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Nicol JL, Cunningham BJ, Woodrow C, Adlard KN, Papinczak ZE, Spence RR, Boytar AN, Mollee P, Weber N, Nicol AJ, Hill MM, Skinner TL. Safety, Feasibility, and Acceptability of a Multisite Individualized Exercise Intervention for People with Multiple Myeloma. Med Sci Sports Exerc 2023; 55:2214-2227. [PMID: 37535331 DOI: 10.1249/mss.0000000000003267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
INTRODUCTION High rates of disease- and treatment-related symptoms, such as bone lesions, in people with multiple myeloma (MM) create uncertainty on the safety and feasibility of exercise. This study determined the safety, feasibility, and acceptability of an individualized exercise medicine program for people with MM at any disease stage. METHODS A multisite, randomized waitlist-controlled trial was conducted of an individualized, high-intensity aerobic, resistance, and impact-loading exercise program. The exercise sessions were supervised twice weekly by accredited exercise physiologists, with one additional unsupervised session per week, for 12 wk. Safety was determined by number of adverse and serious adverse events. Feasibility outcome measures were study eligibility, recruitment, adherence, and attrition. Acceptability was determined by qualitative interviews and subjective levels of enjoyment. RESULTS Of 203 people with MM screened, 88% were eligible, with 34% accepting participation (60 people) and 20% attrition for the between-group analysis, meeting a priori criteria (≥25% and <25%, respectively). No adverse or serious adverse events attributed to testing and/or exercise training were reported. Attendance at supervised exercise sessions was 98%, with 45% completion of the home-based exercise sessions. Adherence rates were 35%, 63%, and 34% for the aerobic, resistance, and impact-loading protocols, with 55%, 80%, and 37% of participants meeting a priori criteria (75% of protocol). Acceptability of the exercise program was high (mean, 82%; 95% confidence interval, 78%-87%) and highly supported by qualitative responses. CONCLUSIONS An individualized, high-intensity aerobic, resistance, and impact-loading exercise medicine program is safe and acceptable, and feasible by some measures for people with MM. Adherence to the prescribed exercise protocols was limited by comorbidities and disease symptoms. Strategies to improve unsupervised exercise completion are warranted in this population.
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Affiliation(s)
| | - Brent J Cunningham
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | - Carmel Woodrow
- Haematology Department, Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, AUSTRALIA
| | - Kirsten N Adlard
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | - Zoe E Papinczak
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | | | - Alexander N Boytar
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | | | - Nicholas Weber
- Haematology, Cancer Care Services, Royal Brisbane and Women's Hospital, Queensland, AUSTRALIA
| | - Andrew J Nicol
- Brisbane Clinic for Lymphoma, Myeloma and Leukaemia, Greenslopes Private Hospital, Brisbane, Queensland, AUSTRALIA
| | | | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
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Gilson ND, Papinczak ZE, Haslam C, Mielke GI, Fooken J, Brown WJ. A stepped down physical activity support program for military service veterans: The Active Choices pilot study. Health Promot J Austr 2023. [PMID: 37724696 DOI: 10.1002/hpja.807] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/31/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023] Open
Abstract
ISSUE ADDRESSED Referral to supervised physical activity (PA) programs is an effective treatment for military service veterans (MSVs) suffering from a range of chronic diseases. However, many MSVs fail to maintain PA regimes once discharged from supervision. This pilot study assessed Active Choices, a stepped-down program to support MSVs in the transition from allied health treatment to self-managed PA. METHODS Participants were 34 Australian MSVs (mean [SD] age = 61 [15.8] years) who were completing supervised referral to an exercise physiologist or physiotherapist. MSVs stepped-down to Active Choices and received a 12-week, evidence-based PA support program (2020-2021). Analyses compared within-group changes in accelerometer-assessed PA at three time points (Weeks 0, 12, and 24; linear mixed model). Program retention, PA choices, and allied healthcare service costs were also evaluated. RESULTS Relative to baseline (64 [26] min/day), mean (SD) moderate-to-vigorous PA increased (74 [28] min/day; p < .05) and was maintained (62 [28] min/day) at weeks 12 and 24, respectively. Retention in the program was high (86% [29/34 participants] completion rate at 12 weeks), with water-based group activities the most popular PAs of choice (14/24 activities). Average allied healthcare service costs during the study were lower than typical costs for MSVs (60.51 vs. 97.06 AUD/week). CONCLUSION The findings highlight the potential of Active Choices to support MSVs in the transition from supervised to self-managed MVPA. SO WHAT?: The program could promote the health of veterans and reduce costs for ongoing referral if impact is replicated at scale.
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Affiliation(s)
- Nicholas D Gilson
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Zoe E Papinczak
- Queensland Centre for Mental Health Research, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Catherine Haslam
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Jonas Fooken
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Gilson ND, Andersson D, Papinczak ZE, Rutherford Z, John J, Coombes JS, Brown WJ. High intensity and sprint interval training, and work-related cognitive function in adults: A systematic review. Scand J Med Sci Sports 2023; 33:814-833. [PMID: 36916717 DOI: 10.1111/sms.14349] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/06/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To assess evidence on the impact of acute and chronic high intensity interval training (HIIT) and sprint interval training (SIT) on work-related performance tests of cognitive function in adults. METHODS The databases PubMed, CINAHL, Scopus, PsycINFO, Embase and the Cochrane Library were searched for relevant articles up to August 2022. Eligible studies assessed the effects of HIIT (70-100% VO2max ) and/or SIT (≥100% VO2max ) on cognitive function test scores in cognitively healthy adults, relative to a control or comparative exercise group/condition. Data on participant characteristics, exercise protocol, key outcomes and intervention setting were extracted. Study quality was assessed using a 9 (single session HIIT/SIT) and 14 (multiple session HIIT/SIT) item checklist. RESULTS 36 studies (15 countries; n=11 to 945 participants) met inclusion criteria. Mean quality scores were 'fair-to-good' for acute (single session; mean=6.9 [SD 1.0]), and chronic (multiple session; mean=9.8 [SD 1.6]) training studies. Eighteen from 36 studies (12/20 [55%] acute and 6/16 [38%] chronic training studies) evidenced significant improvements in aspects of cognitive function related to work performance (i.e., attention, inhibition, memory, information processing speed, cognitive flexibility, intelligence, reaction time and learning). Only four studies tested the impact of HIIT/SIT on cognitive function in a work-based setting (e.g., the office or home). CONCLUSIONS While there is promising evidence, particularly from acute training studies, to indicate that high intensity, short duration exercise benefits cognitive function in adults, there is very limited evidence of application in workplace contexts. To better understand the potential benefits to employee performance and safety, HIIT/SIT and cognitive function research needs to transition from laboratory to 'in-situ' occupational settings.
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Affiliation(s)
- Nicholas D Gilson
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Dan Andersson
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Zoe E Papinczak
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Zoe Rutherford
- The University of Queensland, Queensland Centre for Menal Health Research, School of Public Health, Brisbane, Australia
| | - Julie John
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia.,The University of Queensland, Queensland Centre for Menal Health Research, School of Public Health, Brisbane, Australia
| | - Jeff S Coombes
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Wendy J Brown
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
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Gilson ND, Papinczak ZE, Mielke GI, Haslam C, McKenna J, Brown WJ. Stepped-down intervention programs to promote self-managed physical activity in military service veterans: A systematic review of randomised controlled trials. J Sci Med Sport 2021; 24:1155-1160. [PMID: 34246553 DOI: 10.1016/j.jsams.2021.06.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/28/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES A stepped-down program is one where clients transition from the care of a health professional to self-managed care. This study reviewed the effectiveness of stepped-down interventions to promote self-managed physical activity for health in military service veterans. DESIGN Systematic review. METHODS Literature searches of 11 electronic databases were performed (up to 28th April 2020) to identify randomised controlled trials that assessed self-managed physical activity interventions in military service veterans. Data were extracted on study characteristics, intervention programs (with strategies mapped against a taxonomy of behaviour change techniques), and physical activity outcomes; secondary outcomes were physical fitness/function, psychosocial health, and cost effectiveness. Study quality was assessed using a 15-item checklist adapted from the TESTEX scale. RESULTS Searches identified 26 studies (all from the United States; N = 45 to 531 participants) representing 17 intervention programs. Studies were of good quality (M = 10.7; SD = 2.3). More than half (54%) reported positive between-group intervention effects for physical activity outcomes (mean increase of 80 min/week in self-reported physical activity at 10-12 months). Physical fitness/function outcomes improved in 38% of studies, but no studies found significant intervention effects for psychosocial health or cost effectiveness outcomes. Behaviour change techniques most frequently used to elicit physical activity changes were education, goal setting, goal review and self-monitoring. CONCLUSIONS Stepped-down programs that include specific behaviour change techniques have the potential to promote self-management of physical activity in military service veterans. Multi-national randomised controlled trials that use objective physical activity measures are needed to further build the evidence base.
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Affiliation(s)
- Nicholas D Gilson
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia.
| | - Zoe E Papinczak
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Gregore I Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | | | - James McKenna
- Active Lifestyles Research Centre, Leeds Beckett University, United Kingdom
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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Gilson ND, Papinczak ZE, Mielke GI, Haslam C, Fooken J, McKenna J, Brown WJ. Effects of the Active Choices Program on Self-Managed Physical Activity and Social Connectedness in Australian Defence Force Veterans: Protocol for a Cluster-Randomized Trial. JMIR Res Protoc 2021; 10:e21911. [PMID: 33625365 PMCID: PMC7946582 DOI: 10.2196/21911] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 11/16/2022] Open
Abstract
Background A stepped-down program is one in which clients transition from the care of a health professional to self-managed care. Very little is known about the effectiveness of stepped-down physical activity (PA) programs for military service veterans. Objective This study will test Active Choices, a stepped-down behavioral support program designed to help Australian Defence Force veterans and their dependents who are clients of the Department of Veterans’ Affairs, transition from treatment by an exercise physiologist or physiotherapist to self-managed PA. Methods The study is a parallel-group, randomized trial, with city-based exercise physiology or physiotherapy practices that recruit eligible Department of Veterans’ Affairs clients assigned to Active Choices or a comparison program. The study aims to recruit 52 participants (26 in each group). The Active Choices program will consist of 2 face-to-face (Weeks 1, 12) and 2 telephone (Weeks 4 and 8) consultations. During these sessions, the participant and Active Choices consultant will utilize an evidence-based resource booklet to review the key benefits of an active lifestyle, build an action plan for PA preferences, set and review goals, self-monitor progress relative to set goals, and discuss strategies to overcome PA barriers. Linking participants to local PA communities to overcome social isolation will be a program priority. The comparison program will consist of 2 consultations (Weeks 1 and 12) and use fewer behavioral support strategies (education, self-monitoring, and action planning only) than Active Choices. Outcome measures will be administered at baseline, end-intervention (12 weeks), and follow-up (24 weeks) to assess changes in moderate intensity self-managed PA, psychological well-being, and social connectedness. We will also measure health service utilization and costs as well as PA choices across the intervention period. End-intervention interviews will capture participant experiences. Results Due to the impacts of the COVID-19 pandemic on human research activities in Australia, participant recruitment will commence when it is safe and feasible to do so. Conclusions Findings will provide valuable pilot data to support up-scaling of the program and larger effectiveness trials with regional and rural as well as city-based Australian Defence Force veterans and their dependents. Trial Registration Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620000559910; https://www.anzctr.org.au/ACTRN12620000559910.aspx International Registered Report Identifier (IRRID) PRR1-10.2196/21911
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Affiliation(s)
- Nicholas D Gilson
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Zoe E Papinczak
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Gregore Iven Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Catherine Haslam
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Jonas Fooken
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, Australia
| | - Jim McKenna
- Active Lifestyles Research Centre, Leeds Beckett University, Leeds, United Kingdom
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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Papinczak ZE, Connor JP, Feeney GFX, Young RM, Gullo MJ. Treatment seeking in cannabis dependence: The role of social cognition. Drug Alcohol Depend 2017; 170:142-146. [PMID: 27894043 DOI: 10.1016/j.drugalcdep.2016.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Relatively few cannabis dependent individuals seek treatment and little is known about the determinants of treatment seeking. Social Cognitive Theory (SCT) provides a useful framework for examining human behaviour and motivation which may be helpful in explaining treatment seeking. This study examined the differences in cannabis outcome expectancies and cannabis refusal self-efficacy between treatment seekers and non-treatment seekers with cannabis dependence. DESIGN Non-treatment seekers were referred to an illicit drug diversion program. Treatment seekers commenced an outpatient cannabis treatment program and completed a comprehensive assessment that included measures of cannabis outcome expectancies and refusal self-efficacy. SETTING A public hospital alcohol and drug outpatient clinic. PARTICIPANTS 269 non-treatment seekers and 195 individuals commencing cannabis dependence treatment. MEASUREMENTS The Cannabis Expectancy Questionnaire (CEQ), Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), Severity of Dependence Scale - Cannabis (SDS-C), General Health Questionnaire (GHQ-28) and Readiness to Change Questionnaire (RTC) were completed. FINDINGS Treatment seekers had significantly higher levels of negative cannabis outcome expectancies and significantly lower levels of emotional relief refusal self-efficacy (belief in ability to resist using cannabis when experiencing negative affect) (ps<0.001). Treatment seekers had significantly higher levels of psychological distress and self-perceived cannabis dependence compared to non-treatment seekers (ps<0.001). CONCLUSIONS High negative cannabis outcome expectancies and low emotional relief refusal self-efficacy may play a key role in motivation to seek treatment.
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Affiliation(s)
- Zoe E Papinczak
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; School of Psychology, The University of Queensland, Brisbane, QLD 4029, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; Discipline of Psychiatry, School of Medicine, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
| | - Ross McD Young
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; Faculty of Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Matthew J Gullo
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
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