Exercise adherence, perceived exercise benefits and barriers, and spinal mobility in ankylosing spondylitis: a cross-sectional study

This study aimed to determine the effect of perceived exercise benefits and barriers on exercise levels among women who have been treated for breast cancer and have not participated in a formal exercise intervention. This was an anonymous, national, online cross-sectional survey study. Four hundred thirty-two women treated for breast cancer completed an online survey covering their treatment and demographic background, current exercise levels, and perceived exercise benefits and barriers. Each perceived benefit and barrier was considered in a binary logistic regression against reported exercise levels to ascertain significant relationships and associative values (odds ratio [OR]). Agreement with 16 out of 19 exercise barriers was significantly related to being more likely to report insufficient exercise levels, whereas agreement with 6 out of 15 exercise benefits was significantly related to being less likely to report insufficient levels of exercise. Feeling too weak, lacking self-discipline, and not making exercise a priority were the barriers with the largest association to insufficient exercise levels (OR=10.97, 95% confidence interval [CI]=3.90, 30.86; OR=8.12, 95% CI=4.73, 13.93; and OR=7.43, 95% CI=3.72, 14.83, respectively). Conversely, exercise enjoyment, improved feelings of well-being, and decreased feelings of stress and tension were the top 3 benefits associated with being less likely to have insufficient exercise levels (OR=0.21, 95% CI=0.11, 0.39; OR=0.21, 95% CI=0.07, 0.63; and OR=0.31, 95% CI=0.15, 0.63, respectively). Self-reported data measures were used to collect exercise data. Targeting exercise barriers specific to women treated for breast cancer may improve exercise participation levels in this cohort. Awareness of the impact of exercise barriers identified in the present study will enable physical therapists to better plan exercise interventions that support all women treated for breast cancer.

Objective: To analyze the perceived exercise benefits and barriers and their association with physical activity time in Chinese Han children and adolescents aged 9-18 years. Methods: Data were extracted from the 2019 Chinese National Survey on Students' Constitution and Health and a total of 163 656 children and adolescents aged 9-18 years in Han ethnic group were included in the analysis. Mann-Whitney U test and Kruskal-Wallis test were used to compare the perceived exercise benefits score, perceived exercise barriers score and perceived exercise benefits to barriers ratio in the children and adolescents with different demographic characteristics and physical activity time. The differences in physical activity time in subgroups were compared with χ2 tests. log-binomial regression model was used to evaluate the association between physical activity time and perceived exercise benefits and barriers. Results: The M (Q1,Q3) of the perceived exercise benefits score, perceived exercise barriers score, and perceived exercise benefits to barriers ratio in the children and adolescents were 4.11 (3.78, 4.78), 2.70 (2.10, 3.20) and 1.55 (1.22, 2.07), respectively. Children and adolescents living in urban area, boys, those at younger age and those with physical activity time ≥1 hour had higher perceived exercise benefits score and perceived exercise benefits to barriers ratio, but lower perceived exercise barriers score (all P<0.001). The prevalence of physical activity time ≥1 hour was 41.4% in the children and adolescents. In the log-binomial model with two variables of perceived exercise benefits score and perceived exercise barriers score, for each 1-point increase in the perceived exercise benefits, the possibility of physical activity time ≥1 hour increased by 11% (OR=1.11, 95%CI: 1.10-1.12), and for each 1-point increase in the perceived exercise barriers, the possibility of physical activity time ≥1 hour decreased by 15% (OR=0.85, 95%CI: 0.84-0.85). In the log-binomial model with variable of perceived exercise benefits to barriers ratio, for each 1-point increase in the perceived exercise benefits to barriers ratio, the possibility of physical activity time ≥1 hour increased by 12% (OR=1.12, 95%CI: 1.11-1.12). Conclusion: The perceived exercise benefits and barriers are significantly associated with physical activity time in children and adolescents in China.

ObjectivesThe aim of this study was to translate the Exercise Benefits/Barriers Scale (EBBS) into Turkish and investigate the perceptions of Turkish-speaking patients with different axial spondyloarthritis (axSpA) subtypes regarding exercise benefits and barriers.Patients and methodsThis validation study was conducted between June 2018 and December 2021. Patients with axSpA were consecutively assessed regarding physical (age, sex and body mass index) and disease-related characteristics (disease activity, spinal mobility, functional status, quality of life, health status, emotional status, and kinesiophobia). Eligible participants were asked to complete the EBSS and other outcome measurements during their initial visits. EBBS was readministered 7 to 14 days later.ResultsOne hundred forty-eight patients (89 males, 59 females; mean age: 44.3±11.8 years; range, 19 to 65 years) were included in the study. Of the patients, 108 had radiographic axSpA, and 40 had nonradiographic axSpA. EBBS-Barriers and EBBS-Benefits subscales demonstrated adequate internal consistency (Cronbach’s alphas of 0.82 and 0.95, respectively) and test-retest reliability (intraclass correlation coefficients of 0.837 and 0.807, respectively). No significant differences were observed between axSpA subtypes regarding EBBS-Barriers (p=0.12) and EBBS-Benefits (p=0.10) subscales. Significant relationships were detected between kinesiophobia and EBBS-Barriers scores (r=–0.424, p<0.01), as well as EBBS-Benefits scores (r=–0.344, p<0.01) for all patients. EBBS-Benefits scores were correlated to health status (r=–0.412, p=0.08) and quality of life (r=–0.394, p=0.01) in patients with nonradiographic axSpA.ConclusionAccording to our results, the Turkish EBBS is a valid and reliable tool for patients with axSpA. Perceptions of the patients with axSpA regarding exercise barriers and benefits do not differ according to the disease subtype. It appears that kinesiophobia may be an important parameter regarding exercise perception in axSpA.

To investigate Jordanian end-stage renal disease (ESRD)patients' perceived exercise benefits and barriers, and their correlation with patients' demographic variables and dialysis measures. A descriptive correlational study was conducted using cross-sectional survey, using a convenience sample of 190 ESRD dialyzed patients who were recruited from eight hospitals in Jordan. Participants significantly perceived exercise benefits (M= 2.88/4, SD± .67) higher than barriers (M= 2.66, SD± .62). The most frequent perceived exercise benefits were preventing muscular atrophy and improving mood, whereas tiredness and lower-extremity fatigue were the most frequent exercise barriers. Finally, acceptable values of Cronbach's Alpha were revealed for perceived exercise subscale, barriers subscale, and total scale (α= .88, .81, and .70, respectively). Participants focused more on exercise benefits than barriers, and on direct exercise benefits and barriers than the indirect. The results of this study have important implications for the efforts that aim at improving ESRD patients' exercise behaviors.

Previous studies have reported that women have inadequate knowledge and perceptions of osteoporosis, which may influence a lack of preventive health behaviors. However, many of these studies have been conducted in postmenopausal women living outside of the US. PURPOSE: The purpose of this study was to explore osteoporosis knowledge and health beliefs among female college students in the US. METHODS: Female undergraduate students (n = 80) attending The University of Mississippi, Oxford, MS completed the Osteoporosis Health Belief Scale (OHBS) and Osteoporosis Knowledge Test (OKT) (Kim et al., 1991). Pearson’s correlation was used to assess relationships between knowledge, perceived susceptibility and severity, perceived exercise benefits and barriers, perceived calcium benefits and barriers, and health motivation. Chi-square test was conducted to assess the influence of knowledge and health beliefs on dairy intake and exercise. RESULTS: Osteoporosis knowledge was found to have a significant relationship with perceived exercise benefits (r = .36, p < .05) as well as calcium benefits (r = −.221, p < .05). Relationships were also found between perceived severity and calcium benefits (r = .23, p < .05) and exercise barriers (r = .31, p < .05); exercise barriers and calcium barriers (r = .25, p < .05); and health motivation with knowledge (r = .222, p < .05), exercise benefits (r = .048, p < .05), and exercise barriers (r = −.39, p < .05). Knowledge of osteoporosis had a significant association with exercise (X2 = 22.59, p < .05) but not with dairy intake. Health motivation was associated with dairy intake (X2 = 37.09, p < .05) but not exercise. The OKT scores ranged from 7 to 20 out of a possible 24 points (=13.29 ± 2.6, 55%). CONCLUSIONx Female college aged students are not only lacking in knowledge of osteoporosis but also have a low level of perceived susceptibility, and severity of the disease. Previous studies indicate that females are at risk for depletion of bone mineral density as they age. Primary prevention of osteoporosis should begin at a young age to maximize peak bone mass in this population. Health educators and professionals need to focus on increasing knowledge and perceptions regarding osteoporosis in young females to reduce the incidence of this disease.

Background:Studies indicate that women with polycystic ovary syndrome have high depressive symptom scores and more perceived barriers than benefits to exercise, factors that may affect health-related quality-of-life. The purpose of this cross-sectional study was to explore the impact of perceived exercise benefits and barriers, exercise outcome expectations, and depressive symptoms on polycystic ovary syndrome–specific health-related quality-of-life.Methods:A survey link was posted on polycystic ovary syndrome Facebook groups. Women with polycystic ovary syndrome (n = 935) answered questionnaires about demographics, polycystic ovary syndrome–specific health-related quality-of-life, exercise benefits and barriers, exercise outcome expectations, and depressive symptoms. Data were collected using Qualtrics, transferred to SPSS, and statistically analyzed using regression analyses. Mean responses were reported for the questionnaires, with exercise benefits and barriers means divided for a ratio.Results:Respondents were 32 ± 10.6 years of age, mostly White (72%), and employed full-time (65%). The total mean scores were health-related quality-of-life, 2.7 ± 0.1; exercise outcome expectation, 2.4 ± 0.8; and depressive symptoms, 12.4 ± 5.8. The benefit/barrier ratio was 0.9. HRQoL increased 0.32 points for every additional perceived exercise benefit and 0.61 points for every additional exercise outcome expectation (EOE). HRQoL was reduced by 1.19 points for every additional perceived exercise barrier and 2.82 points for every additional one-point increase of the depressive symptoms score.Conclusions:Respondents reported low health-related quality-of-life, greater exercise barriers than benefits, neutral exercise outcome expectations, and high depressive symptoms. These results suggest that promoting exercise benefits, overcoming exercise barriers, and addressing management of depressive symptoms are important foci of future efforts to improve health-related quality-of-life among women with polycystic ovary syndrome.

The level of perceived exercise benefits and barriers is one of the key influencing factors of cardiac exercise rehabilitation (CER). There is a lack of validated tools to assess coronary heart disease (CHD) patients' exercise perception. The aim of this study is to develop a scale assessing CHD patients' perceived exercise benefits and barriers (CHD-PEBBS) and test its reliability and validity. A total of 205 CHD patients were recruited for a cross-sectional survey. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to extract factors, delete items and evaluate construct validity. The Cronbach's alpha coefficient and test-retest reliability were used to test the reliability of the scale. Based on the health belief model, this study developed a perceived benefits and barriers framework. CFA showed that the fit indices (such as χ2/df=2.281, CFI=0.93, RMSEA=0.079) were all acceptable A total of 6 factors were extracted through EFA, with a cumulative variance contribution rate of 75.52%. The perceived benefits subscale included 3 dimensions: "improving physiological indicators", "improving quality of life" and "improving physiological function" with a total of 12 items. The perceived barriers subscale also included 3 dimensions: "lacking of exercise support", "worrying about adverse consequences" and "poor exercise experience or perception" with a total of 10 items. The Cronbach's alpha coefficient of the scale was 0.917, and the test-retest reliability was 0.941. The CHD-PEBBS shows good reliability and validity, which may be used to evaluate the CER perception level of CHD patients, offering precise targets and pathways for exercise rehabilitation interventions in nursing.

Increasing patient adherence to regular exercise post acute myocardial infarction (AMI) is a major goal after hospitalization. It is therefore essential to identify perceived benefits and barriers to exercise and its association with exercise self-efficacy among patients post AMI. The purpose of this study was to identify the perceived benefits and barriers to exercise and the predictors of exercise self-efficacy among patients after AMI. A cross-sectional study design was used with a convenience sample of 254 patients, recruited from the 3 main hospitals in Jordan. Instruments included the Exercise Benefits and Barriers Scale and the Exercise Self-Efficacy Scale. Mean scores were computed to determine the perceived benefits and barriers responses. Multiple linear regression was conducted to explore the predictors of exercise self-efficacy. Data were collected over 5 months. The greatest perceived benefits were related to personal factors, for example, "I enjoy exercise" (2.45 [0.98]), and physical performance, for example, "My muscle tone is improved with exercise" (2.44 [0.86]) and "Exercise increases my stamina" (2.43 [0.86]). The greatest perceived barriers were related to environmental barriers, for example, "Lack of exercise places" (2.67 [0.82]), and internal factors related to physical exertion itself, for example, "Concerned about getting tired during exercise participation" (2.65 [0.72]). The Exercise Self-Efficacy Scale showed that patients post ST-elevation AMI had higher exercise self-efficacy than those with other treatment modalities (AMI, 44.71 [19.07] vs 36.59 [17.34]; P = .001). Patients treated by primary percutaneous coronary intervention had higher exercise self-efficacy, 49.2 (18.61), than patients treated by thrombolysis and percutaneous coronary intervention, 39.28 (18.3), and patients treated by medications other than thrombolytic therapy, 36.59 (17.4) (F2,251 = 11.612, P = .001). The multiple linear regression model explained approximately 29% of the variance in exercise self-efficacy (F11,242 = 7.914, P < .001). Five variables contributed significantly to the prediction of self-efficacy: type of AMI (standardized β = -0.173, t = -3.311, P = .01), perceived exercise benefits (standardized β = 0.322, t = 4.912, P = .01), perceived exercise barriers (standardized β = -0.291, t = -4.521, P = .01), being Argela smokers (water pipe smoking) (standardized β = -0.132, t = -2.617, P = .029), and cholesterol level (standardized β = -0.158, t = -2.174, P = .003). Primary perceived benefits of exercise reported were in the areas of personal factors and improved physical performance. The main perceived barriers to exercise were in the areas of environmental factors and physical exertion. Identification of benefits and barriers to exercise, type of AMI, and treatment modalities of AMI as predictors of exercise self-efficacy is a significant step for developing appropriate interventions that effectively improve exercise self-efficacy and exercise among post-AMI patients.

BackgroundNoncommunicable diseases pose a significant threat to women’s health globally, with most diseases being attributed to modifiable risk factors such as physical inactivity. Women perceive a range of benefits and barriers to exercise; however, there is little evidence about the effect of different lifestyle intervention delivery modes on perceptions of exercise.ObjectiveThis study aimed to compare the effect of a multiple health behavior change (MHBC) intervention called the Women’s Wellness Program. This intervention was delivered in 3 different modes on perceived exercise benefits, perceived exercise barriers, and actual physical activity and exercise in midlife women.MethodsWomen aged 45 to 65 years were recruited via the study website. They were assigned in blocks to 3 different treatment groups (A: Web-based independent; B: face-to-face with nurse consultations; and C: Web-based with virtual nurse consultations). All participants received the 12-week intervention that utilizes principles from social-cognitive theory to provide a structured guide to promote healthy lifestyle behaviors with an emphasis on regular exercise and healthy eating. Data were collected using a self-report Web-based questionnaire at baseline (T1) and postintervention (T2) including perceived exercise benefits and barriers and exercise and physical activity. A data analysis examined both within- and between-group changes over time.ResultsParticipants in this study (N=225) had a mean age of 50.9 years (SD 5.9) and most were married or living with a partner (83.3%, 185/225). Attrition was 30.2% with 157 participants completing the final questionnaire. Women in all intervention groups reported a significant increase in positive perceptions of exercise (P<.05); a significant increase in exercise and overall physical activity (P<.01) with moderate-to-large effect sizes noted for overall physical activity (d=0.5 to d=0.87). Participants receiving support from registered nurses in the face-to-face and Web-based groups had a greater magnitude of change in benefit perceptions and physical activity than those in the Web-based independent group. There was no significant change in exercise barrier perceptions within or between groups over time.ConclusionsThe results of this study suggest that the (MHBC) intervention is effective in increasing exercise benefit perceptions, overall physical activity, and exercise in midlife women. Although Web-based programs are cost-effective and flexible and can be delivered remotely, providing a range of options including face-to-face group delivery and personalized electronic health coaching from registered nurses has the potential to enhance participant engagement and motivation.

Purpose: To assess physical activity (PA), perceived exercise benefits, perceived sleep quality, anxiety and depression levels of adults who exercised and did not exercise during the pandemic. Methods: 1226 voluntary participants who lived in the community (age range 18-55 years) were included in this cross-sectional study. Demographic information was recorded, and exercise motivators and barriers were evaluated through questions prepared by the researchers. PA levels [International Physical Activity Questionnaire-Short Form (IPAQ-SF)], perception about the benefits of exercise [Exercise Benefits and Barriers Scale-Benefits Subscale (EBBS-BS)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and anxiety and depression levels [Hospital Anxiety and Depression Scale (HADS)] were assessed. Results: There were statistically significant differences in scores of IPAQ-SF, PSQI, EBBS-BS, and HADS between those who did and did not exercise (p

Trunk control, which plays a key role in balance and mobility, decreases in patients with multiple sclerosis (PwMS) and many parameters such as sensory, motor, and musculoskeletal systems affect trunk control. The aim of this study was to compare trunk control, spinal mobility, and spinal posture in PwMS with healthy controls and investigate the relationship between trunk control with spinal posture and spinal mobility in PwMS. The study was completed with 38 PwMS and 38 healthy controls with matched age and sex. Trunk control was evaluated with the Trunk Impairment Scale (TIS). Spinal posture and mobility were evaluated in sagittal and frontal planes using an IDIAG M360 Spinal Mouse. Spinal posture was evaluated in upright, maximum flexion, extension, left and right lateral flexion positions, and spinal mobility was evaluated from upright to flexion, extension, right and left flexion positions in sagittal and frontal planes. TIS scores, thoracic mobility angles (from upright to flexion and left lateral flexion), lumbar mobility angles (from upright to extension and right lateral flexion) and lumbar posture angle (maximum right lateral flexion) were lower, and thoracic posture angles (upright and maximum extension) were higher in PwMS than healthy controls (p < 0.05). No significant difference was found between other spinal postures and mobility values. In addition, there was only a negative relationship between thoracic spinal mobility from upright to extension and trunk control in PwMS (r = -0.349; p = 0.032). These findings indicate the importance of early detection of trunk disturbances in PwMS. Thus, even in the early stages of multiple sclerosis, detailed trunk assessment will guide the implementation of comprehensive exercise programs.

The current study aimed to examine the effectiveness of multimedia messaging service (MMS) education on exercise benefits and barriers in patients with type 2 diabetes. A quasi-experimental, pretest-post-test design recruited 98 patients with type 2 diabetes. The intervention group received MMS education to improve perceived exercise benefits and decrease exercise barriers over two months, and the control group received routine care. All patients completed a survey at three time points (baseline, 4 and 8 weeks post-intervention). The results showed that there was an improvement in both perceived life enhancement and physical performance domains in the intervention group. The exercise context barriers decreased after the first follow-up but increased during the second follow-up in the intervention group. Cohen's d values indicated a medium effect size in life enhancement (0.502) and physical performance (0.525) subscales. A small effect size was found in psychological outlook (0.196) and exercise context (0.132) subscales. However, there was no significant effect of the intervention in time expenditure (-0.244) and physical exertion (-0.119) subscales. In conclusion, theoretically based MMS health education targeting perceived exercise benefits and barriers was feasible and cost-effective in changing patients with diabetes' perceptions and intended behaviors about regular physical activity.

Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment METHODS: This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis. Increased thoracic curvature angle was associated with decreased FEV1 (r=-0.360, p=0.026) and decreased subcostal mobility (r=-0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=-0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=-0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from -0.357 to 0.661, p<0.05). The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients' spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.

With the emergence of a global pandemic, new challenges have arisen. Among them are issues relating to exercising, and perceived benefits of and barriers to exercising, particularly when many people find their opportunities for exercise limited by lockdowns. The aim of this study was to investigate how COVID‑19 has affected Turkish society's perceptions of exercise and physical activity levels. This descriptive and cross-sectional study of 410 eligible participants used anonline demographic background survey, the International Physical ActivityQuestionnaire and the ExerciseBenefits/Barriers Scale. The isolation period affects individuals' physical activity levels, with results indicating minimal activity levels in the general population. Higher levels of physical activity were associated with increases in the perception of exercise benefits and decreases in perceived barriers to exercise. Reducing the perception of barriers related to exercise can increase the feasibility and promote both physical and mental health through physical activity.

Availability of Exercise Program, Perceived Exercise Benefits and Barriers, and Exercise Habits in Maintenance Hemodialysis Patients: A Multicenter Cross-sectional Study.