Activity Interventions For People Research Articles

Physical Activity Interventions in People with Diabetes: A Systematic Review of The Qualitative Evidence.

The aim of this systematic review is to summarize the results of qualitative research into people with type 2 diabetes mellitus (T2DM) and their propensity to engage in physical activity (PA), and to identify and analyse their experiences and opinions of interventions and programs designed to increase their adherence to PA recommendations. Systematic review of qualitative studies extracted from databases using the SPIDER systematic search method. The review included studies that combined qualitative and mixed methods research and compiled the experiences and opinions of people with T2DM who had participated in interventions to increase their levels of PA. A thematic summary of qualitative data was performed. The review comprised nine studies published between 2017 and 2021, which included 170 people. Four themes and ten subthemes were identified. The four themes include: (1) factors related to PA, (2) factors related to the program, (3) factors related to the support the participants received and (4) factors related to the person. The support patients receive, both from family/friends and from health providers, is key to consolidating changes in habits and in promoting individualized health education. Future interventions and health policies should reinforce programs designed to promote PA that prioritize the experiences of people in order to increase their adherence to PA programs.

Adherence Support Strategies for Physical Activity Interventions in People With Chronic Musculoskeletal Pain-A Systematic Review and Meta-Analysis.

Chronic musculoskeletal (MSK) pain significantly impacts individuals' quality of life. Regular physical activity is an important key to therapy. However, adherence to exercise is often below the intended levels. This systematic review aims to assess the effectiveness of adherence support strategies in physical activity randomized controlled trials (RCTs) for patients with chronic MSK pain, to address the challenge of motivation and adherence in this population. Ovid and CINAHL databases were searched for MSK "chronic pain," "adherence" and "physical activity" (in various synonyms) for RCTs with a follow-up of at least 6months. After a screening process that included several team members, a narrative synthesis and a meta-analysis on adherence and effect sizes of different outcomes were performed. An initial database output of 5816 articles resulted in 76 RCTs that remained for analysis. These RCTs showed high heterogeneity of intervention design and outcome data. Adherence to exercise varied widely, with 21 RCTs achieving rates of 80% or higher using strategies like education, goal setting, self-monitoring, and personal feedback. The meta-analysis, based on 29 out of 76 RCTs, indicated a nonsignificant correlation between adherence levels and an improved outcome (eg,pain or quality of life). No individual strategy emerged as superior, emphasizing the complexity and diversity of intervention designs. This review offers strategies, such as information/education and individual goal setting/feedback that may be beneficial for enhancing physical activity in patients with chronic MSK pain. Future research should focus on including promising adherence support strategies and providing data for adherence calculations.

Physical activity interventions to improve the health and wellbeing of people experiencing homelessness: a mixed-methods systematic review

BackgroundPeople experiencing homelessness have poor health. Physical activity is known to improve health outcomes. No published systematic review of physical activity interventions in this population exists. We aimed to systematically synthesise evidence for physical activity interventions in people experiencing homelessness. MethodsWe searched EMBASE, Web of Science, CINAHL, PubMed, PsycINFO, SPORTDiscus, and Cochrane Library from Jan 1, 1970, to Feb 8, 2021, for studies only published in English. Search terms included “people experiencing homelessness” and “physical interventions”. We included quantitative and qualitative studies of people experiencing homelessness from high-income countries with physical activity interventions in any setting that was compared with or without standard of care, evaluating any health or wellbeing-related outcome—eg, cardiovascular, depression. The Joanna Briggs Institute's (JBI) critical analysis tools were used for quality assessment, with very poor-quality studies rejected. JBI mixed-methods systematic reviews methodology was followed, with qualitisation of quantitative data and convergent synthesis of evidence. The protocol is registered with PROSPERO, number CRD42020216716. FindingsWe screened 2837 records, generating 14 reports (13 studies: eight qualitative and five quantitative [one randomised control trial, three quasi-experimental, one analytical cross-sectional]) of sufficient quality from the UK, USA, Denmark, and Australia, including 403 participants. Interventions included soccer (n=6), group activities (eg, gardening [n=5]), and multi-modal individual interventions (eg, bicycle provision with safety-training [n=2]). Quantitative studies reported 19 outcomes (13 objective, six subjective) quantifying physical health (eg, VO2max; n=13), mental health (eg, Beck Depression Inventory; n=5), and social wellbeing (Outcomes Rating Scale; n=1). Nine quantitative outcomes changed substantially in favour of the intervention. No change was reported in three outcomes, and the relative change of remaining outcomes could not be quantified. Synthesis of qualitative studies found themes reporting predominantly positive perceived impact on physical and mental health and social wellbeing, which corroborated the quantitative findings through convergent synthesis. InterpretationMore qualitative than quantitative studies were identified, with qualitative evidence suggesting physical activity interventions can benefit health and wellbeing. However, quantitative evidence was either positive or inconclusive. Evidence suggests a tentative recommendation for physical activity interventions in people experiencing homelessness. FundingNational Institute for Health Research School for Public Health Research.

Planning implementation and scale-up of physical activity interventions for people with walking difficulties: study protocol for the process evaluation of the ComeBACK trial

BackgroundThere is currently little evidence of planning for real-world implementation of physical activity interventions. We are undertaking the ComeBACK (Coaching and Exercise for Better Walking) study, a 3-arm hybrid Type 1 randomised controlled trial evaluating a health coaching intervention and a text messaging intervention. We used an implementation planning framework, the PRACTical planning for Implementation and Scale-up (PRACTIS), to guide the process evaluation for the trial. The aim of this paper is to describe the protocol for the process evaluation of the ComeBACK trial using the framework of the PRACTIS guide.MethodsA mixed methods process evaluation protocol was developed informed by the Medical Research Council (MRC) guidance on process evaluations for complex interventions and the PRACTIS guide. Quantitative data, including participant questionnaires, health coach and administrative logbooks, and website and text message usage data, is being collected over the trial period. Semi-structured interviews and focus groups with trial participants, health coaches and health service stakeholders will explore expectations, factors influencing the delivery of the ComeBACK interventions and potential scalability within existing health services. These data will be mapped against the steps of the PRACTIS guide, with reporting at the level of the individual, provider, organisational and community/systems. Quantitative and qualitative data will elicit potential contextual barriers and facilitators to implementation and scale-up. Quantitative data will be reported descriptively, and qualitative data analysed thematically.DiscussionThis process evaluation integrates an evaluation of prospective implementation and scale-up. It is envisaged this will inform barriers and enablers to future delivery, implementation and scale-up of physical activity interventions. To our knowledge, this is the first paper to describe the application of PRACTIS to guide the process evaluation of physical activity interventions.Trial registrationAustralian and New Zealand Clinical Trials Registry (ANZCTR) Registration date: 10/12/2018.

Proposing a Core Outcome Set for Physical Activity and Exercise Interventions in People With Rare Neurological Conditions.

Rare neurological conditions (RNCs) encompass a variety of diseases that differ in progression and symptoms but typically include muscle weakness, sensory and balance impairment and difficulty with coordinating voluntary movement. This can limit overall physical activity, so interventions to address this are recommended. The aim of this study was to agree a core outcome measurement set for physical activity interventions in people living with RNCs. We followed established guidelines to develop core outcome sets. Broad ranging discussions in a series of stakeholder workshops led to the consensus that (1) physical well-being; (2) psychological well-being and (3) participation in day-to-day activities should be evaluated in interventions. Recommendations were further informed by a scoping review of physical activity interventions for people living with RNCs. Nearly 200 outcome measures were identified from the review with a specific focus on activities or functions (e.g, on lower limb function, ability to perform daily tasks) but limited consideration of participation based outcomes (e.g., social interaction, work and leisure). Follow on searches identified two instruments that matched the priority areas: the Oxford Participation and Activities Questionnaire and the Sources of Self-Efficacy for Physical Activity. We propose these scales as measures to assess outcomes that are particularly relevant to assess when evaluating physical activity interventions mong people with RNCs. Validation work across rare neurological conditions is now required to inform application of this core outcome set in future clinical trials to facilitate syntheses of results and meta-analyses.

Systematic review and meta-analysis of between-group and single-case physical activity interventions for people with intellectual disabilities.

Systematic review and meta-analysis of between-group and single-case physical activity interventions for people with intellectual disabilities.

Supplemental Material for Systematic Review and Meta-Analysis of Between-Group and Single-Case Physical Activity Interventions for People With Intellectual Disabilities

Supplemental Material for Systematic Review and Meta-Analysis of Between-Group and Single-Case Physical Activity Interventions for People With Intellectual Disabilities

Preserving Mobility in Older Adults with Physical Frailty and Sarcopenia: Opportunities, Challenges, and Recommendations for Physical Activity Interventions.

One of the most widely conserved hallmarks of aging is a decline in functional capabilities. Mobility loss is particularly burdensome due to its association with negative health outcomes, loss of independence and disability, and the heavy impact on quality of life. Recently, a new condition, physical frailty and sarcopenia, has been proposed to define a critical stage in the disabling cascade. Physical frailty and sarcopenia are characterized by weakness, slowness, and reduced muscle mass, yet with preserved ability to move independently. One of the strategies that have shown some benefits in combatting mobility loss and its consequences for older adults is physical activity. Here, we describe the opportunities and challenges for the development of physical activity interventions in people with physical frailty and sarcopenia. The aim of this article is to review age-related physio(patho)logical changes that impact mobility in old age and to provide recommendations and procedures in accordance with the available literature.

I007 Physical activity interventions for people with MSK conditions

I007 Physical activity interventions for people with MSK conditions

Motives for physical activity in the adoption and maintenance of physical activity in men with alcohol use disorders

Within the self-determination theory and the trans-theoretical model (stages of change) frameworks, we investigated motives for physical activity adoption and maintenance in men with alcohol use disorder (AUD). Fifty Ugandan patients completed the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) to assess exercise motives, the Patient-centred Assessment and Counselling for Exercise (PACE) to determine stage of change and the Alcohol Use Disorders Identification Test. The relationship between motives for physical activity and stage of change was investigated using ANOVA with post-hoc Scheffe tests. Multivariate analyses found significantly higher levels of introjected, identified and integrated motivation in the action and maintenance stage versus the pre-action stage. There were no differences in intrinsic motivation between the stages of change. Our results suggest that in order to adopt and maintain an active lifestyle the most important source of motivation comes from the benefits that may be obtained rather than from the inherent pleasure or challenge associated with it. The study provides a platform for future research to investigate the importance of autonomous motivation within physical activity interventions for people with AUD.

What information is important for accredited exercise physiologists to facilitate change in clients living with type 2 diabetes mellitus?

Accredited Exercise Physiologists (AEPs) prescribe exercise and physical activity interventions for people living with type 2 diabetes mellitus (T2DM). During initial consultations, AEPs face the challenge of collecting enough information to facilitate behaviour change and adherence to treatment recommendations. The objective of this research is to explore the initial consultation practices of AEPs with clients living with T2DM and resultant recommendations provided to clients to promote long-term adherence. This study was an exploratory descriptive qualitative study. Twenty-one AEPs who currently practice in the Townsville Region participated in focus groups or semi-structured interviews. Data were analysed using a thematic and triangulation approach. Results revealed that an interview style consultation is standard practice, which varied based on experience of the AEP. Interviewing techniques facilitating behaviour change were under-utilised, especially among less-experienced AEPs who focused on the medical information. Assessment of the psychosocial wellbeing of the client living with T2DM by AEPs was limited. AEPs recommended that group exercise sessions yielded greater success for clients adopting physical activity. It is recommended that new graduate AEPs develop greater confidence in strategies of gathering information to facilitate behaviour change in clients with T2DM. A mentorship program could ensure the continued development of new graduate AEPs through the transfer of knowledge and skills.

Web-Based Intervention Preferences and Physical Activity Motivation of People with Depressive Symptoms

Physical activity is an effective method for managing depressive symptoms, and web-based interventions may be an effective tool for promoting physical activity within this population. People with depressive symptoms may experience condition-specific facilitators and barriers to be considered when developing physical activity interventions. This study provides insight into web-based physical activity intervention preferences and physical activity motivation of people with depressive symptoms. This study was part of a larger trial of a web-based physical activity intervention for people with depressive symptoms. Thematic analysis of participants’ (N = 20) written responses to open-ended survey questions was conducted. Preferences for web-based intervention features included social forums, self-monitoring, suggestions for types of physical activity in different circumstances and information targeted to people with depressive symptoms. When discussing physical activity motivation instrumental beliefs (i.e., beliefs of the benefits and cost of physical activity) and controllability (i.e., whether the behaviour is under their control) were discussed. Additionally, people reported condition-specific barriers of physical activity such as depressive symptoms of apathy, worthlessness, and pain. Further research is needed to test the effectiveness of web-based physical activity interventions targeting people with depressive symptoms, which incorporates these findings.

Implementation in action: how Australian Exercise Physiologists approach exercise prescription for people with mental illness

Background: Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown.Aims: To examine the way in which Australian AEPs prescribe exercise for people with mental illness.Methods: Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics.Results: AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult.Conclusions: Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.

Dropout from physical activity interventions in people living with HIV: a systematic review and meta-analysis

ABSTRACTPhysical activity (PA) interventions have been shown to improve the health of people living with HIV (PLWH), yet treatment dropout poses an important challenge. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in PA interventions in PLWH. Electronic databases were searched for records up to September 2016. Randomized control trials of PA interventions in PLWH reporting dropout rates were included. Random effects meta-analysis and meta-regression analyses were employed. In 36 studies involving 49 PA intervention arms, 1128 PLWH were included (mean age = 41.6 years; 79.3% male; 39% White). The trim and fill adjusted treatment dropout rate was 29.3% (95% CI = 24.5–34.7%). There was a significant lower dropout rate in resistance training interventions compared with aerobic (p = 0.003) PA interventions, in studies utilizing supervised interventions throughout the study period (p < 0.001), and in studies using adequately qualified professionals (p < 0.001). Exerciser/participant variables that moderated higher dropout rates were a lower percentage of male participants (β = 1.15, standard error (SE) = 0.49, z = 2.0, p = 0.048), a lower body mass index(BMI) (β = 0.14, SE = 0.06, z = 2.16, p = 0.03), and a lower cardiorespiratory fitness (β = 0.10, SE = 0.04, z = 2.7, p = 0.006). The dropout from PA interventions is much higher in PLWH than in many other populations with chronic morbidities. Qualified professionals (i.e., exercise physiologists, physical educators, or physical therapists) should be incorporated as key care providers in the multidisciplinary care of HIV/AIDS and should prescribe supervised PA for PLWH in order to enhance adherence and reduce the burden of HIV/AIDS. Special attention should be given men, those with a higher BMI, and those with a lower cardiorespiratory fitness.

Performance-Focussed Sport – An Avenue to Gold-Medal Clinical Outcomes for People with Neurological Impairments?

This paper investigates the premise that long-term engagement in performance-focussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderate-intensity activity recommended for good health is 450 MET.minutes/week, although evidence from the general population indicates that outcomes may be enhanced by completing up to five times this volume (2250 MET.minutes/week) at vigorous (rather than moderate) intensity. Most studies evaluating physical activity interventions for people with NI deliver low volumes (&lt;450 MET.minutes/week), which may explain why evidence for some clinical outcomes is weak. Athletes (with or without NI) who aim to achieve high-level sports performance undertake an increasingly large volume of vigorous intensity physical activity over several seasons. Evidence that people with NI may enhance clinical outcomes through performance-focussed sports training includes: evidence from studies investigating the benefits of high-intensity and/or high volume clinical exercise; scientific evidence from elite/high-level athletes; and anecdotal evidence from Paralympic athlete testimonials. Additionally, sports participants with NI may also accrue an important array of psychosocial benefits, including higher rates of employment, and higher satisfaction with life and social integration. Rigorous, prospective, longitudinal clinical monitoring of people with NI undertaking performance-focussed sports training are required to evaluate its clinical utility.

Prevalence and predictors of treatment dropout from physical activity interventions in schizophrenia: a meta-analysis

Physical activity interventions have been shown to improve the health of people with schizophrenia, yet treatment dropout poses an important challenge in this population, and rates vary substantially across studies. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in physical activity interventions in people with schizophrenia. We systematically searched major electronic databases from inception until August 2015. Randomized controlled trials of physical activity interventions in people with schizophrenia reporting dropout rates were included. Two independent authors conducted searches and extracted data. Random-effects meta-analysis and meta-regression analyses were conducted. In 19 studies, 594 patients with schizophrenia assigned to exercise interventions were investigated (age=37.2 years, 67.5% male, range=37.5%-100%). Trim and fill adjusted treatment dropout rate was 26.7% [95% confidence interval (CI)=19.7%-35.0%], which is more than double than in nonactive control interventions (odds ratio=2.15, 95% CI=1.29-3.58, P=.003). In the multivariate regression, qualification of the professional delivering the intervention (β=-1.06, 95% CI=-1.77 to -0.35, P=.003) moderated treatment dropout rates, while continuous supervision of physical activity approached statistical significance (P=.05). Qualified professionals (e.g., physical therapists/exercise physiologists) should prescribe supervised physical activity for people with schizophrenia to enhance adherence, improve psychiatric symptoms and reduce the onset and burden of cardiovascular disease.

A17 Physiotherapy in HD: Clinical Guidelines and Tips

In 2009, the European Huntington’s Disease Network (EHDN) Physiotherapy working group produced a comprehensive Guidance Document and subsequent Clinical Guidelines for physiotherapists in response to the overt need for practice guidelines to guide therapy interventions. At the time, however, there was insufficient literature in support of physiotherapy interventions and approaches to be able to conduct a full, structured evidenced-based review, therefore, physiotherapy expert subgroups were formed to consider the evidence and incorporate consensus as to best practice. Since this time, there has been a growing number of research studies that have evaluated the feasibility and potential benefits of physiotherapy and physical activity interventions for people with Huntington’s disease HD, including case studies, feasibility studies of exercise and physiotherapy, and assessment of multidisciplinary inpatient rehabilitation programmes. In this presentation, we will provide an overview of recent studies to date, and discuss their impact on the ongoing clinical validation of Physiotherapy Clinical Guidelines. We will further present the recently developed series of Clinical Tips for Physiotherapists by the EHDN Physiotherapy Working Group, which provide targeted guidance in a readily accessible format. Directions for future research in physical therapies and their potential for symptom management and disease modification across the spectrum of the disease will also be discussed.

Physical Activity Context Preferences in People With Arthritis and Osteoporosis

Patient-group specific preferences can be used to design physical activity programs. This study compared physical activity context preferences between (1) people with musculoskeletal conditions (ie, arthritis and/or osteoporosis) and people without these conditions, and (2) people with arthritis only and people with osteoporosis only. Data were from 1684 participants (57.2 ± 6.6 years) with self-reported arthritis and/or osteoporosis and 4550 participants (52.9 ± 6.9 years) without these conditions. Participants indicated the extent to which they disagreed/agreed with a preference for each of 14 contexts. Marginal means and 95% confidence intervals are presented, differences were tested with ANCOVA. Compared with participants without musculoskeletal conditions, those with arthritis and/or osteoporosis indicated a slightly stronger preference for activities that are not just about exercise [3.55 (3.51-3.59) vs. 3.49 (3.46-3.52), P = .02], and a weaker preference for vigorous activities [3.02 (2.97-3.06) vs. 3.08 (3.06-3.11), P = .02], and activities with a set routine or format [3.29 (3.24-3.33) vs. 3.35 (3.32-3.38), P = .02]. Participants with arthritis only [n = 1063, 2.64, (2.59-2.70)] had a stronger preference against supervision than those with osteoporosis only [n = 146, 2.84 (2.69-2.99); P = .02]. Only small differences were found in the activity context preferences between people with and without musculoskeletal conditions, and between people with osteoporosis and people with arthritis. The context of physical activity interventions for people with arthritis and/or osteoporosis does not have to be different from those for people without these conditions.

A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia

Depression is common in older people with dementia. Physical activity is effective in reducing depression in adults but there is limited evidence about its effectiveness in people with dementia. A systematic review and partial meta-analysis of physical activity interventions in people with dementia is reported. We searched eight databases for English language papers and reference lists of relevant papers. Included studies reported a physical activity intervention lasting at least 12 weeks in which participants were older and had a diagnosis of dementia. Studies compared the intervention with a non-active or a no-intervention control and reported at least one outcome related to physical function, quality of life or depression. At least two authors independently assessed each paper for inclusion and for study quality and extracted data. We included 13 randomised controlled trials with 896 participants. Three of six trials that reported walking as an outcome found an improvement, as did four of the five trials reporting timed get up and go tests. Only one of the four trials that reported depression as an outcome found a positive effect. Both trials that reported quality of life found an improvement. There is some evidence that physical activity interventions improve physical function in older people with dementia. Evidence for an effect on depression and quality of life is limited.

Cardiometabolic effects of physical activity interventions for people with schizophrenia

Objectives: To identify and evaluate the recent evidence of physical activity (PA) with or without diet counselling on cardiometabolic parameters in people who have schizophrenia.Methods: Keyword searches were used to identify articles since 2003 up to August 2009 from PubMed, SPORTDiscus, Cochrane Central Register of Controlled Trials, EMBASE, PEDro, DARE, ProQuest Dissertations and Theses and PsycINFO. There were no limitations in terms of study design and sample size. Data were extracted from each included study using key items that included participants, study design, intervention modalities, and outcome measures.Results: Thirteen studies met the inclusion criteria. Physical activity with or without diet counselling results in modest weight loss, reductions in systolic and diastolic blood pressure and decreases in fasting plasma concentrations of glucose and insulin. Identifying an optimal dose or intervention strategy for PA is not yet possible. Compliance to PA seems to be an important predictor of the PA response.Discussion: There is evidence that PA with or without diet counselling is feasible and effective in reducing weight and improving obesity-related cardiometabolic risk profile in people with schizophrenia. More research focussing on the effectiveness of different PA interventions in prevention and treatment of the metabolic syndrome in people with schizophrenia is highly needed.