1
|
Jane B, Downey J. Exercise referral schemes in the UK: mapping provision and aims. J Public Health (Oxf) 2024:fdae057. [PMID: 38702841 DOI: 10.1093/pubmed/fdae057] [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: 06/18/2023] [Revised: 02/09/2024] [Accepted: 04/12/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Exercise Referral Schemes (ERS) are designed so health professionals can refer certain patients to a supervised programme of physical activity. However, evaluations have questioned the effectiveness of these schemes/programmes. The aim of this study was to systematically review the provision of ERS in England and analyse related promotional material. METHODS Content analysis methods were used to analyse scheme websites and promotional material. A coding scheme was used to analyse the data, which included information on the programme's aims, inclusion criteria, type of activities, accessibility and cost. RESULTS The study identified 625 sites offering ERS across 168 geographic areas. Findings highlighted a lack of clarity in what constitutes a scheme. Over a third of schemes did not explicitly state their aims, but of those that did, the focus was mainly on notions of physical and mental health benefits. CONCLUSIONS This study is the first to review the scope and offer of ERS in the UK by examining promotional material and highlights issues around the stated aims of ERS. More clarity on aims is needed in the material that promotes the schemes and most likely within the schemes themselves. Such improvements could make a difference when considering engagement with delivery stakeholders and potential participants.
Collapse
Affiliation(s)
- Ben Jane
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth PL6 8BH, UK
| | - John Downey
- School of Nursing and Midwifery, University of Plymouth, Plymouth PL4 8AA, UK
| |
Collapse
|
2
|
Greenwood H, Davidson AR, Thomas R, Albarqouni L. Common barriers and enablers to the use of non-drug interventions for managing common chronic conditions in primary care: an overview of reviews. BMC PRIMARY CARE 2024; 25:108. [PMID: 38582829 PMCID: PMC10998330 DOI: 10.1186/s12875-024-02321-8] [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: 09/11/2023] [Accepted: 02/23/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Non-drug interventions are recommended for chronic condition prevention and management yet are underused in clinical practice. Understanding barriers and enablers to using non-drug interventions may help implement non-drug interventions in primary care. We aimed to conduct an overview of reviews to identify and summarise common barriers and enablers for using non-drug interventions for common chronic conditions in primary care. METHODS We included qualitative and quantitative reviews that used systematic process or methods to examine barriers and enablers to using non-drug interventions for chronic condition prevention and management in primary care settings. We searched 5 electronic databases (PubMed, Cochrane Database of Systematic Reviews, EMBASE, PsycInfo and CINAHL) from inception to September 2022. Two authors independently screened reviews. One author extracted and deductively coded data to Consolidated Framework of Implementation Research (CFIR) (and where relevant, Theoretical Domains Framework [TDF]). A second author validated 10% of extracted data and coding. Data was synthesised thematically using CFIR and TDF. One author assessed the methodological quality of included reviews using a modified AMSTAR 2 tool, with 10% validated by a second author. We assessed overlap between primary studies in included reviews. RESULTS From 5324 records, we included 25 reviews, with data predominately from patients. Overall, 130 subthemes (71 barrier and 59 enabler) were identified across 4 CFIR domains (Innovation, Outer Setting, Inner Setting, and Individuals), and all TDF domains. Common barrier and enabler subthemes were identified for CFIR constructs of Innovation Adaptability, Innovation Cost, Innovation Relative Advantage, Local Attitudes, External Pressure, Local Conditions, Relational Connections, Available Resources, and Access to Knowledge and Information. For TDF domains, important barrier and enabler subthemes were identified for Knowledge, Skills, Environmental Context and Resources, Beliefs about Consequences, Reinforcement, and Emotion. CONCLUSIONS We synthesised reviews to provide new insight into common barriers and enablers for using non-drug interventions to prevent and manage chronic conditions in primary care. The factors identified can inform the development of generalisable implementation interventions to enhance uptake of multiple non-drug interventions simultaneously. TRIAL REGISTRATION This study was registered in PROSPERO (CRD42022357583).
Collapse
Affiliation(s)
- Hannah Greenwood
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia.
| | - Alexandra R Davidson
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | - Rae Thomas
- Tropical Australian Academic Health Centre, Townsville, Australia
| | - Loai Albarqouni
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| |
Collapse
|
3
|
Albarqouni L, Greenwood H, Dowsett C, Hoffmann T, Thomas R, Glasziou P. Attitudes, beliefs, behaviours and perspectives on barriers and enablers of Australian general practitioners towards non-drug interventions: a national survey. Fam Med Community Health 2024; 12:e002457. [PMID: 38199611 PMCID: PMC10806537 DOI: 10.1136/fmch-2023-002457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Many guidelines recommend non-drug interventions (NDIs) for managing common conditions in primary care. However, compared with drug interventions, NDIs are less widely known, promoted and used. We aim to (1) examine general practitioners' (GPs') knowledge, attitudes and practices for NDIs, including their use of the Royal Australian College of General Practitioners (RACGP) Handbook of Non-Drug Interventions (HANDI), and (2) identify factors influencing their use of NDIs and HANDI. METHODS We conducted a web-based cross-sectional survey of practicing GP members in Australia during October-November 2022. The survey contained five sections: characteristics of GP; knowledge and use of NDIs; attitudes towards NDIs; barriers and enablers to using HANDI; and suggestions of NDIs and ideas to improve the uptake of NDIs in primary care. RESULTS Of the 366 GPs who completed the survey, 242 (66%) were female, and 248 (74%) were ≥45 years old. One in three GPs reported that they regularly ('always') recommend NDIs to their patients when appropriate (34%), whereas one-third of GPs were unaware of HANDI (39%). GPs identified several factors that improve the uptake of HANDI, including 'access and integration of HANDI in clinical practice', 'content and support to use in practice' and 'awareness and training'. CONCLUSIONS While many GPs are aware of the effectiveness of NDIs and often endorse their use, obstacles still prevent widespread adoption in primary care. The results of this survey can serve as a foundation for developing implementation strategies to improve the uptake of effective evidence-based NDIs in primary care.
Collapse
Affiliation(s)
- Loai Albarqouni
- Institute for Evidence-based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| | - Hannah Greenwood
- Institute for Evidence-based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| | - Caroline Dowsett
- Institute for Evidence-based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| | - Tammy Hoffmann
- Institute for Evidence-based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| | - Rae Thomas
- Institute for Evidence-based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
- Tropical Australian Academic Health Centre, Townsville, Queensland, Australia
| | - Paul Glasziou
- Institute for Evidence-based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| |
Collapse
|
4
|
Ravender R, Roumelioti ME, Schmidt DW, Unruh ML, Argyropoulos C. Chronic Kidney Disease in the Older Adult Patient with Diabetes. J Clin Med 2024; 13:348. [PMID: 38256482 PMCID: PMC10816477 DOI: 10.3390/jcm13020348] [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: 10/06/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Diabetes mellitus (DM) and chronic kidney disease (CKD) are common in middle aged and older adult individuals. DM may accelerate the aging process, and the age-related declines in the estimated glomerular filtration rate (eGFR) can pose a challenge to diagnosing diabetic kidney disease (DKD) using standard diagnostic criteria especially with the absence of severe albuminuria among older adults. In the presence of CKD and DM, older adult patients may need multidisciplinary care due to susceptibility to various health issues, e.g., cognitive decline, auditory or visual impairment, various comorbidities, complex medical regimens, and increased sensitivity to medication adverse effects. As a result, it can be challenging to apply recent therapeutic advancements for the general population to older adults. We review the evidence that the benefits from these newer therapies apply equally to older and younger patients with CKD and diabetes type 2 and propose a comprehensive management. This framework will address nonpharmacological measures and pharmacological management with renin angiotensin system inhibitors (RASi), sodium glucose co-transporter 2 inhibitors (SGLT2i), non-steroidal mineralocorticoids receptor antagonists (MRAs), and glucagon like peptide 1 receptor agonists (GLP1-RAs).
Collapse
Affiliation(s)
| | | | | | | | - Christos Argyropoulos
- Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine, MSC 04-2785, Albuquerque, NM 87131, USA; (R.R.); (M.-E.R.); (D.W.S.); (M.L.U.)
| |
Collapse
|
5
|
Grannell A, Hallson H, Gunlaugsson B, Jonsson H. Exercise therapy as a digital therapeutic for chronic disease management: consideration for clinical product development. Front Digit Health 2023; 5:1250979. [PMID: 38173910 PMCID: PMC10761443 DOI: 10.3389/fdgth.2023.1250979] [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: 06/30/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Digital exercise therapies (DET) have the potential to bridge existing care gaps for people living with chronic conditions. Acting as either a standalone, embedded within multi-modal lifestyle therapy, or adjunct to pharmacotherapy or surgery, evidence-based DETs can favorably impact the health of a rapidly growing population. Given the nascent nature of digital therapeutics, the regulatory landscape has yet to mature. As such, in the absence of clear guidelines clinical digital product developers are responsible for ensuring the DET adheres to fundamental principles such as patient risk management and clinical effectiveness. The purpose of this narrative review paper is to discuss key considerations for clinical digital product developers who are striving to build novel digital therapeutic (DTx) solutions and thus contribute towards standardization of product development. We herein draw upon DET as an example, highlighting the need for adherence to existing clinical guidelines, human-centered design and an intervention approach that leverages the Chronic Care Model. Specific topics and recommendations related to the development of innovative and scalable products are discussed which ultimately allow for differentiation from a basic wellness tool and integration to clinical workflows. By embodying a code of ethics, clinical digital product developers can adequately address patients' needs and optimize their own future digital health technology assessments including appropriate evidence of safety and efficacy.
Collapse
Affiliation(s)
- Andrew Grannell
- Sidekick Health, Research & Development Unit, Kópavogur, Iceland
| | | | | | | |
Collapse
|
6
|
Yedjou CG, Webster S, Osborne D, Liu J, Balagurunathan Y, Odewuni C, Latinwo L, Ngnepiepa P, Alo R, Tchounwou PB. Health Promotion and Racial Disparity in COVID-19 Mortality Among African American Populations. REPORTS ON GLOBAL HEALTH RESEARCH 2023; 6:168. [PMID: 37946735 PMCID: PMC10634601 DOI: 10.29011/2690-9480.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
COVID-19, known as Coronavirus Disease 2019, is a major health issue resulting from novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Its emergence has posed a significant menace to the global medical community and healthcare system across the world. Notably, on December 12, 2020, the Food and Drug Administration (FDA) approved the utilization of the Pfizer and Moderna COVID-19 vaccines. As of July 31, 2022, the United Stated has witnessed over 91.3 million cases of COVID-19 and nearly 1.03 million fatalities. An intriguing observation is the recent reduction in the mortality rate of COVID-19, attributed to an augmented focus on early detection, comprehensive screening, and widespread vaccination. Despite this positive trend in some demographics, it is noteworthy that the overall incidence rates of COVID-19 among African American and Hispanic populations have continued to escalate, even as mortality rates have decreased. Therefore, the objective of this research study is to present an overview of COVID-19, spotlighting the disparities among different racial and ethnic groups. It also delves into the management of COVID-19 within the minority populations. To reach our research objective, we used a publicly available COVID-19 dataset from kaggle:https://www.kaggle.com/datasets/paultimothymooney/covid19-cases-and-deaths-by-race. In addition, we obtained COVID-19 datasets from 10 different states with the highest proportion of African American populations. Many considerable strikes have been made in COVID-19. However, success rate of treatment in the African American population remains relatively limited when compared to other ethnic groups. Hence, there arises a pressing need for novel strategies and innovative approaches to not only encourage prevention measures against COVID-19, but also to increase survival rates, diminish mortality rates, and ultimately improve the health outcomes of ethnic and racial minorities.
Collapse
Affiliation(s)
- Clement G Yedjou
- Department of Biological Sciences, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | - Shayla Webster
- Department of Biological Sciences, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | - Daniel Osborne
- Department of Mathematics, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | - Jinwei Liu
- Department of Computer Science, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | | | - Carolyn Odewuni
- Department of Biological Sciences, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | - Lekan Latinwo
- Department of Biological Sciences, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | - Pierre Ngnepiepa
- Department of Mathematics, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | - Richard Alo
- Department of Computer Science, College of Science and Technology, Florida Agricultural and Mechanical University, 1610 S. Martin Luther King Blvd, Tallahassee, FL 32307, USA
| | - Paul B Tchounwou
- RCMI Center for Urban Health Disparities Research and Innovation, Morgan State University, 1700 E. Cold Spring Lane, Baltimore, MD 21252, USA
| |
Collapse
|
7
|
O'Brien MW, Pellerine LP, Howitt SD, deGraauw C, Fowles JR. Physical activity counselling and exercise prescription practices of chiropractors in Canada and internationally: an exploratory survey. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2023; 67:105-116. [PMID: 37840580 PMCID: PMC10575325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Physical activity and exercise (PAE) counselling and exercise prescriptions increase patient physical activity. However, the perceptions/practices of chiropractors are poorly understood. Methods We surveyed the practices among chiropractors working in Canada (n=50) and Internationally (n=37). Chiropractors completed self-reflection questionnaires regarding their current practices and perceptions towards providing PAE counselling to patients. Chiropractor responses were obtained via Canadian provincial survey and educational workshops. Results Chiropractor respondents included PAE content and exercise prescriptions in most patient appointments (67±27% and 59±35%, respectively), but the largest barriers (2.5/4.0) and least confidence were in their patients to follow through (52±21%). Canadian respondents reported higher knowledge (~0.4/4.0 higher), greater self-confidence (10-20% higher), and provided more PAE recommendations (8%) and prescriptions (16%) than International respondents. Chiropractor respondents were least comfortable advising patients with cancer. Conclusion Chiropractor respondents may serve as health promotors to address patient inactivity, and the challenges identified should be addressed through educational training.
Collapse
Affiliation(s)
- Myles W O'Brien
- School of Physiotherapy (Faculty of Health) and Department of Medicine (Faculty of Medicine), Dalhousie University
- Geriatric Medicine Research, Dalhousie University and Nova Scotia Health
| | - Liam P Pellerine
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University
| | | | | | | |
Collapse
|
8
|
Nye NS, Grubic T, Kim M, O'Connor F, Deuster PA. Universal Training Precautions: A Review of Evidence and Recommendations for Prevention of Exercise-Related Injury, Illness, and Death in Warfighters and Athletes. J Athl Train 2023; 58:232-243. [PMID: 35724358 PMCID: PMC10176841 DOI: 10.4085/1062-6050-0400.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Facing pressure to train for victory, warfighters and athletes encounter numerous health risks that are directly related to their regular physical training. The concept of universal training precautions (UTPs) signifies universal processes designed to prevent unnecessary bodily harm, including injury, illness, and death, during physical training programs. Although no formal guidelines exist for collectively implementing a defined set of UTPs to address a broad scope of exercise-related health risks, recommendations and guidelines have been published relating to preventing sudden death during high school sports and collegiate conditioning sessions. A long list of critical topics must be considered as UTPs, including physical fitness factors, transition-period accommodation, hydration, environmental factors and acclimatization, appropriate recovery, use of medications and dietary supplements, and importantly, leadership. In this article, we outline in detail, with corresponding Strength of Recommendation Taxonomy ratings, what should be considered universal recommendations to minimize the risk of warfighters and athletes coming to harm when participating in group physical activities.
Collapse
Affiliation(s)
| | - Tyler Grubic
- Aviation Survival Training Center, NAS Patuxent River, MD
| | - Michael Kim
- Sports Medicine Clinic, Fort Belvoir Community Hospital, VA
| | | | - Patricia A. Deuster
- USU/MEM Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Silver Spring, MD
| |
Collapse
|
9
|
Room J, Dawes H, Boulton M, Barker K. The AERO study: A feasibility randomised controlled trial of individually tailored exercise adherence strategies based on a brief behavioural assessment for older people with musculoskeletal conditions. Physiotherapy 2023; 118:88-96. [PMID: 36266133 DOI: 10.1016/j.physio.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/06/2022] [Accepted: 08/25/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Exercise is a widely used treatment modality for older people with musculoskeletal conditions. The effectiveness of exercise programmes is limited by adherence. The aims of this study were to examine the acceptability and feasibility of the AERO intervention in facilitating exercise adherence in older people with musculoskeletal conditions, and to inform the design of a future randomised controlled trial. METHODS A two arm feasibility randomised controlled trial with an embedded qualitative study conducted at one orthopaedic hospital in the South of England. Older adults referred to physiotherapy with musculoskeletal conditions were randomised to receive either usual care consisting of standard physiotherapy only, or the AERO intervention, consisting of usual care with the addition of tailored exercise adherence approaches based on a brief behavioural assessment. Feasibility outcomes included recruitment, randomisation, retention, acceptability, and fidelity to trial protocol. Secondary outcomes included exercise adherence, physical activity, and behavioural regulation. RESULTS 48 participants were recruited to the study with 27 randomised to usual care and 21 to AERO and usual care. On the basis of recruitment, retention, the acceptability to participants and physiotherapists and fidelity, the AERO intervention was determined to be feasible. CONCLUSION The AERO intervention in which participants received tailored adherence strategies based on a behavioural assessment plus standard physiotherapy is feasible and acceptable. It is now ready to be tested in an adequately powered randomised controlled trial. CONTRIBUTION OF THE PAPER CLINICAL TRIAL REGISTRATION NUMBER: This study was registered at clinicaltrials.gov REF: NCT03643432.
Collapse
Affiliation(s)
- Jonathan Room
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS FT, Oxford, UK; Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Helen Dawes
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK
| | - Mary Boulton
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK
| | - Karen Barker
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS FT, Oxford, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| |
Collapse
|
10
|
Lehtovirta M, Wu F, Rovio SP, Heinonen OJ, Laitinen TT, Niinikoski H, Lagström H, Viikari JSA, Rönnemaa T, Jula A, Ala-Korpela M, Raitakari OT, Pahkala K. Association of physical activity with metabolic profile from adolescence to adulthood. Scand J Med Sci Sports 2023; 33:307-318. [PMID: 36331352 DOI: 10.1111/sms.14261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Physical activity benefits cardiometabolic health, but little is known about its detailed links with serum lipoproteins, amino acids, and glucose metabolism at young age. We therefore studied the association of physical activity with a comprehensive metabolic profile measured repeatedly in adolescence. METHODS The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project. At ages 13, 15, 17, and 19 years, data on physical activity were collected by a questionnaire, and circulating metabolic measures were quantified by nuclear magnetic resonance metabolomics from repeatedly assessed serum samples (age 13: n = 503, 15: n = 472, 17: n = 466, and 19: n = 361). RESULTS Leisure-time physical activity (LTPA;MET h/wk) was directly associated with concentrations of polyunsaturated fatty acids, and inversely with the ratio of monounsaturated fatty acids to total fatty acids (-0.006SD; [-0.008, -0.003]; p < 0.0001). LTPA was inversely associated with very-low-density lipoprotein (VLDL) particle concentration (-0.003SD; [-0.005, -0.001]; p = 0.002) and VLDL particle size (-0.005SD; [-0.007, -0.003]; p < 0.0001). LTPA showed direct association with the particle concentration and size of high-density lipoprotein (HDL), and HDL cholesterol concentration (0.004SD; [0.002, 0.006]; p < 0.0001). Inverse associations of LTPA with triglyceride and total lipid concentrations in large to small sized VLDL subclasses were found. Weaker associations were seen for other metabolic measures including inverse associations with concentrations of lactate, isoleucine, glycoprotein acetylation, and a direct association with creatinine concentration. The results remained after adjusting for body mass index and proportions of energy intakes from macronutrients. CONCLUSIONS Physical activity during adolescence is beneficially associated with the metabolic profile including novel markers. The results support recommendations on physical activity during adolescence to promote health and possibly reduce future disease risks.
Collapse
Affiliation(s)
- Miia Lehtovirta
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Harri Niinikoski
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Hanna Lagström
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Tapani Rönnemaa
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland
| | - Mika Ala-Korpela
- Computational Medicine, Center for Life Course Health Research, Faculty of Medicine, University of Oulu & Biocenter Oulu, Oulu, Finland.,NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| |
Collapse
|
11
|
Influence of the body positions adopted for resistance training on intraocular pressure: a comparison between the supine and seated positions. Graefes Arch Clin Exp Ophthalmol 2023:10.1007/s00417-023-06009-0. [PMID: 36795163 DOI: 10.1007/s00417-023-06009-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES A variety of factors are known to mediate on the intraocular pressure (IOP) response to resistance training. However, the influence of the body position adopted during resistance training on IOP remain unknown. The objective of this study was to determine the IOP response to the bench press exercise at three levels of intensity when performed in supine and seated positions. METHODS Twenty-three physically active healthy young adults (10 men and 13 women) performed 6 sets of 10 repetitions against the 10-RM (repetition maximum) load during the bench press exercise against three levels of intensity (high intensity: 10-RM load; medium intensity: 50% of the 10-RM load; and control: no external load) and while adopting two different body positions (supine and seated). A rebound tonometer was employed to measure IOP in baseline conditions (after 60 s in the corresponding body position), after each of the 10 repetitions, and after 10 s of recovery. RESULTS The body position adopted during the execution of the bench press exercise significantly affected the changes in IOP (p < 0.001, ηp2 = 0.83), with the seated position providing lower increases in IOP levels compared to the supine position. There was an association between IOP and exercise intensity, with greater IOP values in the more physically demanding conditions (p < 0.001, ηp2 = 0.80). CONCLUSIONS The use of seated positions, instead of supine positions, for the execution of resistance training should be prioritized for maintaining more stable IOP levels. This set of findings incorporates novel insights into the mediating factors on the IOP response to resistance training. In future studies, the inclusion of glaucoma patients would allow to assess the generalizability of these findings.
Collapse
|
12
|
Yang J, Li X, He T, Ju F, Qiu Y, Tian Z. Impact of Physical Activity on COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114108. [PMID: 36360985 PMCID: PMC9657212 DOI: 10.3390/ijerph192114108] [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: 09/08/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 05/14/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is seriously endangering human health worldwide. This study finds effective intervention modalities of physical activity on COVID-19 through a narrative review. METHODS In this study, 41 papers were selected for a narrative literature review after a comprehensive database search from 20 December 2019, to 30 August 2022. RESULTS 41 articles meet the established criteria, and in this review, we comprehensively describe recent studies on exercise and COVID-19, including the impact and recommendations of exercise on COVID-19 prevention, patients with COVID-19, and noninfected populations. CONCLUSIONS The literature suggests that physical activity (PA) contributes to the prevention and treatment of COVID-19, can promote recovery of physical function, alleviate post-acute COVID-19 syndrome, and improve patients' psychological well-being. It is recommended to develop appropriate exercise prescriptions for different populations under the guidance of a physician.
Collapse
Affiliation(s)
- Jia Yang
- College of Physical Education, Hunan University, Changsha 410012, China
| | - Xiang Li
- College of Physical Education, Hunan University, Changsha 410012, China
| | - Taiyu He
- Chongqing Medical University, Chongqing 400016, China
| | - Fangyuan Ju
- College of Physical Education, Yangzhou University, Yangzhou 225012, China
- Correspondence: (F.J.); (Y.Q.); (Z.T.)
| | - Ye Qiu
- College of Biology, Hunan University, Changsha 410012, China
- Correspondence: (F.J.); (Y.Q.); (Z.T.)
| | - Zuguo Tian
- College of Physical Education, Hunan University, Changsha 410012, China
- Correspondence: (F.J.); (Y.Q.); (Z.T.)
| |
Collapse
|
13
|
O'Brien MW, Shivgulam ME, Petterson JL, Wu Y, Frayne RJ, Mekari S, Kimmerly DS. Habitual sedentary time and stationary time are inversely related to aerobic fitness. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:260-266. [PMID: 36600973 PMCID: PMC9806710 DOI: 10.1016/j.smhs.2022.10.002] [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: 07/08/2022] [Revised: 09/23/2022] [Accepted: 10/06/2022] [Indexed: 01/07/2023] Open
Abstract
A one metabolic-equivalent-of-task increase in peak aerobic fitness (peak MET) is associated with a clinically relevant improvement in survival risk and all-cause mortality. The co-dependent impact of free-living physical behaviours on aerobic fitness are poorly understood. The purpose of this study was to investigate the impact of theoretically re-allocating time spent in physical behaviours on aerobic fitness. We hypothesized that substituting sedentary time with any physical activity (at any intensity) would be associated with a predicted improvement in aerobic fitness. Peak volume rate of oxygen uptake ( V ˙ O2peak) was assessed via indirect calorimetry during a progressive, maximal cycle ergometer protocol in 103 adults (52 females; [38 ± 21] years; [25.0 ± 3.8] kg/m2; V ˙ O2peak: [35.4 ± 11.5] ml·kg-1·min-1). Habitual sedentary time, standing time, light- (LPA), moderate- (MPA), and vigorous-physical activity (VPA) were assessed 24-h/day via thigh-worn inclinometry for up to one week (average: [6.3 ± 0.9] days). Isotemporal substitution modelling examined the impact of replacing one physical behaviour with another. Sedentary time (β = -0.8, 95% CI: [-1.3, -0.2]) and standing time (β = -0.9, 95%CI: [-1.6, -0.2]) were negatively associated with V ˙ O2peak, whereas VPA was positively associated with relative V ˙ O2peak (β = 9.2, 95%CI: [0.9, 17.6]). Substituting 30-min/day of VPA with any other behaviour was associated with a 2.4-3.4 higher peak MET. Higher standing time was associated with a lower aerobic fitness. As little as 10-min/day of VPA predicted a clinically relevant 0.8-1.1 peak MET increase. Theoretically, replacing any time with relatively small amounts of VPA is associated with improvements in aerobic fitness.
Collapse
Affiliation(s)
- Myles W. O'Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Corresponding author. School of Health and Human Performance, Division of Kinesiology, Dalhousie University, 6230 South Street, Halifax, Nova Scotia, B3H 4R2, Canada.
| | - Madeline E. Shivgulam
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jennifer L. Petterson
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yanlin Wu
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan J. Frayne
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Said Mekari
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Derek S. Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
14
|
Do digital interventions increase adherence to home exercise rehabilitation? A systematic review of randomised controlled trials. Arch Physiother 2022; 12:24. [PMID: 36184611 PMCID: PMC9527092 DOI: 10.1186/s40945-022-00148-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home exercise regimes are a well-utilised rehabilitation intervention for many conditions; however, adherence to prescribed programmes remains low. Digital interventions are recommended as an adjunct to face-to-face interventions by the National Health Service in the UK and may offer increased exercise adherence, however the evidence for this is conflicting. METHOD A systematic review was undertaken using MEDLINE and CINAHL databases using the PRISMA guidelines. Randomised controlled trials in any clinical population evaluating the adherence to prescribed home exercise interventions with and without additional digital interventions were included. Publication quality was assessed using the Cochrane Risk of Bias tool. RESULTS The search strategy returned a total of 1336 articles, of which 10 randomised controlled trials containing data for 1117 participants were eligible for inclusion. 565 participants were randomised to receive the interventions, and 552 to the control. Seven of the ten trials reported a significant difference in adherence between the control and intervention groups favouring an additional digital intervention. Three trials reported equivalent findings. These three reported longer-term outcomes, suggesting an interaction between adherence and duration of intervention. There was substantial heterogeneity in outcome assessment metrics used across the trials prohibiting formal meta-analysis. This included studies were of low to moderate quality in terms of risk of bias. CONCLUSION The addition of a digital interventions to prescribed home exercise programmes can likely increase exercise adherence in the short term, with longer term effects less certain.
Collapse
|
15
|
Validity of the activPAL monitor to measure stepping activity and activity intensity: A systematic review. Gait Posture 2022; 97:165-173. [PMID: 35964334 DOI: 10.1016/j.gaitpost.2022.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/24/2022] [Accepted: 08/04/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Accumulating step counts and engaging in moderate-to-vigorous intensity physical activity is positively associated with numerous health benefits. The activPAL is a thigh-worn monitor that is frequently used to measure physical activity. RESEARCH QUESTION Can the activPAL accurately measure stepping activity and identify physical activity intensity? METHODS We systematically reviewed validation studies examining the accuracy of activPAL physical activity outcomes relative to a criterion measure in adults (>18 years). Citations were not restricted to language or date of publication. Sources were searched up to May 16, 2021 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier. The study was pre-registered in Prospero (ID# CRD42021248240). Study quality was determined using a modified Hagströmer Bowles checklist. RESULTS Thirty-nine studies (20 laboratory arms, 17 semi-structured arms, 11 uncontrolled protocol arms; 1272 total participants) met the inclusion criteria. Most studies demonstrated a high validity of the activPAL to measure steps across laboratory (12/15 arms), semi-structured (10/13 arms) and uncontrolled conditions (5/7 arms). Studies that demonstrated low validity were generally conducted in unhealthy populations, included slower walking speeds, and/or short walking distances. Few studies indicated that the activPAL accurately measured physical activity intensity across laboratory (0/6 arms), semi-structured (0/5 arms) and uncontrolled conditions (2/5 arms). Using the default settings, the activPAL overestimates light-intensity activity but underestimates moderate-to-vigorous intensity activity. The overall study quality was 11.5 ± 2.0 out of 19. CONCLUSION Despite heterogeneous methodological and statistical approaches, the included studies generally provide supporting evidence that the activPAL can accurately detect stepping activity but not physical activity intensity. Strategies that use alternative data processing methods have been developed to better characterize physical activity intensity, but all methods still underestimate vigorous-intensity activity.
Collapse
|
16
|
Faught E, Morgan TL, Tomasone JR. Five ways to counter ableist messaging in medical education in the context of promoting healthy movement behaviours. CANADIAN MEDICAL EDUCATION JOURNAL 2022; 13:82-86. [PMID: 36310911 PMCID: PMC9588188 DOI: 10.36834/cmej.74119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
One in five Canadians have a disability and there are well-documented gaps in care for this equity-deserving group that have roots in medical education. In this paper, we highlight the unintended consequences of ableist messaging for persons living with disabilities, particularly in the context of promoting healthy movement behaviours. With its broad reach and public trust, the medical community has a responsibility to acknowledge the reality of ableism and take meaningful action. We propose five strategies to counter ableist messaging in medical education: (1) increase knowledge and confidence among physicians and trainees to optimize movement behaviours in persons living with disabilities, (2) perform personal and institutional language audits to ensure terminology related to disability is inclusive and avoids causing unintended harm, (3) challenge ableist messages effectively, (4) address the unmet healthcare needs of persons living with disabilities, and (5) engage in efforts to reform medical curricula so that persons living with disabilities are represented and treated equitably. Physicians and trainees are well-positioned to deliver competent and inclusive care, making medical education an opportune setting to address health inequities related to disability.
Collapse
Affiliation(s)
- Emma Faught
- School of Medicine, Queen’s University, Ontario, Canada
| | - Tamara L Morgan
- School of Kinesiology and Health Studies, Queen’s University, Ontario, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen’s University, Ontario, Canada
| |
Collapse
|
17
|
[Barriers and facilitators of the EfiKroniK exercise program for people with chronic diseases in Primary Care]. Aten Primaria 2022; 54:102456. [PMID: 36037780 PMCID: PMC9440267 DOI: 10.1016/j.aprim.2022.102456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/13/2022] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Explore patients' perceptions during a supervised exercise program and detect the barriers and facilitators that influence exercise adherence after the supervision period. DESIGN A qualitative observational study with three focus groups as the main data collection technique was conducted. SITE: Primary Health centers of Bizkaia. PARTICIPANTS Out of the 175 randomized patients in the hybrid effectiveness-implementation trial, a sample of 19 patients from the intervention group were included in the qualitative study (12 advanced-stage onco-haematological patients and seven with severe mental disorders). METHODS Content analysis of the generated transcripts was performed by combining a deductive approach, based on the domains of the PRACTIS theoretical framework, and an inductive one, based on the postulates of the Grounded Theory. RESULTS The data analysis showed that participants were satisfied with the EfiKroniK program and that the main identified benefits were discovery of the benefits of physical exercise, the psychological and emotional management of the disease, the benefits from peer communication and emotional support, and the break from routine of their illness. Participants decreased the levels of physical exercise at the end of the supervision6 due to the confluence of several barriers. CONCLUSION A supervised exercise program carried out in Primary Care contributed to the improvement of the quality of life as well as the emotional and social well-being of patients with advanced-stage diseases. Our study identified potential barriers and facilitators associated with exercise participation and its continuity, however, it is necessary to encourage inter-sectoral coordination within the socio-health system to promote integrated and continuous care for chronic patients.
Collapse
|
18
|
Mitzner TL, Remillard ET, Mumma KT. Research-Driven Guidelines for Delivering Group Exercise Programs via Videoconferencing to Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7562. [PMID: 35805221 PMCID: PMC9265495 DOI: 10.3390/ijerph19137562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/11/2022] [Accepted: 06/18/2022] [Indexed: 12/04/2022]
Abstract
Telehealth holds much potential for supporting older adults' physical and social health. In particular, telewellness interventions to support the physical and social wellness of older adults are needed to overcome participation barriers with in-person programs. This paper presents guidelines for delivering telewellness interventions to older adults, which were informed by a human factors approach to developing a Tele Tai Chi intervention for older adults with mobility disabilities, including reviewing user needs literature and conducting user-centered needs assessment research. From these findings, we developed a protocol and support materials for delivering a telewellness intervention and conducted a feasibility study. We also established an adaptation committee to provide recommendations on the intervention. The outcome of our human factors approach was the establishment of research-driven design guidelines for delivering group exercise programs to older adults using videoconferencing. The guidelines provide direction for designing a telewellness protocol, supporting remote participation, and promoting socialization and engagement. These guidelines can be used to deliver interventions that increase access to socially-engaging, physical activity programs for older adults, which can ultimately help support their physical health, mental health, and quality of life.
Collapse
Affiliation(s)
- Tracy L. Mitzner
- Center for Inclusive Design and Innovation, Georgia Institute of Technology, Atlanta, GA 30318, USA; (E.T.R.); (K.T.M.)
| | | | | |
Collapse
|
19
|
Mankowski RT, Justice JN. Translational Research on Aging and Adaptations to Exercise. Exp Gerontol 2022; 166:111872. [DOI: 10.1016/j.exger.2022.111872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
Sheill G, Hennessy M, Neill LO, Reynolds S, Towns J, Gill M, Guinan E. Exercise and chronic health conditions in the community: A qualitative Study of Patients and Fitness instructors. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1025-1034. [PMID: 33704862 DOI: 10.1111/hsc.13288] [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: 04/01/2020] [Revised: 11/14/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
Further information is needed on how community exercise facilities can be effectively utilised to engage people living with chronic health conditions in exercise. The aim of this study was to identify the exercise barriers, facilitators and needs of patients with chronic disease in the community; and to provide recommendations to support the transition from hospital-based to community-based exercise. Using a qualitative approach, four focus groups were conducted with patients who had completed hospital-based exercise programmes (n = 11) and fitness instructors (n = 10). Data were audio recorded, member checked and transcribed verbatim for thematic analysis using NVivo. The side effects of chronic health conditions, the gym environment and a need for support when joining/attending a gym were perceived as barriers to exercising in the community. In contrast, the presence of supportive staff was perceived by patients as a facilitator to engaging in exercise in the community. A total of three themes emerged from participants views on exercise needs in the community; the referral and induction process in community gyms, fitness instructor training and experience and creating a supportive exercise environment. Themes informed eight key recommendations to support patients to exercise in the community, including supportive gym referral and induction processes for patients with chronic conditions, increased professional training for fitness instructors in the area of chronic disease management and exercise prescription, and exercise support at regular intervals for those with chronic conditions attending community gyms. This study found that there is potential for community gyms to play a key role in promoting health among people with chronic conditions. However, more can be done to foster an inclusive atmosphere in this space. Patients living with chronic conditions need information and advice on exercising in their communities. Community gyms require further support to ensure that facilities meet the exercise needs of people with chronic conditions.
Collapse
Affiliation(s)
- Gráinne Sheill
- Wellcome HRB Clinical Research Facility, St James's Hospital, Dublin, Ireland
| | - Martina Hennessy
- Wellcome HRB Clinical Research Facility, St James's Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Linda O Neill
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Jeremy Towns
- Wellcome HRB Clinical Research Facility, St James's Hospital, Dublin, Ireland
| | - Michael Gill
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Department of Psychiatry & Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - Emer Guinan
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
21
|
de Boer JJ, Feleus A, Hesselink A, Siemonsma P, Verhoef J, Schmitt M. Using storytelling methodology to identify barriers and facilitators of sustained physical activity in patients with a chronic disease: a qualitative study. BMJ Open 2022; 12:e057236. [PMID: 35351725 PMCID: PMC8961147 DOI: 10.1136/bmjopen-2021-057236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To identify implicit and more profound barriers and facilitators and involving context elements to accomplish sustained physical activity (PA) in patients with a chronic disease. Understanding these barriers and facilitators may help develop future strategies to be used by healthcare professionals in primary care to support patients with a chronic disease to reach sustained PA. DESIGN AND METHODS The qualitative, narrative research method storytelling was applied. Perspectives of both patients with a chronic disease (n=12) and involved healthcare professionals (n=11) were collected. Stories were audiotaped and retrieved from the transcriptions. Analysis involved a cyclic process of constant comparison. Main themes were arranged in the theoretical framework of the Capability, Opportunity, Motivation and Behaviour (COM-B) model. PARTICIPANTS Patients were adults with a chronic disease or at high risk of developing a chronic disease who participated in a PA promoting programme. Eligible healthcare professionals were those involved in these PA promoting programmes in primary care, such as physiotherapists, nurse practitioners or sports consultants. RESULTS From 176 stories, 62 relevant and unique stories were selected for further analysis. Eleven main themes were identified and afterwards linked to the COM-B model. Trust in one's own capabilities and in the healthcare professional were relevant themes. Also, health literacy and coping with temporary interruption were important capabilities. Important motivators were customised PA, increasing awareness, meaningful activities, exercising in a group and success experiences. Aversion to sports was seen as a barrier. Interprofessional collaboration and prerequisites can be a facilitator or a barrier. CONCLUSIONS This study provides insight into deeper motivations, barriers and facilitators of sustained PA from both the patients' and healthcare professionals' perspective. Comparing these perspectives revealed different views and beliefs on some themes. Attention for temporary interruptions, aversion to sports and health literacy were identified to be important for sustained PA.
Collapse
Affiliation(s)
- Johanna Jacoba de Boer
- Department of Physiotherapy and Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Anita Feleus
- Department of Physiotherapy and Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Arlette Hesselink
- Department of Physical Therapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Petra Siemonsma
- Department of Physical Therapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - John Verhoef
- Department of Physical Therapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Maarten Schmitt
- Department of Physiotherapy and Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| |
Collapse
|
22
|
Vooturi S, Lakshmi ANR, Jayalakshmi S. Adherence to exercise in people with epilepsy. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2038264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sudhindra Vooturi
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, India
| | - A. N. R Lakshmi
- Department of Physiology, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, India
| | - Sita Jayalakshmi
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, India
| |
Collapse
|
23
|
Tersa-Miralles C, Bravo C, Bellon F, Pastells-Peiró R, Rubinat Arnaldo E, Rubí-Carnacea F. Effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders in office workers: a systematic review. BMJ Open 2022; 12:e054288. [PMID: 35105632 PMCID: PMC8804637 DOI: 10.1136/bmjopen-2021-054288] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To determine the effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders. DESIGN Systematic review of randomised controlled trials (RCTs). DATA SOURCES The bibliographical databases PubMed, CINAHL Plus, Cochrane, Scopus, ISI WoS and PeDRO were searched, with studies from 1 January 2010 to 31 December 2020 eligible for inclusion. ELIGIBILITY CRITERIA We included RCTs, reported in English or Spanish, with at least an intervention group performing workplace exercises among office workers with musculoskeletal disorders. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed the risk of bias. A narrative synthesis was carried out with a tabular method specifying the study characteristics following the SWiM (Synthesis Without Meta-Analysis) guideline for synthesis without meta-analysis. The revised Cochrane Risk of Bias (RoB-2) tool was used to analyse the risk of bias of the included studies. RESULTS Seven studies with a total of 967 participants met the inclusion criteria and were included in this review. Due to heterogeneity in different workplace exercise interventions, outcome measures and statistical analyses, it was not possible to conduct a meta-analysis and a narrative synthesis was performed. The interventions were classified into three categories: multiple body regions, neck and shoulder, and lower back. The seven studies concluded that workplace exercise interventions were effective in reducing musculoskeletal disorders and pain compared with other types of interventions or with control groups with no interventions. The RoB-2 tool found a high risk of bias in six of the seven studies. CONCLUSIONS The findings of the RCTs on workplace exercise interventions suggest that interventions were effective in treating musculoskeletal disorders among office workers. However, due to the high risk of bias of the included studies, no firm conclusions could be drawn and more high-quality studies are needed. PROSPERO REGISTRATION NUMBER CRD42020177462.
Collapse
Affiliation(s)
| | - Cristina Bravo
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, Lleida, Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura, GESEC, University of Lleida, Lleida, Spain
| | - Filip Bellon
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, Lleida, Spain
| | - Roland Pastells-Peiró
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, Lleida, Spain
| | - Esther Rubinat Arnaldo
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, Lleida, Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura, GESEC, University of Lleida, Lleida, Spain
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - Francesc Rubí-Carnacea
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, GRECS, Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré, Lleida, Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura, GESEC, University of Lleida, Lleida, Spain
| |
Collapse
|
24
|
Reid H, Ridout AJ, Tomaz SA, Kelly P, Jones N. Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions. Br J Sports Med 2021; 56:427-438. [PMID: 34649919 PMCID: PMC8995821 DOI: 10.1136/bjsports-2021-104281] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/29/2022]
Abstract
Introduction The benefits of physical activity for people living with long-term conditions (LTCs) are well established. However, the risks of physical activity are less well documented. The fear of exacerbating symptoms and causing adverse events is a persuasive barrier to physical activity in this population. This work aimed to agree clear statements for use by healthcare professionals about medical risks of physical activity for people living with LTCs through expert consensus. These statements addressed the following questions: (1) Is increasing physical activity safe for people living with one or more LTC? (2) Are the symptoms and clinical syndromes associated with common LTCs aggravated in the short or long term by increasing physical activity levels? (3) What specific risks should healthcare professionals consider when advising symptomatic people with one or more LTCs to increase their physical activity levels? Methods Statements were developed in a multistage process, guided by the Appraisal of Guidelines for Research and Evaluation tool. A patient and clinician involvement process, a rapid literature review and a steering group workshop informed the development of draft symptom and syndrome-based statements. We then tested and refined the draft statements and supporting evidence using a three-stage modified online Delphi study, incorporating a multidisciplinary expert panel with a broad range of clinical specialties. Results Twenty-eight experts completed the Delphi process. All statements achieved consensus with a final agreement between 88.5%–96.5%. Five ‘impact statements’ conclude that (1) for people living with LTCs, the benefits of physical activity far outweigh the risks, (2) despite the risks being very low, perceived risk is high, (3) person-centred conversations are essential for addressing perceived risk, (4) everybody has their own starting point and (5) people should stop and seek medical attention if they experience a dramatic increase in symptoms. In addition, eight symptom/syndrome-based statements discuss specific risks for musculoskeletal pain, fatigue, shortness of breath, cardiac chest pain, palpitations, dysglycaemia, cognitive impairment and falls and frailty. Conclusion Clear, consistent messaging on risk across healthcare will improve people living with LTCs confidence to be physically active. Addressing the fear of adverse events on an individual level will help healthcare professionals affect meaningful behavioural change in day-to-day practice. Evidence does not support routine preparticipation medical clearance for people with stable LTCs if they build up gradually from their current level. The need for medical guidance, as opposed to clearance, should be determined by individuals with specific concerns about active symptoms. As part of a system-wide approach, consistent messaging from healthcare professionals around risk will also help reduce cross-sector barriers to engagement for this population.
Collapse
Affiliation(s)
- Hamish Reid
- Moving Medicine, Faculty of Sport And Exercise Medicine, Edinburgh, UK.,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, South Yorkshire, UK
| | - Ashley Jane Ridout
- Sport and Exercise Medicine, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, Oxfordshire, UK
| | - Simone Annabella Tomaz
- Stirling Physical Activity Research Knowledge and Learning Exchange (SPARKLE), University of Stirling, Stirling, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
| | - Natasha Jones
- Moving Medicine, Faculty of Sport And Exercise Medicine, Edinburgh, UK .,Sport and Exercise Medicine, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, Oxfordshire, UK
| | | |
Collapse
|
25
|
Physiotherapists' perceptions of how patient adherence and non-adherence to recommended exercise for musculoskeletal conditions affects their practice: a qualitative study. Physiotherapy 2021; 113:107-115. [PMID: 34571284 DOI: 10.1016/j.physio.2021.06.001] [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: 08/07/2020] [Revised: 05/28/2021] [Accepted: 06/06/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The aim of this study was to explore physiotherapists' perceptions of how patients' adherence and non-adherence to recommended exercise affects their practice. DESIGN A qualitative study with a focus group and semi-structured interviews. The focus group and interviews were audio recorded and transcribed verbatim. Transcripts were analysed using thematic analysis. SETTING MSK physiotherapy services in the United Kingdom. PARTICIPANTS Focus group: 8 UK registered physiotherapists (age range=24-48; seven female, one male). Semi-structured interviews: 10 UK registered physiotherapists (age range=28-52; eight female, two male). RESULTS Participants described how exercise adherence could be a challenging aspect of clinical practice and how they tried to improve it. Four main themes were identified: 1) A challenge but worth it; 2) It's frustrating but you can't win them all; 3) Striving to see the individual; and 4) Striving to help the patient. The importance of establishing a good working relationship with patients was emphasised. This included working collaboratively with the patient, avoiding blaming them for non-adherence and thinking about the language they used in discussing exercises. CONCLUSION Patient non-adherence to recommended exercise is a challenging aspect of clinical practice. Physiotherapists can acknowledge this difficulty, and the frustrations it may potentially bring, yet remain resilient in the face of it. Clinicians should consider potential approaches and strategies to optimise the potential for behaviour change, and to improve exercise adherence. Robust interventions to help clinicians facilitate better exercise adherence are also needed.
Collapse
|
26
|
Johnson NA, Sultana RN, Brown WJ, Bauman AE, Gill T. Physical activity in the management of obesity in adults: A position statement from Exercise and Sport Science Australia. J Sci Med Sport 2021; 24:1245-1254. [PMID: 34531124 DOI: 10.1016/j.jsams.2021.07.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 07/05/2021] [Accepted: 07/18/2021] [Indexed: 12/12/2022]
Abstract
This Position Statement examines the evidence for physical activity in weight and adiposity loss, prevention of weight and adiposity gain, and in weight regain in adults, and provides guidance on implications for exercise practitioners. Research evidence indicates that >150 min but preferably 300 min per week of aerobic activity of at least moderate intensity is required to prevent weight and adiposity gain, and at least the upper end of this range of activity to prevent weight regain after weight loss. For meaningful weight and total adiposity loss, a minimum of 300-420 min per week of aerobic activity of at least moderate intensity is required. The evidence around the volume of aerobic physical activity required to reduce central adiposity is emerging, and research suggests that it may be substantially less than that required for weight loss. The impact of high-intensity physical activity and resistance exercise for weight management is uncertain. During consultations for weight management, exercise practitioners should advise that metabolic and cardiovascular health benefits can be achieved with physical activity at any weight, and irrespective of weight change.
Collapse
Affiliation(s)
- Nathan A Johnson
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Sydney University, Australia; Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Sydney University, Australia.
| | - Rachelle N Sultana
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Sydney University, Australia; Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Sydney University, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - Adrian E Bauman
- Prevention Research Collaboration, School of Public Health, Sydney University, Australia
| | - Tim Gill
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Sydney University, Australia
| |
Collapse
|
27
|
Gunnee M, Bridgwater H, Super J. Benefits of exercise oncology courses for medical oncology trainees. Postgrad Med J 2021; 98:e162. [PMID: 34489314 DOI: 10.1136/postgradmedj-2021-141067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - Jonathan Super
- School of Medicine, Imperial College London, London, UK .,Department of Surgery, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK
| |
Collapse
|
28
|
Passantino A, Dalla Vecchia LA, Corrà U, Scalvini S, Pistono M, Bussotti M, Gambarin FI, Scrutinio D, La Rovere MT. The Future of Exercise-Based Cardiac Rehabilitation for Patients With Heart Failure. Front Cardiovasc Med 2021; 8:709898. [PMID: 34422933 PMCID: PMC8371325 DOI: 10.3389/fcvm.2021.709898] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/29/2021] [Indexed: 01/14/2023] Open
Abstract
Cardiac rehabilitation (CR) is a comprehensive program that includes exercise training, titration of medical therapy, lifestyle modification, educational support, and psychosocial assessment. All these components are safe and beneficial resulting in significant improvements in quality of life, functional capacity, mortality, and hospital readmission. Current guidelines support its use in a broad spectrum of cardiac disease. This review focuses on exercise-based CR for heart failure (HF) patients in whom CR is a recommended treatment. Exercise should be prescribed according to a personalized approach, optimizing, and tailoring the rehabilitative program to the patient's characteristics. Specific CR programs are dedicated to older patients, those with HF and preserved ejection fraction, and recipients of cardiac implantable electronic devices or left ventricular assistance device. Telemedicine may increase CR participation and overcome some of the barriers that limit its utilization.
Collapse
Affiliation(s)
- Andrea Passantino
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Bari, Italy
| | | | - Ugo Corrà
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Veruno, Italy
| | - Simonetta Scalvini
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Cardiac Rehabilitation, Lumezzane, Italy
| | - Massimo Pistono
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Veruno, Italy
| | - Maurizio Bussotti
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Milan, Italy
| | - Fabiana Isabella Gambarin
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Veruno, Italy
| | - Domenico Scrutinio
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Bari, Italy
| | - Maria Teresa La Rovere
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Montescano, Italy
| |
Collapse
|
29
|
Albert FA, Malau-Aduli AEO, Crowe MJ, Malau-Aduli BS. The 'PRICE' of Physical Activity Referral Schemes (PARS): Stakeholders' Recommendations for Delivering Quality Care to Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8627. [PMID: 34444376 PMCID: PMC8394463 DOI: 10.3390/ijerph18168627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 12/22/2022]
Abstract
Evidence-based strategies are needed to curb the growing cases of physical inactivity related morbidities. Delivering holistic care through collaborative shared decision making could boost the effectiveness of physical activity referral schemes (PARS) and foster the quality of care for patients with multimorbidity. A qualitative study involving semi-structured telephone interviews was utilised to gain insights from Australian PARS stakeholders (general practitioners, exercise physiologists, and patients). A pluralistic evaluation approach was employed to explore and integrate participants' opinions and experiences of PARS and their recommendations were used to develop a model for quality care delivery in PARS initiatives. Five overarching themes: promote, relate, incentivise, communicate, and educate were identified as the 'PRICE' for developing effective and functional PARS programmes that foster quality patient care. It was evident that PARS programmes or policies aimed at optimising publicity, encouraging incentives, improving interdisciplinary information sharing and professional relationships between patients and healthcare professionals can transform healthcare delivery and provide top quality PARS care services to patients. Therefore, governments, healthcare systems, and PARS administrators can translate and leverage the insights from this study to optimise the delivery of high quality care to PARS patients.
Collapse
Affiliation(s)
- Francis A. Albert
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
| | - Aduli E. O. Malau-Aduli
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
| | - Melissa J. Crowe
- Division of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia;
| | - Bunmi S. Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
| |
Collapse
|
30
|
Miliani A, Cherid H, Rachedi M. Modèles alternatifs dans la pratique de la rééducation à l’ère de la pandémie de Covid-19. KINÉSITHÉRAPIE, LA REVUE 2021. [PMCID: PMC7862881 DOI: 10.1016/j.kine.2021.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
La pandémie de Covid-19 a imposé un changement soudain et forcé dans le spectre des soins de santé qui s’est produit avec une rapidité sans précédent. La nécessité d’accommoder le changement à une grande échelle a exigé de l’ingéniosité et une réflexion décisive. Ces changements affectent les acteurs du domaine de la médecine physique et de la réadaptation (MPR) personnellement et professionnellement. Les experts réfléchissent maintenant à la manière d’améliorer la pratique médicale en utilisant de nouvelles approches en réadaptation. Les modèles et les expériences rapportés dans la littérature, tels que la téléréadaptation, la préadaptation et l’activité physique adaptée sont basés sur la stratégie de l’auto-rééducation collaborative qui est proposée comme un élément-clé de ces voies alternatives. Ces approches innovantes aideront à restructurer les processus d’exercice de la réadaptation, non seulement dans ces moments inhabituels, mais aussi dans l’avenir de la MPR. Niveau de preuve NA.
Collapse
|
31
|
López Fernández J, López-Valenciano A, Mayo X, Horton E, Clavel I, Liguori G, Jiménez A. Comparative analysis of reported physical activity from leisure centres' members versus the general population in Spain. BMJ Open 2021; 11:e043963. [PMID: 34187813 PMCID: PMC8245461 DOI: 10.1136/bmjopen-2020-043963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 06/04/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES (1) To describe the physical activity (PA) levels of the members of a Spanish leisure centre operator according to age and gender; (2) to describe the differences in the three PA levels between the members of a Spanish leisure centre operator and the general Spanish population considering the PA Eurobarometer data according to their gender and age and (3) to explore the intensity origin of the PA either in Spanish members of leisure centres or the Spanish population considering their gender. DESIGN Descriptive epidemiology study. PARTICIPANTS Data from 16 Spanish leisure centres (n=3627) and from the 2017 Eurobarometer 472 for Spain (n=1002) were used for this research. PRIMARY AND SECONDARY OUTCOMES MEASURES The PA levels were analysed with the International Physical Activity Questionnaire short version, and respondents were grouped into physical inactivity (PIA), moderate-PA and high-PA. Moreover, gender (men or women) and age (18-29 years; 30-44 years; 45-59 years; 60-69 years; ≥70 years) were considered. Total metabolic equivalent (MET)-min/week, as well as total MET-min/week for walking intensity, moderate intensity and vigorous intensity were recorded. RESULTS Leisure centres showed a lower prevalence of PIA and a higher prevalence of high-PA than the general population (p<0.05). Women displayed a higher prevalence of PIA and lower prevalence of high-PA than men (p<0.05). The prevalence of PIA increases with age while the prevalence of high-PA decreases. CONCLUSION Leisure centres engage most of their members in regular PA, including women and older adults, and these members also perform a higher number of MET in vigorous PA, than the general population.
Collapse
Affiliation(s)
- Jorge López Fernández
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
- GO fit LAB, Ingesport-GO fit, Alcobendas, Spain
| | - Alejandro López-Valenciano
- Observatory of Healthy & Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - Xián Mayo
- Observatory of Healthy & Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - Elizabeth Horton
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Ivan Clavel
- Faculty of Sports Sciences and Physical Education, Department of Physical Education and Sports, University of A Coruña, A Coruna, Galicia, Spain
| | - Gary Liguori
- College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA
| | - Alfonso Jiménez
- GO fit LAB, Ingesport-GO fit, Alcobendas, Spain
- Observatory of Healthy & Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
- Advanced Wellbeing Research Centre, College of Health, Sheffield Hallam University College of Health Wellbeing and Life Sciences, Sheffield, UK
| |
Collapse
|
32
|
Bunzli S, Taylor N, O'Brien P, Dowsey M, Wallis J, Choong P, Shields N. How Do People Communicate About Knee Osteoarthritis? A Discourse Analysis. PAIN MEDICINE 2021; 22:1127-1148. [PMID: 33502513 DOI: 10.1093/pm/pnab012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the ways in which people talk about knee osteoarthritis and how this may influence engagement in physical activity and activity-based interventions as recommended by clinical practice guidelines. DESIGN A qualitative synthesis using discourse analysis methods. METHODS Systematic review methods were used to identify qualitative studies exploring the perceptions of people with knee osteoarthritis, their carers, and/or clinicians. Methodological quality was evaluated through the use of the Critical Appraisal Skills Programme. Raw quotes extracted from each study were analyzed with inductive discourse analysis. RESULTS A search of five electronic databases from inception until August 2019 yielded 778 articles. Sixty-two articles from 56 studies were included, reporting data (1,673 direct quotes) from people with knee osteoarthritis, carers, and clinicians in 16 countries. Two overarching discourses were identified-impairment and participation. The overarching impairment discourse prevailed in all participant groups and study settings. In this discourse, knee osteoarthritis was likened to a machine that inevitably wore down over time and required a doctor to repair. The overarching participatory discourse almost always coexisted alongside an impairment discourse. According to this discourse, a "busy body" was perceived as "healthy," and people could remain active despite knee osteoarthritis. CONCLUSION The prevailing impairment discourse may potentially discourage people from using knees that have passed their "use-by date" and increase reliance on doctors to repair joint damage. Consistent with recommendations in clinical practice guidelines, a participatory discourse may provide an alternative way of communicating that may encourage people with knee osteoarthritis to continue to engage in physical activity by focusing on what they can do, rather than what they cannot do.
Collapse
Affiliation(s)
- Samantha Bunzli
- University of Melbourne, Department of Surgery, St Vincent's Hospital Melbourne, Victoria, Australia
| | - Nicholas Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia
| | - Penny O'Brien
- University of Melbourne, Department of Surgery, St Vincent's Hospital Melbourne, Victoria, Australia
| | - Michelle Dowsey
- University of Melbourne, Department of Surgery, St Vincent's Hospital Melbourne, Victoria, Australia
| | - Jason Wallis
- Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia.,Monash Department of Clinical Epidemiology, Cabrini Institute, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Choong
- University of Melbourne, Department of Surgery, St Vincent's Hospital Melbourne, Victoria, Australia
| | - Nora Shields
- Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Australia
| |
Collapse
|
33
|
O'Brien MW, Bray NW, Kivell MJ, Fowles JR. A scoping review of exercise referral schemes involving qualified exercise professionals in primary health care. Appl Physiol Nutr Metab 2021; 46:1007-1018. [PMID: 33872547 DOI: 10.1139/apnm-2020-1070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Qualified exercise professionals (QEPs) have the training, knowledge, and scope of practice to effectively provide physical activity counselling, prescribe exercise, and deliver exercise programming to patients with or without chronic diseases. Healthcare providers identify an interest in referring patients to QEPs; however, the impact of exercise referral schemes (ERS) involving QEPs on patients' physical health is unclear. A scoping review regarding the available evidence of ERS involving healthcare provider referrals to QEPs was performed. A literature search was conducted in 6 databases (initially: n = 6011 articles), yielding n = 23 articles examining QEP delivered physical activity counselling (n = 7), QEP supervised exercise training (n = 4), or some combination (n = 12). Although studies were heterogeneous in methods, procedures, and populations, ERSs increased patients' subjective physical activity levels. Few studies incorporated objective physical activity measures (n = 5/23), and almost half measured aerobic fitness (n = 11/23). ERS involving a QEP that includes activity counselling and/or exercise programming/training report favourable impacts on patients' subjectively measured physical activity and objectively measured aerobic fitness. Based on the existing literature on the topic, this scoping review provides recommendations for designing and evaluating ERS with QEPs that include: objective measures, long-term follow-up, QEP qualifications, and the cost-effectiveness of ERS. Novelty: ERS involving QEPs report increased patients' perceived physical activity level and may improve patients' cardiorespiratory fitness. Promoting the collaboration of QEPs with other healthcare providers can enhance patients' physical fitness and health. This scoping review provides recommendations for the design and evaluation of ERS involving QEPs.
Collapse
Affiliation(s)
| | - Nick W Bray
- School of Kinesiology, Western University, ON, Canada
| | | | - Jonathon R Fowles
- Nova Scotia Health, NS, Canada.,School of Kinesiology, Centre of Lifestyle Studies, Acadia University, NS, Canada
| |
Collapse
|
34
|
Ellis KR, Cuthbertson CC, Carthron D, Rimmler S, Gottfredson NC, Bahorski SG, Phillips A, Corbie-Smith G, Callahan L, Rini C. A Longitudinal Observational Study of Multimorbidity and Partner Support for Physical Activity Among People with Osteoarthritis. Int J Behav Med 2021; 28:746-758. [PMID: 33797056 DOI: 10.1007/s12529-021-09985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical activity can improve osteoarthritis-related symptoms; however, many people with osteoarthritis (PWOA) are insufficiently active. Social support for physical activity from an intimate partner can help PWOA increase activity, but managing multiple, chronic physical or mental health conditions (i.e., multimorbidity) may influence provision and receipt of that support. METHOD Data from a 1-year longitudinal observational study was used to examine associations between multimorbidity and three dimensions of partner support for physical activity-companionship partner support (doing activity together), enacted partner support, and social support effectiveness-in 169 insufficiently active PWOA and their partners. RESULTS Multivariable-adjusted multi-level models indicated baseline differences in support by multimorbidity status: when partners had multimorbidity, PWOA reported receiving less companionship support and less effective support from partners; when PWOA had multimorbidity, partners reported providing less enacted support and both partners and PWOA reported less effective partner support. Broad trends (p < .05) indicate initial increases and subsequent decreases in companionship and enacted partner support when PWOA had multimorbidity, and among partners with and without multimorbidity. When PWOA had multimorbidity, an initial increase in support effectiveness was followed by no significant change; a similar trend was seen among partners with and without multimorbidity. CONCLUSION Multimorbidity may generally contribute to less partner support for physical activity or less effective support, although influences on support over time are less clear. Physical activity interventions for couples experiencing multimorbidity would likely benefit from attention to the impact of multiple chronic health conditions on physical activity and physical activity-related partner support.
Collapse
Affiliation(s)
- Katrina R Ellis
- School of Social Work, University of Michigan, 1080 South University, Ann Arbor, MI, 48109, USA.
| | - Carmen C Cuthbertson
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dana Carthron
- College of Nursing & Division of Public Health, Michigan State University, East Lansing, MI, USA
| | - Shelby Rimmler
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nisha C Gottfredson
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie G Bahorski
- Division of Public Health, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | | | - Giselle Corbie-Smith
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leigh Callahan
- University of North Carolina Division of Rheumatology, Allergy and Immunology, Department of Medicine, Thurston Arthritis Research Center, Chapel Hill, NC, USA
| | - Christine Rini
- Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| |
Collapse
|
35
|
Dantas LO, Salvini TDF, McAlindon TE. Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther 2021; 25:135-146. [PMID: 33262080 PMCID: PMC7990728 DOI: 10.1016/j.bjpt.2020.08.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/11/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a chronic progressive disease that imparts a substantial socioeconomic burden to society and healthcare systems. The prevalence of knee OA has dramatically risen in recent decades due to consistent increases in life expectancy and obesity worldwide. Patient education, physical exercise, and weight loss (for overweight or obese individuals) constitute the first-line knee OA treatment approach. However, less than 40% of patients with knee OA receive this kind of intervention. There is an unmet need for healthcare professionals treating individuals with knee OA to understand the current recommended treatment strategies to provide effective rehabilitation. OBJECTIVE To guide physical therapists in their clinical decision making by summarizing the safest and most efficacious treatment options currently available, and by delineating the most traditional outcome measures used in clinical research for knee OA. CONCLUSION There is a need for healthcare providers to abandon low-quality and ineffective treatments and educate themselves and their patients about the current best evidence-based practices for knee OA.
Collapse
Affiliation(s)
- Lucas Ogura Dantas
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil; Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, MA, USA
| | | | - Timothy E McAlindon
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, MA, USA.
| |
Collapse
|
36
|
Lukkahatai N, Soivong P, Li D, Jaiman P, Thamkaew S, Chaiwong D, Hiranlalit N, Inouye J. Feasibility of Using Mobile Technology to Improve Physical Activity Among People Living with Diabetes in Asia. Asian Pac Isl Nurs J 2021; 5:236-247. [PMID: 33791411 PMCID: PMC7993889 DOI: 10.31372/20200504.1110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Chronic conditions such as diabetes (DM) and cardiovascular disease are associated with disability and poor quality of life. Asians are 30% more likely than non-Hispanic Whites to develop type 2 DM. The important roles of wearable technological applications or devices in maintaining individuals' motivation to attain their physical activity (PA) goal have been reported. However, evidence of the feasibility and impact of the mobile technology on the PA in Thailand is limited. This study aims to examine the feasibility and the impact of the immediate performance feedback feature of the wearable device on PA. Methods: This pilot study recruited persons aged 18 or older with diabetes from two diabetes clinics in Chiang Mai, Thailand. Participants were randomly assigned into three groups: the aware group (AW: can see the step count on the device screen), the unaware group (UW: the device screen was completely covered), and the control group (usual care). Participants in the AW and UW groups were asked to wear the device for 2 full days while the usual care group did not wear the device. All participants completed a questionnaire package at their first study visit. Data analysis of univariate and multivariate general linear models were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC). All significance levels were set at 5%. Results: One hundred and fourteen participants age ranged from 39 to 75 years old were included in this analysis. The majority were female (n = 86, 69%) and married (n = 103, 82%). No adverse events were reported among device users. Within 2 days, there were less than 10% missing data and more than 70% of participants liked the devices mainly because they could see the step count. More than 63% of participants who wore the device had an average of steps greater than 10,000 per day. Although the number of steps and sleep hours were not significantly different between the AW and UW groups, 68% of the AW participants found that the device help them with their exercise. Discussion: The results demonstrate the feasibility of the use of the wearable device among people living with chronic conditions. Participants found that the step count screen provided immediate physical performance feedback that was helpful with their exercise. The behavioral changes, however, could not be examined due to the short duration of the usage. Future studies that require longer device usage in larger sample sizes are needed.
Collapse
Affiliation(s)
- Nada Lukkahatai
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States
| | - Pratum Soivong
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Dongmei Li
- University of Rochester, Rochester, New York, United States
| | | | | | | | | | - Jillian Inouye
- John A. Burns School of Medicine, University of Hawai‘i, Hawai‘i, United States
| |
Collapse
|
37
|
Hassett L, Tiedemann A, Hinman RS, Crotty M, Hoffmann T, Harvey L, Taylor NF, Greaves C, Treacy D, Jennings M, Milat A, Bennell KL, Howard K, van den Berg M, Pinheiro M, Wong S, Kirkham C, Ramsay E, O'Rourke S, Sherrington C. Physical activity coaching for adults with mobility limitations: protocol for the ComeBACK pragmatic hybrid effectiveness-implementation type 1 randomised controlled trial. BMJ Open 2020; 10:e034696. [PMID: 33148720 PMCID: PMC7640503 DOI: 10.1136/bmjopen-2019-034696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Mobility limitation is common and often results from neurological and musculoskeletal health conditions, ageing and/or physical inactivity. In consultation with consumers, clinicians and policymakers, we have developed two affordable and scalable intervention packages designed to enhance physical activity for adults with self-reported mobility limitations. Both are based on behaviour change theories and involve tailored advice from physiotherapists. METHODS AND ANALYSIS This pragmatic hybrid effectiveness-implementation type 1 randomised control trial (n=600) will be undertaken among adults with self-reported mobility limitations. It aims to estimate the effects on physical activity of: (1) an enhanced 6-month intervention package (one face-to-face physiotherapy assessment, tailored physical activity plan, physical activity phone coaching from a physiotherapist, informational/motivational resources and activity monitors) compared with a less intensive 6-month intervention package (single session of tailored phone advice from a physiotherapist, tailored physical activity plan, unidirectional text messages, informational/motivational resources); (2) the enhanced intervention package compared with no intervention (6-month waiting list control group); and (3) the less intensive intervention package compared with no intervention (waiting list control group). The primary outcome will be average steps per day, measured with the StepWatch Activity Monitor over a 1-week period, 6 months after randomisation. Secondary outcomes include other physical activity measures, measures of health and functioning, individualised mobility goal attainment, mental well-being, quality of life, rate of falls, health utilisation and intervention evaluation. The hybrid effectiveness-implementation design (type 1) will be used to enable the collection of secondary implementation outcomes at the same time as the primary effectiveness outcome. An economic analysis will estimate the cost-effectiveness and cost-utility of the interventions compared with no intervention and to each other. ETHICS AND DISSEMINATION Ethical approval has been obtained by Sydney Local Health District, Royal Prince Alfred Zone. Dissemination will be via publications, conferences, newsletters, talks and meetings with health managers. TRIAL REGISTRATION NUMBER ACTRN12618001983291.
Collapse
Affiliation(s)
- Leanne Hassett
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- Discipline of Physiotherapy, Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Maria Crotty
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Tammy Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Lisa Harvey
- John Walsh Centre for Rehabilitation Research, Northern Clinical School, The University of Sydney, St Leonards, New South Wales, Australia
| | - Nicholas F Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, New South Wales, Australia
| | - Colin Greaves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Daniel Treacy
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- Prince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Matthew Jennings
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Andrew Milat
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- NSW Ministry of Health, Liverpool, New South Wales, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kirsten Howard
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Maayken van den Berg
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Marina Pinheiro
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- Discipline of Physiotherapy, Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Siobhan Wong
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Catherine Kirkham
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Elizabeth Ramsay
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Sandra O'Rourke
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, University of Sydney/ Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
38
|
Abstract
OBJECTIVE The purpose of this commentary is to summarize the evidence of the feasibility and benefits of exercise for cancer patients with complex health profiles. Case studies are used to describe the therapeutic approach taken by exercise professionals. The information presented will assist the cancer care team in understanding their role in supporting these patients to move more. DATA SOURCES Professional organizations, peer-reviewed manuscripts, and expert clinical opinion. CONCLUSION Individually-tailored exercise is safe and feasible in the presence of complex health profiles, and all patients can benefit through exercise, regardless of individual circumstance or disease burden. However, to ensure patients benefit through physical activity, including exercise, a multidisciplinary approach, whereby all members of the health care team promote and encourage physical activity is needed. IMPLICATIONS FOR NURSING PRACTICE There is a clear need for collaboration between the oncology team and exercise professionals, particularly when dealing with patients with complex health profiles. These patients are more likely to engage in exercise when they are advised and supported by their oncology team to do so. As such, promotion of physical activity and, when relevant, referral to an exercise professional is the responsibility of all members of the cancer team.
Collapse
|
39
|
McMullan II, Bunting BP, Smith L, Koyanagi A, Tully MA. Is There an Association Between Self-Reported Physical Activity and Self-Rated Vision Over Time? Results From the Irish Longitudinal Study of Ageing. J Aging Phys Act 2020; 28:774-781. [PMID: 32460245 DOI: 10.1123/japa.2019-0371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/25/2019] [Accepted: 02/25/2020] [Indexed: 11/18/2022]
Abstract
Research suggests that physical activity (PA) has many health benefits for an aging population. Evidence exploring the association between PA and vision is limited. This study includes the measures of self-reported PA (International Physical Activity Questionnaire) and self-rated vision at three points in time over a 6-year period used in the Irish Longitudinal study of Ageing, a cohort of community-dwelling older adults (50 years or older). A path analysis found that PA was indirectly associated with vision over 6 years controlling for age, sex, marital status, employment, education, depression (Centre for Epidemiologic Studies Depression Scale), self-reported general health, cardiovascular disease (e.g., heart attack), high blood pressure, diabetes, eye disease (e.g., glaucoma, diabetic eye disease, macular degeneration, cataract), and disabilities associated with activities of daily living. Further research is needed to fully understand the relationship over time and generalize the findings.
Collapse
|
40
|
Rodriguez-Lopez C, Alcazar J, Sánchez-Martín C, Ara I, Csapo R, Alegre LM. Mechanical Characteristics of Heavy vs. Light Load Ballistic Resistance Training in Older Adults. J Strength Cond Res 2020; 36:2094-2101. [PMID: 32947572 DOI: 10.1519/jsc.0000000000003826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rodriguez-Lopez, C, Alcazar, J, Sánchez-Martín, C, Ara, I, Csapo, R, and Alegre, LM. Mechanical characteristics in heavy vs. light load ballistic resistance training in older adults. J Strength Cond Res XX(X): 000-000, 2020-Although power-oriented resistance training (RT) is strongly recommended to counter age-related neuromuscular function declines, there is still controversy about which intensities of load should be used to elicit optimal training adaptations. Knowledge of the mechanical characteristics of power-oriented RT performed at different intensities might help to better understand the training stimulus that triggers load-dependent adaptations in older adults. Using a cross-over design, 15 well-functioning older volunteers (9 men and 6 women; 73.6 ± 3.8 years) completed 2 volume × load-matched ballistic RT sessions with heavy (HL: 6 × 6 × 80% 1-repetition maximum [1RM]) and light-load (LL: 6 × 12 × 40% 1RM) on a horizontal leg press exercise. Electromyographic (EMG) and mechanical variables (work, force, velocity, and power) as well as intraset neuromuscular fatigue (i.e., relative losses in force, velocity, and power) were analyzed. More concentric mechanical work was performed in the LL training session, compared with HL (36.2 ± 11.2%; p < 0.001). Despite the higher mean EMG activity of the quadriceps femoris muscle (13.2 ± 21.1%; p = 0.038) and greater concentric force (35.2 ± 7.6%; p < 0.001) during HL, higher concentric velocity (41.0 ± 12.7%, p < 0.001) and a trend toward higher concentric power (7.2 ± 18.9%, p = 0.075) were found for LL. Relative velocity losses were similar in both sessions (≈10%); however, relative force losses were only found in LL (7.4 ± 6.5%, p = 0.003). Considering the greater mechanical work performed and concentric power generated, ballistic RT using LL may, therefore, represent a stronger stimulus driving training adaptations as compared with volume × load-matched heavy-load training. Relative losses in force and power should be monitored in addition to velocity losses during ballistic RT.
Collapse
Affiliation(s)
- Carlos Rodriguez-Lopez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Coral Sánchez-Martín
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Robert Csapo
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG, University for Health Sciences, Medical Informatics and Technology, Hall, Austria
| | - Luis M Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| |
Collapse
|
41
|
O’Brien MW, Shields CA, Solmundson K, Fowles JR. Exercise is Medicine Canada workshop training improves physical activity practices of physicians across Canada, independent of initial confidence level. CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e5-e15. [PMID: 33062086 PMCID: PMC7522882 DOI: 10.36834/cmej.68376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Educational workshops help physicians (MDs) include physical activity and exercise (PAE) content in more patient appointments. It is unclear if MDs with varying degrees of confidence discussing PAE with their patients equally benefit from such training. We evaluated whether MDs' initial confidence affects the impact of an educational PAE workshop. METHODS MDs (n = 63) across Canada completed self-reflection questionnaires initially and 3-months following a PAE workshop. MDs were divided into low-confidence [confidence score (out of 100%): <40%; n = 21], medium-confidence (40-60%; n = 19) and high-confidence (>60%; n = 23). RESULTS PAE counselling confidence increased in all groups (relative increase: Low=~40%, Medium=~20%, High=~10%). Training increased the low-confidence group's knowledge, awareness of guidance/resources and perception of their patients' interest in lifestyle management (~30% change; all p < 0.001). Compared to baseline, a greater proportion (all p < 0.001) of MDs reported prescribing exercise at 3-month follow-up in each of the low-confidence (10% to 62%) medium-confidence (16% to 89%) and high-confidence (57% to 87%) groups. CONCLUSION PAE training favorably improved MDs' confidence, perceived impact of many barriers and the proportion of MDs prescribing exercise, at each level of confidence. An educational workshop particularly assisted MDs with low-confidence (i.e., those who needed it the most) integrate PAE into their practice.
Collapse
Affiliation(s)
- Myles W. O’Brien
- School of Kinesiology, Acadia University, Nova Scotia, Canada
- Nova Scotia Health Authority, Nova Scotia, Canada
- Division of Kinesiology, Dalhousie University, Nova Scotia, Canada
| | | | - Kara Solmundson
- Faculty of Medicine, Department of Family Practice, University of British Columbia, British Columbia, Canada
| | - Jonathon R. Fowles
- School of Kinesiology, Acadia University, Nova Scotia, Canada
- Nova Scotia Health Authority, Nova Scotia, Canada
| |
Collapse
|
42
|
Randomized Trial of General Strength and Conditioning Versus Motor Control and Manual Therapy for Chronic Low Back Pain on Physical and Self-Report Outcomes. J Clin Med 2020; 9:jcm9061726. [PMID: 32503243 PMCID: PMC7355598 DOI: 10.3390/jcm9061726] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 12/29/2022] Open
Abstract
Exercise and spinal manipulative therapy are commonly used for the treatment of chronic low back pain (CLBP) in Australia. Reduction in pain intensity is a common outcome; however, it is only one measure of intervention efficacy in clinical practice. Therefore, we evaluated the effectiveness of two common clinical interventions on physical and self-report measures in CLBP. Participants were randomized to a 6-month intervention of general strength and conditioning (GSC; n = 20; up to 52 sessions) or motor control exercise plus manual therapy (MCMT; n = 20; up to 12 sessions). Pain intensity was measured at baseline and fortnightly throughout the intervention. Trunk extension and flexion endurance, leg muscle strength and endurance, paraspinal muscle volume, cardio-respiratory fitness and self-report measures of kinesiophobia, disability and quality of life were assessed at baseline and 3- and 6-month follow-up. Pain intensity differed favoring MCMT between-groups at week 14 and 16 of treatment (both, p = 0.003), but not at 6-month follow-up. Both GSC (mean change (95%CI): −10.7 (−18.7, −2.8) mm; p = 0.008) and MCMT (−19.2 (−28.1, −10.3) mm; p < 0.001) had within-group reductions in pain intensity at six months, but did not achieve clinically meaningful thresholds (20mm) within- or between-group. At 6-month follow-up, GSC increased trunk extension (mean difference (95% CI): 81.8 (34.8, 128.8) s; p = 0.004) and flexion endurance (51.5 (20.5, 82.6) s; p = 0.004), as well as leg muscle strength (24.7 (3.4, 46.0) kg; p = 0.001) and endurance (9.1 (1.7, 16.4) reps; p = 0.015) compared to MCMT. GSC reduced disability (−5.7 (−11.2, −0.2) pts; p = 0.041) and kinesiophobia (−6.6 (−9.9, −3.2) pts; p < 0.001) compared to MCMT at 6-month follow-up. Multifidus volume increased within-group for GSC (p = 0.003), but not MCMT or between-groups. No other between-group changes were observed at six months. Overall, GSC improved trunk endurance, leg muscle strength and endurance, self-report disability and kinesiophobia compared to MCMT at six months. These results show that GSC may provide a more diverse range of treatment effects compared to MCMT.
Collapse
|
43
|
Abstract
The current COVID-19 pandemic will place enormous pressure on healthcare systems around the world. Large numbers of people are predicted to become critically ill with acute respiratory distress syndrome and will require management in intensive care units. High levels of physical, cognitive, and psychosocial impairments can be anticipated. Rehabilitation providers will serve as an important link in the continuum of care, helping move patients on from acute sites to eventual discharge to the community. Likely impairment patterns, considerations for healthcare practitioner resilience, and organization of services to meet demand are discussed. Innovative approaches to care, such as virtual rehabilitation, are likely to become common in this environment.
Collapse
Affiliation(s)
- Robert Simpson
- From the University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | |
Collapse
|
44
|
Gray ID, Kross AR, Renfrew ME, Wood P. Precision Medicine in Lifestyle Medicine: The Way of the Future? Am J Lifestyle Med 2020; 14:169-186. [PMID: 32231483 PMCID: PMC7092395 DOI: 10.1177/1559827619834527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/21/2018] [Accepted: 02/08/2019] [Indexed: 02/06/2023] Open
Abstract
Precision medicine has captured the imagination of the medical community with visions of therapies precisely targeted to the specific individual's genetic, biological, social, and environmental profile. However, in practice it has become synonymous with genomic medicine. As such its successes have been limited, with poor predictive or clinical value for the majority of people. It adds little to lifestyle medicine, other than in establishing why a healthy lifestyle is effective in combatting chronic disease. The challenge of lifestyle medicine remains getting people to actually adopt, sustain, and naturalize a healthy lifestyle, and this will require an approach that treats the patient as a person with individual needs and providing them with suitable types of support. The future of lifestyle medicine is holistic and person-centered rather than technological.
Collapse
Affiliation(s)
- Ian D. Gray
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Andrea R. Kross
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Melanie E. Renfrew
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Paul Wood
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| |
Collapse
|
45
|
McFadden T, Fortier M, McGinn R, Levac BM, Sweet SN, Tomasone JR. Demographic differences in Canadian medical students' motivation and confidence to promote physical activity. Fam Pract 2020; 37:56-62. [PMID: 31271643 DOI: 10.1093/fampra/cmz034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Physical activity (PA) remains under prescribed by physicians. Motivation and confidence are clear drivers of frequency of promoting PA. Research shows demographic differences in physicians' preventive practices, yet none have included medical students who form habits during training. OBJECTIVES Study objectives were to (i) examine how Canadian medical students' motivation to recommend PA to future patients differs according to six demographic variables (i.e. gender, ethnicity, year of study, university, proposed specialty and academic background) and (ii) examine how Canadian medical students' confidence to recommend PA to future patients differs according to these same demographic variables. METHODS A cross-sectional design was used. First to fourth year medical students from three medical schools responded to an online survey (N = 221). RESULTS Female participants were more motivated to counsel patients on PA and refer to an exercise specialist compared to males (P < 0.01). Second year students were more motivated to assess a patients' level of PA compared to third and fourth year students (P < 0.01). Students pursuing family medicine were more confident to assess and counsel compared to students pursuing paediatrics (P < 0.01). CONCLUSION Given that motivation and confidence have a positive influence on frequency-promoting PA, these results suggest where future efforts should focus, to improve PA promotion in medical practice. Physical inactivity continues to be a major issue worldwide, and medical students as future physicians have a unique opportunity to enhance PA amongst the population.
Collapse
Affiliation(s)
- Taylor McFadden
- School of Human Kinetics, University of Ottawa, Ottawa.,Physician Health and Wellness, Canadian Medical Association, Ottawa
| | | | - Ryan McGinn
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa.,Faculty of Medicine, University of Ottawa, Ottawa
| | - Brendan M Levac
- Department of Surgery, McMaster University, Hamilton Health Sciences, Hamilton
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| |
Collapse
|
46
|
Lindeman C, McCurdy A, Lamboglia CG, Wohlers B, Pham ANQ, Sivak A, Spence JC. The extent to which family physicians record their patients' exercise in medical records: a scoping review. BMJ Open 2020; 10:e034542. [PMID: 32054628 PMCID: PMC7044842 DOI: 10.1136/bmjopen-2019-034542] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Exercise is an effective modality for the prevention and treatment of chronic conditions and family physicians are the healthcare providers tasked to manage patients' chronic disease status. However, little is known about the exercise documentation in family-physician records. Therefore, a scoping review was conducted to describe family-physician-recorded exercise-related advice to patients in electronic medical records. DESIGN Scoping review. SETTING Primary care clinics. SEARCH STRATEGY PubMed, Medline, SPORTDiscus, Google, Dissertations & Theses Global, OCLC PapersFirst (via First Search) and included references were searched between 1 January 1990 and 10 June 2018. Extracted information included year, geographic origin, data input structure, input frequency and content of exercise inputs in family physicians' electronic medical records. The primary outcomes are the structure, purpose and frequency of inputs. RESULTS Of a possible 1758 documents, 83 remained after a title and abstract scan and 22 after a full-text review. These documents included 32 findings of physical activity/exercise medical record documentation: counselling/advising patients (50.0%), status (12.5%), embedded questionnaires (12.5%), status as a risk factor (12.5%), health promotion documentation (6.3%), inactivity status (3.1%) and grading (3.1%). The frequency of exercise inputs in primary care records vary from as low as 0.4% of patients with documentation of physical activity health promotion inputs to as high as 87.8% of patients with exercise or physical activity status recorded. The majority of included documents (63.6%) were focused on patients with identified chronic conditions. CONCLUSION The findings suggest that the structure and purpose of exercise documentation is often unclear or unspecified. Studies that present exercise information from family-physician medical records tend to focus on patients with specific chronic conditions and present little detail about the field from which information was extracted. The review found that the proportion of patients with physical activity or exercise information is often less than half.
Collapse
Affiliation(s)
- Cliff Lindeman
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Ashley McCurdy
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Carminda G Lamboglia
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Brendan Wohlers
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Anh N Q Pham
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Allison Sivak
- Coutts Library, University of Alberta, Edmonton, Alberta, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
47
|
Hunt AP, Minett GM, Gibson OR, Kerr GK, Stewart IB. Could Heat Therapy Be an Effective Treatment for Alzheimer's and Parkinson's Diseases? A Narrative Review. Front Physiol 2020; 10:1556. [PMID: 31998141 PMCID: PMC6965159 DOI: 10.3389/fphys.2019.01556] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022] Open
Abstract
Neurodegenerative diseases involve the progressive deterioration of structures within the central nervous system responsible for motor control, cognition, and autonomic function. Alzheimer's disease and Parkinson's disease are among the most common neurodegenerative disease and have an increasing prevalence over the age of 50. Central in the pathophysiology of these neurodegenerative diseases is the loss of protein homeostasis, resulting in misfolding and aggregation of damaged proteins. An element of the protein homeostasis network that prevents the dysregulation associated with neurodegeneration is the role of molecular chaperones. Heat shock proteins (HSPs) are chaperones that regulate the aggregation and disaggregation of proteins in intracellular and extracellular spaces, and evidence supports their protective effect against protein aggregation common to neurodegenerative diseases. Consequently, upregulation of HSPs, such as HSP70, may be a target for therapeutic intervention for protection against neurodegeneration. A novel therapeutic intervention to increase the expression of HSP may be found in heat therapy and/or heat acclimation. In healthy populations, these interventions have been shown to increase HSP expression. Elevated HSP may have central therapeutic effects, preventing or reducing the toxicity of protein aggregation, and/or peripherally by enhancing neuromuscular function. Broader physiological responses to heat therapy have also been identified and include improvements in muscle function, cerebral blood flow, and markers of metabolic health. These outcomes may also have a significant benefit for people with neurodegenerative disease. While there is limited research into body warming in patient populations, regular passive heating (sauna bathing) has been associated with a reduced risk of developing neurodegenerative disease. Therefore, the emerging evidence is compelling and warrants further investigation of the potential benefits of heat acclimation and passive heat therapy for sufferers of neurodegenerative diseases.
Collapse
Affiliation(s)
- Andrew P. Hunt
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Geoffrey M. Minett
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Oliver R. Gibson
- Centre for Human Performance, Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Graham K. Kerr
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ian B. Stewart
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|
48
|
Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, Ryan ED. Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association. J Strength Cond Res 2019; 33:2019-2052. [PMID: 31343601 DOI: 10.1519/jsc.0000000000003230] [Citation(s) in RCA: 503] [Impact Index Per Article: 100.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Fragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res 33(8): 2019-2052, 2019-Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts: (a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.
Collapse
Affiliation(s)
| | - Eduardo L Cadore
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandor Dorgo
- Department of Kinesiology, University of Texas at El Paso, El Paso, Texas
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarre, CIBER of Frailty and Healthy Aging (CIBERFES), Navarrabiomed, Pamplona, Navarre, Spain
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan-Medicine, Ann Arbor, Michigan
| | - Eric D Ryan
- Department of Exercise and Sport Science, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
49
|
McMullan II, Bunting BP, McDonough SM, Tully MA, Casson K. Changes in physical activity predict changes in a comprehensive model of balance in older community-dwelling adults. A longitudinal analysis of the TILDA study. J Frailty Sarcopenia Falls 2019; 4:102-110. [PMID: 32300724 PMCID: PMC7155306 DOI: 10.22540/jfsf-04-102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2019] [Indexed: 12/18/2022] Open
Abstract
Objective: Falls due to poor balance can cause injury, disability, and death in older adults. The relationship between free-living physical activity (PA) and balance over time is poorly understood. The aim of this study is to explore the association between PA and balance in older adults over time Methods: Using two waves of data from the TILDA study (n=8,504 participants) a structural equation model was used to identify a composite measure of balance that incorporated measures of Timed Up and Go; handgrip strength; Mini Mental State Exam; vision; hearing; and steadiness. The patterns of change in PA and balance were then compared over time (controlling for covariates) Results: The results showed that one extra metabolic equivalent of task (MET) minute of PA improves balance by 4% over one week (Est=-0.10, SE=0.12), and by 5% cumulatively over two years (Est=-0.13, SE=0.02). Medication, alcohol consumption, sex, age, fear of falling, education, pain, and problems performing activities of daily living (ADL) were risk factors for balance Conclusion: This study provides a novel and robust model that should guide comprehensive balance assessment. PA promotion should engage older adults in more free-living PA that may be more relevant to them.
Collapse
Affiliation(s)
- Ilona I McMullan
- UKCRC Centre of Excellence for Public Health (NI), Ulster University, UK
| | - Brendan P Bunting
- UKCRC Centre of Excellence for Public Health (NI), Ulster University, UK
| | - Suzanne M McDonough
- Institute of Nursing and Health Research, Ulster University, UK.,School of Physiotherapy, University of Otago, New Zealand.,School of Physiotherapy, Royal College of Surgeons in Dublin, Ireland
| | - Mark A Tully
- UKCRC Centre of Excellence for Public Health (NI), Ulster University, UK.,Institute of Mental Health Services, Ulster University, UK
| | - Karen Casson
- Institute of Nursing and Health Research, Ulster University, UK
| |
Collapse
|
50
|
Schäfer I, Hansen H, Kaduszkiewicz H, Bickel H, Fuchs A, Gensichen J, Maier W, Riedel-Heller SG, König HH, Dahlhaus A, Schön G, Weyerer S, Wiese B, van den Bussche H, Scherer M. Health behaviour, social support, socio-economic status and the 5-year progression of multimorbidity: Results from the MultiCare Cohort Study. JOURNAL OF COMORBIDITY 2019; 9:2235042X19883560. [PMID: 35174099 PMCID: PMC8842469 DOI: 10.1177/2235042x19883560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/26/2019] [Indexed: 12/26/2022]
Abstract
Background: Multimorbidity in elderly patients is a major challenge for physicians, because of a high prevalence of and associations with many adverse outcomes. However, the mechanisms of progressing multimorbidity are not well-understood. The aim of our study was to determine if the progression of multimorbidity is influenced by health behaviour and social support and to analyse if the patients’ socio-economic status had an effect on these prognostic factors. Methods: The study was designed as prospective cohort study based on interviews of 158 GPs and 3189 patients randomly selected from GP records (response rate: 46.2%). Patients were aged 65–85 years at recruitment and observed in four waves of data collection (dropout rate: 41.5%). Statistical analyses of the ‘hot deck’ imputed data included multilevel mixed-effects linear regression allowing for random effects at the study centre and GP practice within study centre level. Results: Regarding cardiovascular and metabolic diseases, multimorbidity progressed more rapidly in patients who reported less physical activity (ß = −0.28; 95% confidence interval = −0.35 to −0.20), had more tobacco-related pack years (0.15; 0.07–0.22) and consumed less alcohol (−0.21; −0.31 to −0.12) at baseline. Multimorbidity related to psychiatric and pain-related disorders progressed more rapidly if the patients had less perceived social support (−0.31; −0.55 to −0.07) and reported less physical activity (−0.08; −0.15 to −0.02) at baseline. Education and income only slightly modified the effects of these variables. Conclusion: Depending on the multimorbidity cluster, different strategies should be used for slowing down the progression of multimorbidity. Changing lifestyle and increasing social support are beneficial for the entire group of elderly multimorbid patients – regardless of their socio-economic status. Registration: ISRCTN89818205
Collapse
Affiliation(s)
- Ingmar Schäfer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Hansen
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Medical Faculty, University of Kiel, Kiel, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University Munich, Munich, Germany
| | - Angela Fuchs
- Institute of General Practice, University Düsseldorf, Düsseldorf, Germany
| | - Jochen Gensichen
- Institute of General Practice, University Hospital Jena, Jena, Germany
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, München, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University Bonn, Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute for Social Medicine, Occupational Health and Public Health, University Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Dahlhaus
- Institute of General Practice, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Birgitt Wiese
- Institute of General Practice, WG Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|