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Waddell A, Denton F, Powell R, Broom DR, Birkett ST, McGregor G, Harwood AE. Home-based Circuit Training and Community Walking for Intermittent Claudication. Ann Vasc Surg 2024; 105:38-47. [PMID: 38579907 DOI: 10.1016/j.avsg.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Supervised exercise training is recommended for people with peripheral artery disease (PAD), yet it remains underutilized. Home-based exercise programs (HBEPs) are a potential alternative. The aim of this study was to assess the feasibility of conducting a full scale trial of a 12-week HBEP for people living with symptomatic PAD. METHODS In a randomized feasibility trial, patients with intermittent claudication were allocated to either an HBEP or a nonexercise control. The HBEP group was given a Fitbit to use during a 12-week exercise program comprising of personalized step goals and a resistance-based circuit to be undertaken at home twice weekly. The primary outcome was feasibility, assessed via eligibility, recruitment, attrition, tolerability, and adherence. Acceptability was assessed via semistructured interviews. Secondary analysis was undertaken to determine the feasibility of collecting clinical outcome data. RESULTS 188 people were screened, 133 were eligible (70.7%), 30 were recruited (22.6%) and one withdrew (3.33%). Mean adherence to the daily step goal was 53.5% (range = 29.8-90.5%), and 58.6% of prescribed circuits were completed of which 56.4% were at the desired intensity. Six adverse events were recorded, 3 of which were related to study involvement. No significant differences were observed in exploratory outcomes. Small clinically important differences were seen in walking speed and pain-free treadmill walking distance which should be confirmed or refuted in a larger trial. CONCLUSIONS The HBEP was feasible and well tolerated, with successful recruitment and minimal attrition. The intervention was acceptable, with walking seen as more enjoyable than circuit exercise. The WALKSTRONG program may be suitable for those who will not, or cannot, take part in supervised exercise outside of the home.
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Affiliation(s)
- Alexander Waddell
- Centre for Physical Activity, Sport and Exercise, Institute of Health and Wellbeing, Coventry University, Coventry, UK.
| | - Francesca Denton
- Centre for Physical Activity, Sport and Exercise, Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Richard Powell
- Centre for Physical Activity, Sport and Exercise, Institute of Health and Wellbeing, Coventry University, Coventry, UK; Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - David R Broom
- Centre for Physical Activity, Sport and Exercise, Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Stefan T Birkett
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Gordon McGregor
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK; Centre for Healthcare and Communities, Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Amy E Harwood
- Centre for Physical Activity, Sport and Exercise, Institute of Health and Wellbeing, Coventry University, Coventry, UK; Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK
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Denton F, Waddell A, Kite C, Hesketh K, Atkinson L, Cocks M, Jones H, Randeva H, Davenport N, Powell R, Clark C, Kyrou I, Harwood AE, McGregor G. Remote maintenance cardiac rehabilitation (MAINTAIN): A protocol for a randomised feasibility study. Digit Health 2023; 9:20552076231152176. [PMID: 36818155 PMCID: PMC9936404 DOI: 10.1177/20552076231152176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 01/03/2023] [Indexed: 02/18/2023] Open
Abstract
Background Long-term adherence to exercise is often poor for people with coronary heart disease (CHD) who have completed supervised, centre-based cardiac rehabilitation. The aim of this study is to assess the feasibility of a remotely prescribed, delivered and monitored cardiac rehabilitation intervention using a wearable device to support long-term adherence to exercise and physical activity during maintenance of cardiac rehabilitation. Methods After completing cardiac rehabilitation, 30 participants with CHD, will be randomised (1:1) to an intervention (n = 15) or a usual care group (n = 15) in a 12-month feasibility randomised controlled trial (RCT). The intervention will comprise of an exercise consultation, personalised exercise prescription delivered via a wearable activity monitor using biometric feedback, regular monitoring via check-ins, and feedback text-messages for 6-months. Participants will be assessed at baseline (following completion of cardiac rehabilitation) and at three-, six-, and 12-months post-randomisation. The primary outcome will be feasibility, including assessment of eligibility, recruitment, adherence, and acceptability. Secondary outcomes will include exercise capacity, physical activity behaviours, cardiovascular disease risk and quality of life. Semi-structured interviews will be conducted at three-, six-, and 12-months post-randomisation (and with those who drop-out) to explore the acceptability of the study intervention and procedures. A questionnaire will be offered to those who decline participation. Discussion The MAINTAIN study will evaluate the feasibility of conducting a future definitive multi-centre RCT testing a remotely prescribed and monitored long-term mHealth maintenance exercise programme, versus usual care, for people with CHD who have completed cardiac rehabilitation. Trial registration number ClinicalTrials.gov, NCT05292287. Registered on 22/03/2022.
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Affiliation(s)
- Francesca Denton
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Francesca Denton, Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, UK.
| | - Alexander Waddell
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Chris Kite
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- School of Public Health Studies, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Katie Hesketh
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lou Atkinson
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Matthew Cocks
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Helen Jones
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Harpal Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Nathan Davenport
- UK Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Richard Powell
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- UK Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Cain Clark
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Ioannis Kyrou
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, UK
- Laboratory of Dietetics and Quality of Life, School of Food and Nutritional Sciences, Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Amy E Harwood
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Gordon McGregor
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- UK Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
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McGuire S, Krishnan N, Malik AR, Waddell A, Russell SL, Denton F, Ennis S, Horton E, Jakovljevic D, McGregor G. Hypoxia during maintenance hemodialysis-the critical role of pH. Clin Kidney J 2022; 16:262-271. [PMID: 36755842 PMCID: PMC9900580 DOI: 10.1093/ckj/sfac191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Indexed: 11/12/2022] Open
Abstract
Background The impact and management of subclinical hypoxia during hemodialysis is a significant medical challenge. As key determinants of O2 availability and delivery, proposed mechanisms contributing to hypoxia include ischemia, alkalemia and pulmonary leukocyte sequestration. However, no study has comprehensively investigated and compared these interrelated mechanisms throughout a typical hemodialysis treatment week. This study aimed to comprehensively assess the physiological mechanisms that contribute to hypoxia during hemodialysis. Methods In 76 patients, we measured arterial blood gases and pH at four time-points during hemodialysis (start, 15 min, 60 min, end) over the course of a standard treatment week. For the mid-week hemodialysis session, we additionally measured central hemodynamics (non-invasive cardiac output monitoring) and white blood cell count. Results Linear regression modelling identified changes in pH, but not central hemodynamics or white blood cell count, to be predictive of changes in PaO2 throughout hemodialysis (e.g. at 60 min, β standardized coefficient pH = 0.45, model R2 = 0.25, P < .001). Alkalemia, hypokalemia, decreased calcium and increased hemoglobin-O2 affinity (leftward shift in the oxyhemoglobin dissociation curve) were evident at the end of hemodialysis. pH and hemoglobin-O2 affinity at the start of hemodialysis increased incrementally over the course of a standard treatment week. Conclusion These data highlight the important role of pH in regulating O2 availability and delivery during hemodialysis. Findings support routine pH monitoring and personalized dialysate bicarbonate prescription to mitigate the significant risk of alkalemia and subclinical hypoxia.
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Affiliation(s)
- Scott McGuire
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK,Department of Nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Nithya Krishnan
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK,Department of Nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Abdul R Malik
- Department of Nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Alex Waddell
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
| | - Sophie L Russell
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
| | - Francesca Denton
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
| | - Stuart Ennis
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Elizabeth Horton
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
| | - Djordje Jakovljevic
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
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Denton F, Power S, Waddell A, Birkett S, Duncan M, Harwood A, McGregor G, Rowley N, Broom D. Is It Really Home-Based? A Commentary on the Necessity for Accurate Definitions across Exercise and Physical Activity Programmes. Int J Environ Res Public Health 2021; 18:ijerph18179244. [PMID: 34501833 PMCID: PMC8431042 DOI: 10.3390/ijerph18179244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022]
Abstract
Background: There is wide discrepancy in how published research defines and reports home-based exercise programmes. Studies consisting of fundamentally different designs have been labelled as home-based, making searching for relevant literature challenging and time consuming. This issue has been further highlighted by an increased demand for these programmes following the COVID-19 pandemic and associated government-imposed lockdowns. Purpose: To examine what specifically constitutes home-based exercise by: (1) developing definitions for a range of terms used when reporting exercise and physical activity programmes and (2) providing examples to contextualise these definitions for use when reporting exercise and physical activity programmes. Methods: A literature search was undertaken to identify previous attempts to define home-based exercise programmes. A working document, including initial definitions and examples were developed, which were then discussed between six experts for further refinement. Results: We generated definitions for universal key terms within three domains (and subdomains) of programme design: location (home-based, community/centre-based, or clinical setting), prescription (structured or unstructured) and delivery (supervised, facilitated, or unsupervised). Examples for possible combinations of design terms were produced. Conclusions: Definitions will provide consistency when using reporting tools and the intention is to discuss the issues presented as part of a Delphi study. This is of paramount importance due to the predicted increase in emerging research regarding home-based exercise.
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Affiliation(s)
- Francesca Denton
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
| | - Sofie Power
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
| | - Alexander Waddell
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
| | - Stefan Birkett
- School of Sport and Health Sciences, University of Central Lancashire, Preston PR1 2HE, UK;
| | - Michael Duncan
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
| | - Amy Harwood
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
| | - Gordon McGregor
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Nikita Rowley
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
| | - David Broom
- Institute of Health and Wellbeing, Coventry University, Coventry CV1 2DS, UK; (F.D.); (S.P.); (A.W.); (M.D.); (A.H.); (G.M.); (N.R.)
- Correspondence:
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5
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Kite C, Lagojda L, Clark CCT, Uthman O, Denton F, McGregor G, Harwood AE, Atkinson L, Broom DR, Kyrou I, Randeva HS. Changes in Physical Activity and Sedentary Behaviour Due to Enforced COVID-19-Related Lockdown and Movement Restrictions: A Protocol for a Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph18105251. [PMID: 34069251 PMCID: PMC8155982 DOI: 10.3390/ijerph18105251] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/14/2022]
Abstract
Prolonged lockdown/restriction measures due to the COVID-19 pandemic have reportedly impacted opportunities to be physically active for a large proportion of the population in affected countries globally. The exact changes to physical activity and sedentary behaviours due to these measures have not been fully studied. Accordingly, the objective of this PROSPERO-registered systematic review is to evaluate the available evidence on physical activity and sedentary behaviours in the general population during COVID-19-related lockdown/restriction measures, compared to prior to restrictions being in place. Defined searches to identify eligible studies published in English, from November 2019 up to the date of submission, will be conducted using the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus, PSYCinfo, Coronavirus Research Database, Public Health Database, Publicly Available Content Database, SCOPUS, and Google Scholar. The applied inclusion criteria were selected to identify observational studies with no restrictions placed on participants, with outcomes regarding physical activity and/or sedentary behaviour during lockdown/restriction measures, and with comparisons for these outcomes to a time when no such measures were in place. Where appropriate, results from included studies will be pooled and effect estimates will be presented in random effects meta-analyses. To the best of our knowledge, this will be the first systematic review to evaluate one complete year of published data on the impact of COVID-19-related lockdown/restriction measures on physical activity and sedentary behaviour. Thus, this systematic review and meta-analysis will constitute the most up-to-date synthesis of published evidence on any such documented changes, and so will comprehensively inform clinical practitioners, public health agencies, researchers, policymakers and the general public regarding the effects of lockdown/restriction measures on both physical activity and sedentary behaviour.
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Affiliation(s)
- Chris Kite
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; (C.K.); (C.C.T.C.)
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Lukasz Lagojda
- Clinical Evidence Based Information Service (CEBIS), University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK;
| | - Cain C. T. Clark
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; (C.K.); (C.C.T.C.)
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | - Olalekan Uthman
- Division of Health Sciences, Warwick—Centre for Global Health, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
| | - Francesca Denton
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK; (F.D.); (G.M.); (A.E.H.); (D.R.B.)
| | - Gordon McGregor
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK; (F.D.); (G.M.); (A.E.H.); (D.R.B.)
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Amy E. Harwood
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK; (F.D.); (G.M.); (A.E.H.); (D.R.B.)
| | - Lou Atkinson
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK;
| | - David R. Broom
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK; (F.D.); (G.M.); (A.E.H.); (D.R.B.)
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; (C.K.); (C.C.T.C.)
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK; (F.D.); (G.M.); (A.E.H.); (D.R.B.)
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B4 7ET, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Correspondence: (I.K.); (H.S.R.)
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; (C.K.); (C.C.T.C.)
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Correspondence: (I.K.); (H.S.R.)
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Whelan ME, Denton F, Bourne CLA, Kingsnorth AP, Sherar LB, Orme MW, Esliger DW. A digital lifestyle behaviour change intervention for the prevention of type 2 diabetes: a qualitative study exploring intuitive engagement with real-time glucose and physical activity feedback. BMC Public Health 2021; 21:130. [PMID: 33435946 PMCID: PMC7805160 DOI: 10.1186/s12889-020-09740-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/21/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Mobile health technologies have advanced to now allow monitoring of the acute physiological responses to lifestyle behaviours. Our aim was to explore how people engaged with real-time feedback on their physical activity and glucose levels over several weeks. METHODS Semi-structured interviews with 26 participants (61.5% female, 56.6 years) at moderate-to-high risk of developing type 2 diabetes were conducted. Interviews were completed after participants took part in an intervention comprising a flash glucose monitor (Freestyle Libre) and a physical activity monitor (Fitbit Charge 2). Purposive sampling ensured representation of ages, genders and group allocations. RESULTS Inductive thematic analysis revealed how individuals intuitively used, interpreted and acted on feedback from wearable technologies. Six key themes emerged: triggers of engagement with the technologies, links between behaviour and health, lack of confidence, changes to movement behaviours, changes to diet and barriers to lifestyle behaviour change. CONCLUSIONS Our findings demonstrate that accessing behavioural and physiological feedback can increase self-awareness of how lifestyle impacts short-term health. Some participants noticed a link between the feedback presented by the two devices and changed their behaviour but many did not. Training and educational support, as well as efforts to optimize how feedback is presented to users, are needed to sustain engagement and behaviour change. Extensions of this work to involve people with diabetes are also warranted to explore whether behavioural and physiological feedback in parallel can encourage better diabetes self-management. TRIAL REGISTRATION ISRCTN Registry, ISRCTN17545949 , 12/05/2017, prospectively registered.
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Affiliation(s)
- Maxine E Whelan
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK.
| | - Francesca Denton
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Claire L A Bourne
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, Leicester, UK
| | - Andrew P Kingsnorth
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Lauren B Sherar
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- NIHR Leicester Biomedical Research Centre-Lifestyle, Leicestershire, UK
| | - Mark W Orme
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Dale W Esliger
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- NIHR Leicester Biomedical Research Centre-Lifestyle, Leicestershire, UK
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Abstract
The Disease Repercussion Profile (DRP) was developed for use with patients with rheumatoid arthritis (RA) and has been shown to be a valid and clinically useful assessment of patient-perceived handicap. This study aimed to determine whether the Disease Repercussion Profile was also suitable for use with patients with systemic lupus erythematosus (SLE). Sixty patients with a definite diagnosis of SLE from a consultant rheumatologist were recruited into the study. They completed a series of questionnaires that assessed quality of life, depression, anxiety, attitudes towards the illness and the DRP. Results showed that patients with SLE endorsed each of the six spheres of the DRP as being frequently affected by their illness. Activity was most often endorsed. Both relationships and social activity were equally frequently adversely affected, and more often affected than the remaining spheres of finance, emotions and appearance. However, as in RA, when any area of function was affected, it was rated as very important to the individual. Indicators of quality of life were reliably related to all areas of function, as was depression and attitudes towards illness. The present study indicates that the DRP does have relevance for patients with SLE. Strong correlations between quality of life indicators, depression, attitudes towards illness and DRP subscales and total score indicate that this measure is a valid tool to assess the effect of illness on individuals with SLE.
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Affiliation(s)
- L Sharpe
- Clinical Psychology Unit F12, School of Psychology, University of Sydney, NSW, Australia.
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