to recruit in this specific population and provide information to inform the design of a future RCT. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39148.
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Affiliation(s)
- Mohammad Zougar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Taif University, Taif city, Saudi Arabia
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
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Tlusty GC, Alonso WW, Berger AM. Exercise Interventions During Hospitalization for Stem Cell Transplantation: An Integrative Review. West J Nurs Res 2022; 44:1167-1182. [PMID: 36154334 DOI: 10.1177/01939459221124433] [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: 01/25/2023]
Abstract
Exercise interventions may influence adverse effects experienced during hospitalization for hematopoietic stem cell transplantation (HSCT). Adherence to exercise interventions is challenging. This review aimed to synthesize the literature to identify exercise interventions implemented during hospitalization for HSCT, including intervention characteristics, adherence, barriers and facilitators, and behavior change techniques using the behavior change technique taxonomy. A review of PubMed, CINAHL, PsycINFO, and Embase was completed. The sample included 19 studies. Exercise interventions demonstrated heterogeneity in prescription components, definitions, measures, and reporting of adherence. Barriers and facilitators of adherence to exercise were reported infrequently. Behavior change techniques most frequently used in studies reporting adherence rates of ≥75% included instruction on how to perform the behavior, graded tasks, and adding objects to the environment. The heterogeneity in definitions and measures of adherence limit forming conclusions to identify barriers and facilitators and determine which behavior change techniques increase adherence to exercise during HSCT.
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Affiliation(s)
- Gisele C Tlusty
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Windy W Alonso
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Ann M Berger
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
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Bourke A, Niranjan V, O’Connor R, Woods C. Barriers to and motives for engagement in an exercise-based cardiac rehabilitation programme in Ireland: a qualitative study. BMC PRIMARY CARE 2022; 23:28. [PMID: 35148675 PMCID: PMC8832858 DOI: 10.1186/s12875-022-01637-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 09/27/2021] [Indexed: 12/04/2022]
Abstract
Background Insufficient physical activity (PA) is a leading risk factor for premature death worldwide. Ireland’s public healthcare system, the Health Service Executive (HSE), has supported the development of the National Exercise Referral Framework (NERF) to tackle low levels of PA amongst those with non-communicable diseases (NCDs). ‘NERF centres’ are medically supervised PA programmes across Ireland that have established referral pathways with local hospitals and general practitioners. ULMedX is one such NERF centre offering exercise-based cardiac rehabilitation (EBCR) with the aim of intervention development to reduce early drop-out and maximise adherence for optimal health benefits. Aim The purpose of this research was to identify the major factors influencing participants’ adherence and early drop-out at ULMedX. Exploring areas for future development were also prioritised. Design & setting Qualitative interviews were conducted with long-term attenders and people who have dropped out (PWDO) from ULMedX. Methods Guided by the Theory of Planned Behaviour the 1–1 semi-structured interviews were performed, transcribed, and evaluated through thematic analysis. Results Analysis was performed on 14 participants (50% female; mean age 67.3 years), comprising long-term attenders (n = 7; 13-month duration, 64% of classes) and PWDO (n = 7; 2.8-month duration, 22% of classes). Three major factors affecting adherence and drop-out were identified: social support, perceived outcomes from participation and practical barriers to attendance. Areas for future development included the provision of evening and advanced classes, psychological support, more exercise variety, more educational seminars and new members start as their own group. Conclusion The findings suggest participants at ULMedX are more likely to have had a better experience and commit to the programme if they believed involvement would benefit their physical and mental health, increase their exercise motivation by engendering a positive attitude to exercise, and that the ability to attend was within their control. Future interventions at ULMedX should have their structures centred around these motives for engagement. ULMedX should also test the participant recommendations to overcome the common barriers to adherence.
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Gjestvang C, Tangen EM, Haakstad LAH. The Coronavirus pandemic and closed fitness clubs negatively affected members exercise habits. Front Sports Act Living 2022; 4:985782. [PMID: 36506717 PMCID: PMC9726910 DOI: 10.3389/fspor.2022.985782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Due to the Coronavirus pandemic, politicians enacted directions to reduce social interactions, including lockdown of fitness clubs. We aimed to investigate how this changed exercise habits of Norwegian gym members. Method Based on survey data, men and women (≥18 years, n = 233, data collection from Aug. 2020 to Jan. 2021) were recruited to this study by an email-invitation from their fitness club chain or by Facebook advertisement. The participants reported on background variables (e.g., age, gender, total household income, occupation, and education), and exercise habits pre- and during social lockdown. Data were analyzed using independent or student t-test, chi-squared test, or McNemar's test, as appropriate. Results Home-based exercise (18.0 vs. 72.5%, p = <0.001), walking (49.8 vs. 65.2%, p = <0.001), and cycling (16.7 vs. 24.5%, p = 0.004) was more common during than pre-lockdown. Also, men (4.33 to 3.68 days/week, p =0.013) and women (4.20 to 3.79 days/week, p = 0.001) reported a lower exercise frequency, and a shorter duration. Exercise frequency was lower in those with a BMI ≥25 than in those with BMI <25 (3.95 vs. 4.48 days/week, p = <0.007) pre-lockdown. High exercise attendees (≥3 sessions/week, 66.5%) reported a smaller decrease in exercise frequency (mean change: 0.06 vs. 1.24 days/week, p = <0.001) and duration (>60 min. per session: 33.0 vs. 3.8%, p = <0.001) than low exercise attendees during lockdown. Discussion Home-based exercise, walking, and cycling were most frequently reported during lockdown. Participants reported a small decrease in exercise duration and frequency compared with pre-lockdown. Closure of fitness clubs impacted low attendees more than high attendees.
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Mikolaizak AS, Taraldsen K, Boulton E, Gordt K, Maier AB, Mellone S, Hawley-Hague H, Aminian K, Chiari L, Paraschiv-Ionescu A, Pijnappels M, Todd C, Vereijken B, Helbostad JL, Becker C. Impact of adherence to a lifestyle-integrated programme on physical function and behavioural complexity in young older adults at risk of functional decline: a multicentre RCT secondary analysis. BMJ Open 2022; 12:e054229. [PMID: 36198449 PMCID: PMC9535207 DOI: 10.1136/bmjopen-2021-054229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
CONTEXT Long-term adherence to physical activity (PA) interventions is challenging. The Lifestyle-integrated Functional Exercise programmes were adapted Lifestyle-integrated Functional Exercise (aLiFE) to include more challenging activities and a behavioural change framework, and then enhanced Lifestyle-integrated Functional Exercise (eLiFE) to be delivered using smartphones and smartwatches. OBJECTIVES To (1) compare adherence measures, (2) identify determinants of adherence and (3) assess the impact on outcome measures of a lifestyle-integrated programme. DESIGN, SETTING AND PARTICIPANTS A multicentre, feasibility randomised controlled trial including participants aged 61-70 years conducted in three European cities. INTERVENTIONS Six-month trainer-supported aLiFE or eLiFE compared with a control group, which received written PA advice. OUTCOME MEASURES Self-reporting adherence per month using a single question and after 6-month intervention using the Exercise Adherence Rating Scale (EARS, score range 6-24). Treatment outcomes included function and disability scores (measured using the Late-Life Function and Disability Index) and sensor-derived physical behaviour complexity measure. Determinants of adherence (EARS score) were identified using linear multivariate analysis. Linear regression estimated the association of adherence on treatment outcome. RESULTS We included 120 participants randomised to the intervention groups (aLiFE/eLiFE) (66.3±2.3 years, 53% women). The 106 participants reassessed after 6 months had a mean EARS score of 16.0±5.1. Better adherence was associated with lower number of medications taken, lower depression and lower risk of functional decline. We estimated adherence to significantly increase basic lower extremity function by 1.3 points (p<0.0001), advanced lower extremity function by 1.0 point (p<0.0001) and behavioural complexity by 0.008 per 1.0 point higher EARS score (F(3,91)=3.55, p=0.017) regardless of group allocation. CONCLUSION PA adherence was associated with better lower extremity function and physical behavioural complexity. Barriers to adherence should be addressed preintervention to enhance intervention efficacy. Further research is needed to unravel the impact of behaviour change techniques embedded into technology-delivered activity interventions on adherence. TRIAL REGISTRATION NUMBER NCT03065088.
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Affiliation(s)
- A Stefanie Mikolaizak
- Department of Clinical Gerontology, Robert-Bosch-Krankenhaus GmbH, Stuttgart, Germany
| | - Kristin Taraldsen
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elisabeth Boulton
- School of Health Sciences, The University of Manchester, Manchester, UK
- Health & Care Policy, Age UK, London, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Katharina Gordt
- Department of Clinical Gerontology, Robert-Bosch-Krankenhaus GmbH, Stuttgart, Germany
| | - Andrea Britta Maier
- Department of Human Movement Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sabato Mellone
- Department of Electrical, Electronic and Information Engineering, University of Bologna, Bologna, Italy
| | - Helen Hawley-Hague
- School of Health Sciences, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Kamiar Aminian
- Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Lorenzo Chiari
- Department of Electrical, Electronic and Information Engineering, University of Bologna, Bologna, Italy
| | | | - Mirjam Pijnappels
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Chris Todd
- School of Health Sciences, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Clemens Becker
- Department of Clinical Gerontology, Robert-Bosch-Krankenhaus GmbH, Stuttgart, Germany
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Osuka Y, Kojima N, Sugie M, Omura T, Motokawa K, Ueda T, Maruo K, Ono R, Aoyama T, Inoue S, Kim H, Sasai H. Effects of a home-based Radio-Taiso exercise programme on health-related quality of life in older adults with frailty: protocol for an assessor-blind randomised controlled trial. BMJ Open 2022; 12:e063201. [PMID: 36137626 PMCID: PMC9511584 DOI: 10.1136/bmjopen-2022-063201] [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: 12/02/2022] Open
Abstract
INTRODUCTION Few clinical trials have examined the effects of home-based exercise programmes on health-related quality of life (HR-QoL) in older adults with frailty. Radio-Taiso is the most famous exercise programme in Japan. A home-based Radio-Taiso exercise programme may serve as an accessible, scalable and sustainable care intervention for older adults with frailty. The primary aim of this trial is to test whether older adults with frailty who are prescribed our home-based Radio-Taiso exercise programme will receive greater benefits for HR-QoL compared with those who are not prescribed the exercise programme. Potential mechanisms underlying the effectiveness of the programme and the effects of the programme on daily lifestyle will also be investigated. METHODS AND ANALYSIS This assessor-blind randomised controlled trial will be conducted at the Tokyo Metropolitan Institute of Gerontology (TMIG) in Itabashi-ku, Tokyo, Japan. From April to May 2022, 226 older adults with prefrailty or frailty according to the revised Japanese version of the Cardiovascular Health Study criteria will be included from a large database. After a baseline assessment in June 2022, participants will be randomly assigned to the intervention (home-based Radio-Taiso exercise and nutrition programme) or control (nutrition programme) groups at a 1:1 ratio. After intervention completion, a follow-up assessment will be conducted in September 2022. The primary outcome is the change in the mental domain of HR-QoL assessed using SF-36. Secondary outcomes include physical and role/social domains and subscales of HR-QoL, frailty phenotype, physical fitness, posture, cognition, exercise self-efficacy, depressive symptoms, brain-derived neurotrophic factor, social network, habitual energy intake, physical activity and sleep conditions. ETHICS AND DISSEMINATION The Research Ethics Committee of TMIG has approved the research protocol. This trial will be conducted in accordance with the principles of the Declaration of Helsinki. The findings will be presented at international academic conferences and published in peer-reviewed international journals. TRIAL REGISTRATION NUMBER UMIN000047229.
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Masamitsu Sugie
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Japan
| | - Takuya Omura
- Department of Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Takuya Ueda
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Risa Ono
- Japan Radio-Taiso Federation, Chiyoda-ku, Japan
| | | | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjyuku-ku, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
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Chrismas BCR, Majed L, Al-Mohannadi AS, Sayegh S. Adherence and retention to the self-managed community-based Step Into Health program in Qatar (2012-2019). Front Public Health 2022; 10:927386. [PMID: 36199850 PMCID: PMC9527577 DOI: 10.3389/fpubh.2022.927386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose Investigate adherence and retention to the "Step Into Health (SIH)" initiative (www.stepintohealth.qa [website access only available from within the State of Qatar]), a Qatari self-managed community-based health program, from 2012 to 2019. Methods Participants (16,711; 16-80 years; 37% females, 34% Qatari) used a pedometer or smartphone application (app) to measure step count. Absolute adherence (ADH) and retention (RET) were calculated, with ADH (%) the ratio between number of days data and SIH enrollment length (RET). Linear Mixed Models identified differences in ADH between RET groups, main effects (i.e., sex, device, age, BMI, nationality) and interaction effects for ADH (RET entered as a covariate). Results Average ADH and RET to SIH (irrespective of sex, age, device and BMI) was 50% (±31%), and 16% (±20%), respectively, with ADH differing significantly between RET groups (F = 460.2, p < 0.001). RET (as a covariate) revealed a significant main effect for device (F = 12.00, p < 0.001) and age (F = 4.31, p = 0.001) on ADH observed. There was a significant association between RET and sex (p < 0.001), device (p < 0.001), and age groups 16-25 y (p < 0.001), and 26-35 y (p < 0.001). There were no significant main effects for sex or BMI on ADH, and no interaction effects (p ≥ 0.21) observed. Conclusions Follow-up data (e.g., interviews, focus groups, etc.) determining why differences in ADH and RET are observed appears prudent. To convert those that lapsed and/or abandoned SIH/PA into committed long-term PA adherers. This would be a first step to develop targeted public health promotions and initiatives to enhance health outcomes at a population level.
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Affiliation(s)
- Bryna C. R. Chrismas
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar,*Correspondence: Bryna C. R. Chrismas
| | - Lina Majed
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
| | - Abdulla Saeed Al-Mohannadi
- World Innovation Summit for Health, Qatar Foundation, Doha, Qatar,Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Suzan Sayegh
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
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Halliday LJ, Boshier PR, Doganay E, Wynter-Blyth V, Buckley JP, Moorthy K. The effects of prehabilitation on body composition in patients undergoing multimodal therapy for esophageal cancer. Dis Esophagus 2022; 36:6632930. [PMID: 35795994 PMCID: PMC9885737 DOI: 10.1093/dote/doac046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/22/2022] [Accepted: 06/13/2022] [Indexed: 02/02/2023]
Abstract
Prehabilitation aims to optimize a patient's functional capacity in preparation for surgery. Esophageal cancer patients have a high incidence of sarcopenia and commonly undergo neoadjuvant therapy, which is associated with loss of muscle mass. This study examines the effects of prehabilitation on body composition during neoadjuvant therapy in esophageal cancer patients. In this cohort study, changes in body composition were compared between esophageal cancer patients who participated in prehabilitation during neoadjuvant therapy and controls who did not receive prehabilitation. Assessment of body composition was performed from CT images acquired at the time of diagnosis and after neoadjuvant therapy. Fifty-one prehabilitation patients and 28 control patients were identified. There was a significantly greater fall in skeletal muscle index (SMI) in the control group compared with the prehabilitation patients (Δ SMI mean difference = -2.2 cm2/m2, 95% CI -4.3 to -0.1, p=0.038). Within the prehabilitation cohort, there was a smaller decline in SMI in patients with ≥75% adherence to exercise in comparison to those with lower adherence (Δ SMI mean difference = -3.2, 95% CI -6.0 to -0.5, P = 0.023). A greater decrease in visceral adipose tissue (VAT) was seen with increasing volumes of exercise completed during prehabilitation (P = 0.046). Loss of VAT during neoadjuvant therapy was associated with a lower risk of post-operative complications (P = 0.017). By limiting the fall in SMI and promoting VAT loss, prehabilitation may have multiple beneficial effects in patients with esophageal cancer. Multi-center, randomized studies are needed to further explore these findings.
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Affiliation(s)
- Laura J Halliday
- Address correspondence to: Miss Laura Halliday, Academic Surgical Unit, 10th Floor, QEQM Building, St Mary’s Hospital, London W2 1NY. Tel: 0203 312 1427 Fax: 0203 312 1810.
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, UK
| | - Emre Doganay
- Department of Surgery and Cancer, Imperial College London, UK
| | - Venetia Wynter-Blyth
- Oesophago-Gastric Cancer Surgery Unit, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - John P Buckley
- Centre for Active Living, University Centre Shrewsbury/University of Chester, Shrewsbury, UK
| | - Krishna Moorthy
- Department of Surgery and Cancer, Imperial College London, UK
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Fimbel L, Pitts M, Schure M, McCormick AKHG, Held S. Recruitment, retention, and intervention adherence for a chronic illness self-management intervention with the Apsáalooke Nation. PUBLIC HEALTH REVIEW 2022; 5:4786. [PMID: 35875172 PMCID: PMC9302479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Recruitment, retention, and adherence within health intervention research have been understudied in Indigenous communities, where well-known health disparities exist. The purpose of this paper is to describe planned versus actual recruitment, retention, and adherence strategies and the evaluation of retention and adherence strategies for a community-based research study of a Chronic Illness (CI) self-management intervention within an Indigenous community. A Community-Based Participatory Research (CBPR) approach was used to develop and implement Báa nnilah, a culturally consonant educational intervention to improve CI self-management. Reasons for participant adherence and retention were tracked and recorded over time. A post-intervention survey assessed barriers and facilitators to intervention adherence. Overall, recruitment, retention, and adherence methods were successful in enrolling and maintaining participation. Using a CBPR approach and culturally consonant strategies may assist in meeting recruitment goals and improving sustained participation of community members, thus impacting health disparities among Indigenous communities.
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Affiliation(s)
- Laurel Fimbel
- Montana State University, Department of Health and Human Development, Bozeman, Montana
| | - Mikayla Pitts
- Montana State University, Department of Health and Human Development, Bozeman, Montana
| | - Mark Schure
- Montana State University, Department of Health and Human Development, Bozeman, Montana
| | | | - Suzanne Held
- Montana State University, Department of Health and Human Development, Bozeman, Montana
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Yang Y, Boulton E, Todd C. Measurement of Adherence to mHealth Physical Activity Interventions and Exploration of the Factors That Affect the Adherence: Scoping Review and Proposed Framework. J Med Internet Res 2022; 24:e30817. [PMID: 35675111 PMCID: PMC9218881 DOI: 10.2196/30817] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/16/2021] [Accepted: 03/15/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) is widely used as an innovative approach to delivering physical activity (PA) programs. Users' adherence to mHealth programs is important to ensure the effectiveness of mHealth-based programs. OBJECTIVE Our primary aim was to review the literature on the methods used to assess adherence, factors that could affect users' adherence, and the investigation of the association between adherence and health outcomes. Our secondary aim was to develop a framework to understand the role of adherence in influencing the effectiveness of mHealth PA programs. METHODS MEDLINE, PsycINFO, EMBASE, and CINAHL databases were searched to identify studies that evaluated the use of mHealth to promote PA in adults aged ≥18 years. We used critical interpretive synthesis methods to summarize the data collected. RESULTS In total, 54 papers were included in this review. We identified 31 specific adherence measurement methods, which were summarized into 8 indicators; these indicators were mapped to 4 dimensions: length, breadth, depth, and interaction. Users' characteristics (5 factors), technology-related factors (12 factors), and contextual factors (1 factor) were reported to have impacts on adherence. The included studies reveal that adherence is significantly associated with intervention outcomes, including health behaviors, psychological indicators, and clinical indicators. A framework was developed based on these review findings. CONCLUSIONS This study developed an adherence framework linking together the adherence predictors, comprehensive adherence assessment, and clinical effectiveness. This framework could provide evidence for measuring adherence comprehensively and guide further studies on adherence to mHealth-based PA interventions. Future research should validate the utility of this proposed framework.
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Affiliation(s)
- Yang Yang
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Elisabeth Boulton
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, Manchester, United Kingdom.,Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Sun X, Wang L, Shen X, Huang C, Wei Z, Su L, Wang S, Liu X, Zhen X. Correlates of Adherence of Multimodal Non-pharmacological Interventions in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study. Front Psychiatry 2022; 13:833767. [PMID: 35747098 PMCID: PMC9210931 DOI: 10.3389/fpsyt.2022.833767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Non-pharmacological interventions are promising for delaying cognitive decline in older adults with mild cognitive impairment (MCI). Although some studies have demonstrated adherence rates and factors influencing participation in single modality non-pharmacological interventions, little is known about the level and correlates of adherence to multimodal non-pharmacological interventions (MNPIs) in older adults with MCI. Objective This study aimed to explore the adherence level and the correlates of adherence to MNPIs in older adults with MCI. Methods A cross-sectional design was employed. Community-dwelling older adults aged 60 years and over were recruited from senior community centers and healthcare centers in Huzhou from March 2019 to December 2020. Data were collected by a general information questionnaire and the adherence scale of cognitive dysfunction management (AS-CDM) in older adults with MCI. Hierarchical regression analyses were applied to explore the correlates of adherence to MNPIs. Results A total of 216 completed questionnaires were finally analyzed. Of these, 68.52% were female, and 45.4% of the participants had no less than 6 years of education. The overall mean score for adherence was 117.58 (SD = 10.51) out of 160, equivalent to 73.49 in the hundred-mark system, indicating a medium-level adherence to MNPIs in older adults with MCI. Of the five dimensions of adherence (AS-CDM), self-efficacy scored the highest, and the lowest was perceived barriers. The univariate analysis showed that the factors associated with the adherence to MNPIs were: regular physical exercise, meat-vegetable balance, absence of multimorbidity, high level of education, living alone, and living in urban (p < 0.05). In the hierarchical regression analysis, the final model explained 18.8% of variance in overall adherence (p < 0.01), which high school (Beta = 0.161, p < 0.05), college and above more (Beta = 0.171, p < 0.05), meat-vegetarian balance (Beta = 0.228, p < 0.05), regular physical exercise (Beta = 0.234, p < 0.05), and presence of multimorbidity (Beta = -0.128, p < 0.05) significantly contributed to adherence. In addition, nearly 80% of older adults with MCI preferred MNPIs. Conclusion Early assessment and management of adherence to MNPIs were essential in older adults with MCI. Furthermore, the findings shed light on several critical areas of intervention to improve adherence to MNPIs in older adults with MCI. Clinical Trial Registration http://www.chictr.org.cn/showproj.aspx?proj=35363, ChiCTR1900020950 (Registered on January 23, 2019).
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Affiliation(s)
- Xue Sun
- School of Medicine, Huzhou University, Huzhou, China
| | - Lina Wang
- School of Medicine, Huzhou University, Huzhou, China
| | - Xinhua Shen
- Department of Neurosis and Psychosomatic Diseases, Third People's Hospital of Huzhou, Huzhou, China
| | - Cheng Huang
- School of Medicine, Huzhou University, Huzhou, China
| | - Zhuqin Wei
- School of Medicine, Huzhou University, Huzhou, China
| | - Liming Su
- School of Medicine, Huzhou University, Huzhou, China
| | - Simeng Wang
- School of Medicine, Huzhou University, Huzhou, China
| | - Xiaoshen Liu
- Department of Orthopedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueting Zhen
- School of Medicine, Tongxiang City Health School, Jiaxing, China
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Current practice in the measurement and interpretation of intervention adherence in randomised controlled trials: A systematic review. Contemp Clin Trials 2022; 118:106788. [PMID: 35562000 DOI: 10.1016/j.cct.2022.106788] [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: 01/18/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ideally all participants in a randomised controlled trial (RCT) should fully receive their allocated intervention; however, this rarely occurs in practice. Intervention adherence affects Type II error so influences the interpretation of trial results and subsequent implementation. We aimed to describe current practice in the definition, measurement, and reporting of intervention adherence in non-pharmacological RCTs, and how this data is incorporated into a trial's interpretation and conclusions. METHODS We conducted a systematic review of phase III RCTs published between January 2018 and June 2020 in the National Institute for Health Research Journals Library for the Health Technology Assessment, Programme Grants for Applied Research, and Public Health Research funding streams. RESULTS Of 237 reports published, 76 met the eligibility criteria and were included. Most RCTs (n = 68, 89.5%) reported adherence, though use of terminology varied widely; nearly three quarters of these (n = 49, 72.1%) conducted a sensitivity analysis. Adherence measures varied between intervention types: behavioural change (n = 10, 43.5%), psychological therapy (n = 5, 83.3%) and physiotherapy/rehabilitation (n = 8, 66.7%) interventions predominately measured adherence based on session attendance. Whereas medical device and surgical interventions (n = 17, 73.9%) primarily record the number of participants receiving the allocated intervention, a third (n = 33, 67.3%) of studies reported a difference in findings between primary and sensitivity analyses. CONCLUSIONS Although most trials report elements of adherence, terminology was inconsistent, and there was no systematic approach to its measurement, analyses, interpretation, or reporting. Given the importance of adherence within clinical trials, there is a pressing need for a standardised approach or framework.
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Jungreitmayr S, Kranzinger C, Venek V, Ring-Dimitriou S. Effects of an App-Based Physical Exercise Program on Selected Parameters of Physical Fitness of Females in Retirement: A Randomized Controlled Trial. Front Physiol 2022; 13:821773. [PMID: 35317213 PMCID: PMC8934397 DOI: 10.3389/fphys.2022.821773] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/11/2022] [Indexed: 12/23/2022] Open
Abstract
Modern technologies enable new options in the delivery of physical exercise programs. Specially designed app-based programs can be used to help older people in particular to integrate physical exercise into their daily lives. This study examines the influence of an app-based physical exercise program on selected parameters of physical fitness, such as muscular strength, balance, and flexibility. The women (n = 110) were on average 65.3 (± 1.5) years old and, compared to age-specific norm values, healthy. The 14-week intervention consisted of an app-based, unsupervised physical exercise program, in which the exercise frequency and duration of sessions were self-selected. The physical exercise program consisted of simple, functional exercises such as arm circles, squats, lateral raises. The participants were provided with an elastic resistance band and an exercise ball allowing them to increase exercise intensity if needed. Participants were randomly assigned to intervention group (IG) and control group (CG). 71% of the IG used the physical exercise program at least 1.2 times per week, whereas 25% of the IG showed usage rates above four times per week. Significant effects were found in the domains of muscular strength and flexibility. While IG could maintain their performance in isometric muscular strength tests and increased their flexibility, CG faced a decrease in those parameters. Thus, this app-based physical exercise program had positively influenced muscular strength and flexibility in women over 60 years of age.
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Affiliation(s)
- Sonja Jungreitmayr
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg, Austria
- *Correspondence: Sonja Jungreitmayr,
| | | | - Verena Venek
- Salzburg Research Forschungsgesellschaft mbH, Salzburg, Austria
| | - Susanne Ring-Dimitriou
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Salzburg, Austria
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41
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Ruiz A, Ng K, Rintala P, Kaseva K, Finni T. Physical activity intention and attendance behaviour in Finnish youth with cerebral palsy - results from a physical activity intervention: an application of the theory of planned behaviour. J Exerc Rehabil 2022; 17:370-378. [PMID: 35036385 PMCID: PMC8743605 DOI: 10.12965/jer.2142588.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/19/2021] [Indexed: 12/02/2022] Open
Abstract
Physical activity is associated with better health in individuals with cerebral palsy (CP). Numerous physical activity interventions have been designed to promote physical activity among youth with CP. No previous studies have explored the factors contributing to the intention to participate and predicting attendance behaviour for these interventions. Using theory of planned behaviour (TPB), this study explored the prediction of physical activity intention and attendance behaviour in a physical activity intervention aiming to promote physical activity in a sample of young individuals with CP. Males with CP aged 9–21 years were asked to complete measures of attitude, subjective norms, perceived behavioural control and, intentions towards a physical activity intervention. Participants had no cognitive impairments to understand and follow instructions, were categorised into Gross Motor Function Classification System I–III, did not receive any specific lower limbs’ medical treatment, or did not participate in a strength training program for lower limbs within 6 months before the study. Subjective norms were found to be the only significant predictor of intention, accounting for 83% of variance in intention. Intention and perceived behaviour control were found to be a nonsignificant predictor of attendance behaviour in youth with CP. The results show that TPB is a relevant tool in the prediction of intention towards a physical activity intervention in Finnish youth with CP.
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Affiliation(s)
- Alfredo Ruiz
- Faculty of Sport and Health Sciences, University of Jyväskylä, Nokia, Finland
| | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu and Kuopio, Finland.,Department of Physical Education and Sport Sciences, University of Limerick, Ireland, Joensuu, Finland
| | - Pauli Rintala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Nokia, Finland
| | - Kaisa Kaseva
- Cicero Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Nokia, Finland
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Feng C, Adebero T, DePaul VG, Vafaei A, Norman KE, Auais M. A Systematic Review and Meta-Analysis of Exercise Interventions and Use of Exercise Principles to Reduce Fear of Falling in Community-Dwelling Older Adults. Phys Ther 2022; 102:6383647. [PMID: 34636923 DOI: 10.1093/ptj/pzab236] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 06/14/2021] [Accepted: 08/30/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Fear of falling (FOF) contributes to activity restriction and institutionalization among older adults, and exercise interventions are linked to reduction in FOF. Adhering to exercise principles and adapting optimal exercise parameters are fundamental to optimizing the effectiveness of exercise interventions. The purpose of this review was to describe FOF exercise interventions in community-dwelling older adults, evaluate the extent to which these interventions followed the exercise principles and reported exercise parameters, and quantify the effect of these interventions on reducing FOF. METHODS Randomized controlled trials (RCTs) of FOF exercise interventions in older adults (≥65 years) were identified from 4 databases. The methodological quality of RCTs was assessed using the Physiotherapy Evidence Database scale. A random-effect model was used in the meta-analysis. RESULTS Seventy-five RCTs were included in this review. With regard to reporting exercise principles, specificity was reported in 92% of trials, progression in 72%, reversibility in 32%, overload in 31%, diminished return in 21%, and initial value in 8%. For exercise parameters, 97% of RCTs reported exercise type; 89%, frequency; and 85%, time. Only 25% reported the intensity. The pooled effect of exercise interventions on FOF among all included studies was a standard mean difference of -0.34 (95% CI = -0.44 to -0.23). CONCLUSION This study showed a significant small to moderate effect size of exercise interventions in reducing FOF among community-dwelling older adults. Most exercise principles and intensity of exercises were not adequately reported in included trials. IMPACT These inadequate reports could undermine efforts to examine the optimal dosage for exercise prescription. More attention must be given to designing and reporting components of therapeutic exercise programs to facilitate evidence-based practice.
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Affiliation(s)
- Chengying Feng
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Tony Adebero
- Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada
| | - Vincent G DePaul
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Afshin Vafaei
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Kathleen E Norman
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Mohammad Auais
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
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Osuka Y, Nofuji Y, Seino S, Maruo K, Oka H, Shinkai S, Fujiwara Y, Sasai H. The effect of a multicomponent intervention on occupational fall‐related factors in older workers: A pilot randomized controlled trial. J Occup Health 2022; 64:e12374. [DOI: 10.1002/1348-9585.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/28/2022] [Accepted: 11/13/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Itabashi‐ku Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Itabashi‐ku Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Itabashi‐ku Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine University of Tokyo Bunkyo‐ku Japan
| | - Shoji Shinkai
- Graduate School of Nutrition and Health Science Kagawa Nutrition University Sakado Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Itabashi‐ku Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Itabashi‐ku Japan
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O'Brien T, Tan A, Rose K, Focht B, Daloul R. Maintenance phase of a physical activity intervention in older kidney transplant recipients: A 12-month follow-up. Geriatr Nurs 2021; 42:1541-1546. [PMID: 34741827 DOI: 10.1016/j.gerinurse.2021.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
Daily walking activities are associated with improving cardiovascular outcomes in older kidney transplant recipients. However, little is known regarding physical activity adherence outcomes in older kidney recipients. The purpose of this randomized controlled trial 12-month follow-up study was to evaluate the feasibility of the intervention (SystemCHANGE™ + activity tracker) during the maintenance period (7-12 months), compared to an attention-control group (activity tracker only) in older kidney recipients (age 60 and older). The sample included 60 participants (n = 30 IG; n = 30 ACG). Adherence rates for wearing the activity tracker daily were 96.5% in the IG and 80.8% in the ACG. The IG demonstrated within-group improvements for blood pressure at 12 months. Overall, there was a decrease in the average daily steps observed in both groups. These data suggest this intervention is feasible and additional boosters should be considered during the maintenance period to encourage physical activity.
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Affiliation(s)
- Tara O'Brien
- The Ohio State University College of Nursing, Columbus, OH Columbus, OH, Newton Hall,1585 Neil Ave, Columbus, OH 43210, USA.
| | - Alai Tan
- The Ohio State University College of Nursing Newton Hall, 1585 Neil Ave, Columbus, OH, USA 43210
| | - Karen Rose
- The Ohio State University College of Nursing Newton Hall, 1585 Neil Ave, Columbus, OH, USA 43210
| | - Brian Focht
- The Ohio State University College of Education and Human Ecology, 152 PAES, 305 Annie and John Glenn Ave, Columbus, OH, USA, 43210
| | - Reem Daloul
- The Ohio State University College of Medicine, 300 West 10th Avenue Suite 1150, Columbus, USA, OH 43210
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45
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Mardaniyan Ghahfarrokhi M, Banitalebi E, Faramarzi M, Motl R. Feasibility and efficacy of home-based neurofunctional exercise vs. resistance exercise programs for ambulatory disability of multiple sclerosis patients with cognitive impairment. Mult Scler Relat Disord 2021; 58:103400. [DOI: 10.1016/j.msard.2021.103400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 01/26/2023]
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Allen SK, Brown V, White D, King D, Hunt J, Wainwright J, Emery A, Hodge E, Kehinde A, Prabhu P, Rockall TA, Preston SR, Sultan J. Multimodal Prehabilitation During Neoadjuvant Therapy Prior to Esophagogastric Cancer Resection: Effect on Cardiopulmonary Exercise Test Performance, Muscle Mass and Quality of Life-A Pilot Randomized Clinical Trial. Ann Surg Oncol 2021; 29:1839-1850. [PMID: 34725764 DOI: 10.1245/s10434-021-11002-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/28/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Neoadjuvant therapy reduces fitness, muscle mass, and quality of life (QOL). For patients undergoing chemotherapy and surgery for esophagogastric cancer, maintenance of fitness is paramount. This study investigated the effect of exercise and psychological prehabilitation on anaerobic threshold (AT) at cardiopulmonary exercise testing (CPET). Secondary endpoints included peak oxygen uptake (peak VO2), skeletal muscle mass, QOL, and neoadjuvant therapy completion. METHODS This parallel-arm randomized controlled trial assigned patients with locally advanced esophagogastric cancer to receive prehabilitation or usual care. The 15-week program comprised twice-weekly supervised exercises, thrice-weekly home exercises, and psychological coaching. CPET was performed at baseline, 2 weeks after neoadjuvant therapy, and 1 week preoperatively. Skeletal muscle cross-sectional area at L3 was analyzed on staging and restaging computed tomography. QOL questionnaires were completed at baseline, mid-neoadjuvant therapy, at restaging laparoscopy, and postoperatively at 2 weeks, 6 weeks and 6 months. RESULTS Fifty-four participants were randomized (prehabilitation group, n = 26; control group, n = 28). No difference in AT between groups was observed post-neoadjuvant therapy. Prehabilitation resulted in an attenuated peak VO2 decline {-0.4 [95% confidence interval (CI) -0.8 to 0.1] vs. -2.5 [95% CI -2.8 to -2.2] mL/kg/min; p = 0.022}, less muscle loss [-11.6 (95% CI -14.2 to -9.0) vs. -15.6 (95% CI -18.7 to -15.4) cm2/m2; p = 0.049], and improved QOL. More prehabilitation patients completed neoadjuvant therapy at full dose [prehabilitation group, 18 (75%) vs. control group, 13 (46%); p = 0.036]. No adverse events were reported. CONCLUSIONS This study has demonstrated some retention of cardiopulmonary fitness (peak VO2), muscle, and QOL in prehabilitation subjects. Further large-scale trials will help determine whether these promising findings translate into improved clinical and oncological outcomes. Trial Registration ClinicalTrials.gov NCT02950324.
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Affiliation(s)
- Sophie K Allen
- Department of General Surgery, The Royal Surrey NHS Foundation Trust Hospital, Guildford, UK.,Minimal Access Therapy Training Unit (MATTU), Guildford, UK
| | - Vanessa Brown
- Department of General Surgery, The Royal Surrey NHS Foundation Trust Hospital, Guildford, UK.,Minimal Access Therapy Training Unit (MATTU), Guildford, UK
| | - Daniel White
- Department of General Surgery, The Royal Surrey NHS Foundation Trust Hospital, Guildford, UK.,Minimal Access Therapy Training Unit (MATTU), Guildford, UK
| | - David King
- Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Julie Hunt
- Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Joe Wainwright
- Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Annabelle Emery
- Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Emily Hodge
- The Fountain Centre, St Luke's Cancer Centre, Guildford, UK
| | - Aga Kehinde
- The Fountain Centre, St Luke's Cancer Centre, Guildford, UK
| | - Pradeep Prabhu
- Department of Anaesthetics, The Royal Surrey NHS Foundation Trust Hospital, Guildford, UK
| | - Timothy A Rockall
- Department of General Surgery, The Royal Surrey NHS Foundation Trust Hospital, Guildford, UK.,Minimal Access Therapy Training Unit (MATTU), Guildford, UK
| | - Shaun R Preston
- Department of General Surgery, The Royal Surrey NHS Foundation Trust Hospital, Guildford, UK
| | - Javed Sultan
- Department of General Surgery, The Royal Surrey NHS Foundation Trust Hospital, Guildford, UK.
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Deraas TS, Hopstock L, Henriksen A, Morseth B, Sand AS, Njølstad I, Pedersen S, Sagelv E, Johansson J, Grimsgaard S. Complex lifestyle intervention among inactive older adults with elevated cardiovascular disease risk and obesity: a mixed-method, single-arm feasibility study for RESTART-a randomized controlled trial. Pilot Feasibility Stud 2021; 7:190. [PMID: 34706777 PMCID: PMC8555104 DOI: 10.1186/s40814-021-00921-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background Physical inactivity and obesity are global public health challenges. Older adults are important to target for prevention and management of disease and chronic conditions. However, many individuals struggle with maintaining increased physical activity (PA) and improved diet. This feasibility study provides the foundation for the RESTART trial, a randomized controlled trial (RCT) to test a complex intervention to facilitate favourable lifestyle changes older adults can sustain. The primary objective of this study was to investigate study feasibility (recruitment, adherence, side-effects, and logistics) using an interdisciplinary approach. Methods This 1-year prospective mixed-method single-arm feasibility study was conducted in Tromsø, Norway, from September 2017. We invited by mail randomly selected participants from the seventh survey of the Tromsø Study (2015–2016) aged 55–75 years with sedentary lifestyle, obesity, and elevated cardiovascular risk. Participants attended a 6-month complex lifestyle intervention program, comprising instructor-led high-intensive exercise and nutritionist- and psychologist-led counselling, followed by a 6-month follow-up. All participants used a Polar activity tracker for daily activity monitoring during the intervention. Participants were interviewed three times throughout the study. Primary outcome was study feasibility measures. Results We invited potential participants (n=75) by mail of which 27 % (n=20) agreed to participate. Telephone screening excluded four participants, and altogether 16 participants completed baseline screening. The intervention and test procedures of primary and secondary outcomes were feasible and acceptable for the participants. There were no exercise-induced injuries, indicating that the intervention program is safe. Participants experienced that the dietary and psychological counselling were delivered too early in the intervention and in too close proximity to the start of the exercise program. Minor logistic improvements were implemented throughout the intervention period. Conclusion This study indicates that it is feasible to conduct a full-scale RCT of a multi-component randomized intervention trial, based on the model of the present study. No dropouts due to exercise-induced injury indicates that the exercises were safe. While minor improvements in logistics were implemented during the intervention, we will improve recruitment and adherence strategies, rearrange schedule of intervention contents (exercise, diet, and psychology), as well as improve the content of the dietary and behavioural counselling to maximize outcome effects in the RESTART protocol. Trial registration ClinicalTrials.gov Identifier: NCT03807323 Registered 16 January 2019 – retrospectively registered.
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Affiliation(s)
- Trygve S Deraas
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Laila Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andre Henriksen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Sofie Sand
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sigurd Pedersen
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Edvard Sagelv
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Evaluation of the instrumented Timed Up and Go test as a tool to measure exercise intervention effects in nursing home residents: results from a PROCARE substudy. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-021-00764-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
Background and objectives
To achieve independence in activities of daily living, a certain level of functional ability is necessary. The instrumented Timed Up and Go (iTUG) test provides guidance for appropriate interventions, for example, when considering the subphases within the TUG. Therefore, we evaluated the iTUG as a tool to measure the effects of a multicomponent exercise intervention on the iTUG subphases in nursing home residents.
Methods
Fifty long-term nursing home residents (34 women, 82.7 ± 6.46 [65–91] years; 16 men, 78.6 ± 7.0 [62–90] years) performed the iTUG test before and after a 16-week intervention period (2 × 45–60 min/week). According to the attendance rates, participants were divided into three groups.
Results
The total iTUG duration decreased from baseline to posttest, F(2,46) = 3.50, p = 0.038, η2p = 0.132. We observed significant correlations between the attendance rates and the total iTUG duration (r(50) = 0.328, p = 0.010). However, we did not observe significant group × time interaction effects in the subphases. The Barthel Index moderated the effect between attendance rate and the total duration of the iTUG test, ΔR2 = 8.34%, F(1,44) = 4.69, p = 0.036, 95% CI [0.001, 0.027].
Conclusions
We confirmed the effectiveness of the iTUG as a tool to measure exercise intervention effects in nursing home residents, especially when participants exhibit high attendance rates. That said, mobility needs to be considered in a more differentiated way, taking into account parameters in the subphases to detect changes more sensitively and to derive recommendations in a more individualized way.
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Intelligent Coaching Assistant for the Promotion of Healthy Habits in a Multidomain mHealth-Based Intervention for Brain Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010774. [PMID: 34682518 PMCID: PMC8535867 DOI: 10.3390/ijerph182010774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/26/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022]
Abstract
Brain Health is defined as the development and preservation of optimal brain integrity and neural network functioning for a given age. Recent studies have related healthy habits with better maintenance of brain health across the lifespan. As a part of the Barcelona Brain Health Initiative (BBHI), a mHealth platform has been developed with the purpose of helping people to improve and monitor their healthy habits, facilitating the delivery of health coaching strategies. A decision support system (DSS), named Intelligent Coaching Assistant (ICA), has been developed to ease the work of professional brain health coaches, helping them design and monitor adherence to multidomain interventions in a more efficient manner. Personalized recommendations are based on users’ current healthy habits, individual preferences, and motivational aspects. Taking these inputs, an initial user profile is defined, and the ICA applies an algorithm for determining the most suitable personalized intervention plan. An initial validation has been done focusing on assessing the feasibility and usability of the solution, involving 20 participants for three weeks. We conclude that this kind of technology-based intervention is feasible and implementable in real-world settings. Importantly, the personalized intervention proposal generated by the DSS is feasible and its acceptability and usability are high.
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Müller J, Weiler M, Schneeweiss A, Haag GM, Steindorf K, Wick W, Wiskemann J. Preventive effect of sensorimotor exercise and resistance training on chemotherapy-induced peripheral neuropathy: a randomised-controlled trial. Br J Cancer 2021; 125:955-965. [PMID: 34226683 PMCID: PMC8476560 DOI: 10.1038/s41416-021-01471-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/25/2021] [Accepted: 06/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a common, unpleasant and usually long-lasting side effect of neurotoxic chemotherapeutic agents. This study aimed to investigate the preventive potential of sensorimotor- (SMT) and resistance training (RT) on CIPN. METHODS Patients (N = 170) were randomised to SMT, RT or usual care (UC). Both exercise groups trained 3×/week for a total of 105 min/week during neurotoxic chemotherapy (mean length: 20 weeks). Before and 3 weeks after neurotoxic chemotherapy, CIPN signs/symptoms were assessed via Total Neuropathy Score (TNSr; primary endpoint) and EORTC QLQ-CIPN15 questionnaire. In addition, balance (centre of pressure), muscle strength (isokinetic), quality of life (QoL, EORTC QLQ-C30) and relative chemotherapy dose intensity (RDI) were investigated. The follow-up period covered 6 months after the end of chemotherapy. RESULTS Intention-to-treat analyses (N = 159) revealed no differences regarding CIPN signs/symptoms. Exploratory per-protocol analyses (minimum training attendance rate 67%; N = 89) indicated that subjectively perceived sensory symptoms in the feet increased less during chemotherapy in the adherent exercisers (pooled group: SMT+RT) than in the UC group (-8.3 points (-16.1 to -0.4); P = 0.039, ES = 1.27). Furthermore, adherent exercisers received a higher RDI (96.6 ± 4.8 vs. 92.2 ± 9.4; P = 0.045), showed a better course of muscular strength (+20.8 Nm (11.2-30.4); P < 0.001, ES = 0.57) and QoL (+12.9 points (3.9-21.8); P = 0.005, ES = 0.64). During follow-up, CIPN signs/symptoms persisted in all groups. CONCLUSIONS This study demonstrates that SMT and/or RT alleviate subjectively perceived sensory CIPN symptoms in the feet and other clinically relevant cancer therapy-related outcomes, if an appropriate training stimulus is achieved. CLINICAL TRIAL REGISTRATION NCT02871284.
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Affiliation(s)
- Jana Müller
- grid.5253.10000 0001 0328 4908Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Institute of Sports and Sport Science, Heidelberg University, Heidelberg, Germany
| | - Markus Weiler
- grid.5253.10000 0001 0328 4908Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Schneeweiss
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.5253.10000 0001 0328 4908Division of Gynecological Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Georg Martin Haag
- grid.5253.10000 0001 0328 4908Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Karen Steindorf
- grid.7497.d0000 0004 0492 0584Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Wolfgang Wick
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.5253.10000 0001 0328 4908Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Joachim Wiskemann
- grid.5253.10000 0001 0328 4908Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
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