Activity Levels In People Research Articles

Effect of counselling during pulmonary rehabilitation on self-determined motivation towards physical activity in people with chronic obstructive pulmonary disease \u2013 protocol of a mixed methods study

BackgroundPhysical activity promotion in people with Chronic Obstructive Pulmonary Disease (COPD) is focus of research and public health. Patient-centred interventions like counselling are promising approaches to help patients reducing sedentary behaviour. Aim of the present study is to investigate if a physical activity counselling program during pulmonary rehabilitation increases physical activity level in daily life in people with COPD.MethodsA two-armed, single blind randomised controlled trial including 56 people with COPD will be conducted in an outpatient pulmonary rehabilitation. Patients will participate in a 12-week-rehabilitation program; individuals randomized to the interventional group will additionally participate in five counselling sessions with a physiotherapist, based on the principles of motivational interviewing. The participants’ physical activity level will be measured using an accelerometer (SenseWear Pro®) before, directly and 3 months after pulmonary rehabilitation. Semi-structured interviews will be conducted to learn more about barriers and facilitators regarding daily physical activity.DiscussionIf the strategy successfully improves the physical activity level in people with COPD, counselling might be implemented in pulmonary rehabilitation.Trial registrationClinical Trials.gov NCT02455206 (05/21/2015), Swiss National Trails Portal SNCTP000001426 (05/21/2015).

Physical activity level in people with age related white matter changes correlates to better motor performance, lower comorbidity and higher cognitive level

BackgroundPhysical activity plays a pivotal role in the development of disability and may modify the negative effect of vascular risk factors on progression of both cardio and cerebrovascular disorders. The aim of this study was to evaluate the activity level in people with age-related white matter changes as identified on magnetic resonance imaging (MRI) in relation to motor performance, cognition and perceived health.MethodsData came from the first year follow up of one participating centers of the LADIS study. Fifty one subjects were first enrolled in the study. Complete first year follow up data was available for 41 subjects. Information on comorbidity, physical activity level, physical function, cognition, level of white matter changes and perceived health was collected. Physical activity level was classified with a yes or no question and with the Frenchay Activities Index (FAI).ResultsOnly 36% of the subjects in this study were physically active according to the yes/no question. 27.5% of the subjects were active according to the FAI score which evaluates the everyday activities. Being active discriminated subjects with better physical function. Subjects active according to the FAI score had a higher cognitive level (p ≤ 0.01), lower comorbidity (p = 0.02) and performed better on all motor function tasks as assessed by walking speed (p ≤ 0.01) and the Short Physical Performance battery (SPPB) (p ≤ 0.01).ConclusionsBeing physically active seems to be a long term protective factor. In our study, the majority of subjects with Age Related White Mattter Changes (ARWMC) with no or mild Instrumental Activity of Daily Living (IADL) disability did not attain recommended level of activity at first year follow up. Whether or not increasing physical activity may slow down cognitive decline and lessen development of disability in physically inactive subjects with manifest ARWC remains to be studied. Trial registration: not applicable.

Functional factors that are important correlates to physical activity in people with multiple sclerosis: a pilot study

ABSTRACTPurpose: Identify functional factors that are important correlates to physical activity levels among people with multiple sclerosis.Methods: A total of eight functional tests were conducted and physical activity was objectively measured (Actigraph GT3X accelerometer) for one week in 34 people with multiple sclerosis. A corrected Akaike Information Criterion analysis was performed to identify the strongest correlates with moderate-to-vigorous physical activity, total activity and sedentary time.Results: The multiple regression analysis converged on a model for moderate-to-vigorous physical activity (R2 = 0.31, F = 6.97, p= 0.003) that included total strength of the less-affected leg (partial r = 0.46, p = 0.007) and average peg test performance (partial r = −0.30, p = 0.087). The model for total activity (R2 = 0.40, F = 10.51, p < 0.001) included five times sit-to-stand performance (partial r= −0.44, p = 0.010) and total strength of the less-affected leg (partial r = 0.31, p = 0.077). The model for sedentary time (R2=0.22, F = 9.23, p = 0.005) only included total strength of the more affected leg (r= −0.47, p = 0.005).Conclusion: These results suggest that leg strength, manual dexterity and the ability to perform functional tasks may be important correlates with physical activity levels in people with multiple sclerosis. The findings of this pilot study can inform future investigations aiming to increase physical activity levels or develop improved rehabilitation protocols for people with multiple sclerosis.Implications for RehabilitationPhysical activity is an effective means of improving the symptoms associated with multiple sclerosis.Participation in physical activity by people with multiple sclerosis may be affected by functional factors such as leg strength, manual dexterity and the ability to rise from a seated position.Bilateral leg strength differences should be assessed and addressed in people with multiple sclerosis.

Efficacy of Task-Specific Training on Physical Activity Levels of People With Stroke: Protocol for a Randomized Controlled Trial

Efficacy of Task-Specific Training on Physical Activity Levels of People With Stroke: Protocol for a Randomized Controlled Trial

Trajectory of physical activity following total hip and knee arthroplasty: data from the English Longitudinal Study of Ageing (ELSA) cohort

Purpose: To determine the prevalence and trajectory of physical activity levels in people before and after total hip (THA) and total knee arthroplasty (TKA).Materials and methods: An analysis of the English Longitudinal Study of Ageing (ELSA) (2004/2005–2014/2015) cohort study, a prospective study of community-dwelling older adults. Two hundred and one people who received a THA or TKA for the management of osteoarthritis were identified. Physical activity was assessed through the frequency of engagement in sedentary, mild, moderate and high physical activity levels pre-operatively, during the recovery phase and a minimum of 2 years’ post-operatively.Results: There was a statistically significant decrease in physical activity from the pre-arthroplasty phase to the operative-recovery phase (p < .01), and a significant increase in physical activity from the operative-recovery phase to final follow-up (p = .05). However, overall there was no significant change in physical activity from pre-operatively to final follow-up where prevalence altered from 8% (95% confidence intervals (CI): 5–12%) to 13% (95% CI: 9–18%) (p = .15). Increasing age, male gender and greater depressive symptoms were explanatory variables associated with physical inactivity (p < .02).Conclusions: Physical activity does not increase following THA or TKA. A proportion of the arthroplasty population remains physically inactive.

Computer and mobile technology interventions for self-management in chronic obstructive pulmonary disease.

Computer and mobile technology interventions for self-management in chronic obstructive pulmonary disease.

Qualitative investigation of the role of collaborative football and walking football groups in mental health recovery

Efforts to increase physical activity levels in people with serious mental health conditions are viewed as desirable but little is known about how best to support this group to engage in exercise over extended periods. From a personal recovery perspective, the dominant paradigm in current mental health service delivery, one promising route involves participation with, rather than administration to or supervision of, mental health service users in team sports, usually football, in order to foster sharing of common interests and experiences. We aimed to explore the factors underlying the success of four collaborative mental health football (soccer) projects and the role played by football in mental health care delivery and in personal recovery. We held semi-structured focus groups with service user (n = 18) and staff (n = 7) participants from four football groups (two 'walking' football and two regular football) in two geographical National Health Service Boards in Scotland. Thematic analysis revealed that, perceived relational, personal and physical recovery-related benefits; competition and collaboration-related aspects were important drivers of interest in and commitment to the groups. Further, participants identified barriers to and concerns for continued success; specifically, they expressed that they need more explicit support from senior management. The clear emerging message was that collaborative football groups were perceived by participants as a conduit for recovery and an important aspect of mental healthcare delivery. Playing football was associated with a sense of wellbeing, and enhanced relationships between service users and staff.

Pedometer Step Count Targets during Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial.

Increasing physical activity is a key therapeutic aim in chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) improves exercise capacity, but there is conflicting evidence regarding its ability to improve physical activity levels. To determine whether using pedometers as an adjunct to PR can enhance time spent in at least moderate-intensity physical activity (time expending ≥3 metabolic equivalents [METs]) by people with COPD. In this single-blind randomized controlled trial, participants were assigned 1:1 to receive a control intervention (PR comprising 8 wk, two supervised sessions per week) or the trial intervention (PR plus pedometer-directed step targets, reviewed weekly for 8 wk). In the randomization process, we used minimization to balance groups for age, sex, FEV1 percent predicted, and baseline exercise capacity and physical activity levels. Outcome assessors and PR therapists were blinded to group allocation. The primary analysis was based on the intention-to-treat principle. The primary outcome was change from baseline to 8 weeks in accelerometer-measured daily time expending at least 3 METs. A total of 152 participants (72% male; mean [SD] FEV1 percent predicted, 50.5% [21.2]; median [first quartile, third quartile] time expending ≥3 METs, 46 [21, 92] min) were enrolled and assigned to the intervention (n = 76) or control (n = 76) arm. There was no significant difference in change in time expending at least 3 METs between the intervention and control groups at 8 weeks (median [first quartile, third quartile] difference, 0.5 [-1.0, 31.0] min; P = 0.87) or at the 6-month follow-up (7.0 [-9, 27] min; P = 0.16). Pedometer-directed step-count targets during an outpatient PR program did not enhance moderate-intensity physical activity levels in people with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT01719822).

Effectiveness and user experience of web-based interventions for increasing physical activity in people with multiple sclerosis: a comprehensive systematic review protocol.

The overall aim of this comprehensive systematic review is to explore the use of web-based interventions for increasing physical activity levels in people with a diagnosis of multiple sclerosis (MS).The quantitative objectives are to identify:The qualitative objectives are to.

The effect of an enriched environment on activity levels in people with stroke in an acute stroke unit: protocol for a before-after pilot study.

BackgroundClinical practice guidelines advocate engaging stroke survivors in as much activity as possible early after stroke. One approach found to increase activity levels during inpatient rehabilitation incorporated an enriched environment (EE), whereby physical, cognitive, and social activity was enhanced. The effect of an EE in an acute stroke unit (ASU) has yet not been explored.Methods/designWe will perform a prospective non-randomized before-after intervention study. The primary aim is to determine if an EE can increase physical, social, and cognitive activity levels of people with stroke in an ASU compared to usual care. Secondary aims are to determine if fewer secondary complications and improved functional outcomes occur within an EE. We will recruit 30 people with stroke to the usual care block and subsequently 30 to the EE block. Participants will be recruited within 24–72 h after onset of stroke, and each block is estimated to last for 12 weeks. In the usual care block current management and rehabilitation within an ASU will occur. In the EE block, the ASU environment will be adapted to promote greater physical, social, and cognitive activity. Three months after the EE block, another 30 participants will be recruited to determine sustainability of this intervention. The primary outcome is change in activity levels measured using behavioral mapping over 12 h (7.30 am to 7.30 pm) across two weekdays and one weekend day within the first 10 days of admission. Secondary outcomes include functional outcome measures, adverse and serious adverse events, stroke survivor, and clinical staff experience.DiscussionThere is a need for effective interventions that starts directly in the ASU. The EE is an innovative intervention that could increase activity levels in stroke survivors across all domains and promote early recovery of stroke survivors in the acute setting.Trial registrationAustralian New Zealand Clinical Trial Registry, ANZCTN12614000679684

Differential Effects of Tango Versus Dance for PD in Parkinson Disease.

Over half of the general population does not achieve recommended daily levels of physical activity, and activity levels in people with Parkinson disease (PD) are lower than in healthy older adults. Dance can serve as an adjunct to traditional treatments to improve gait, balance, and quality of life in people with PD. This study directly compares a tango dance intervention and a dance intervention based on the Dance for PD model, which integrates multiple dance styles. Eleven people with PD participated in a community-based mixed styles dance intervention called Dance for Parkinson’s (D4PD). Participants in the D4PD group were matched to participants in an ongoing community-based exercise study who participated in tango dance. The groups received 12 weeks of intervention, attending 1-h group classes twice a week. Participants were evaluated off anti-PD medication before and after intervention. Measures of balance, repeated sit-to-stand performance and endurance (mini-balance evaluation systems test, four square step test, five times sit to stand, 6-min walk time) improved from pre to post similarly in both groups. Motor sign severity (movement disorders society unified Parkinson disease rating scale motor subsection) and functional mobility (timed up and go) improved in the tango group and worsened in the D4PD group. Gait velocity was not affected by either intervention. Direct comparisons of different interventions are ­critical for developing optimal exercise interventions designed to specifically target motor impairments in PD. Tango dance interventions may preferentially improve mobility and motor signs in people with PD, compared to D4PD.

Physical activity levels improve following discharge in people admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease.

This study aimed to determine the physical activity level of people admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and whether physical activity changed immediately after discharge and 6 weeks post hospital admission. In this prospective observational study, people admitted to hospital with an AECOPD had physical activity levels monitored using the SenseWear(®) Armband (model MF-SW) for 3 days in hospital (T1), during the first week at home following discharge (T2), and at home during the sixth week after admission (T3). Fifty participants (mean age (SD) 71 (10) years) completed the study. There was a linear increase in average steps per day over the three time periods (T1, mean (SD) 1385 (1972) steps/day; T2, 2040 (2680); T3, 2328 (2745); analysis of variance (ANOVA) p = 0.001) and time spent in moderate activity (3.0-6.0 metabolic equivalents; minutes/day) (T1, mean (SD) 16 (27) minutes/day; T2, 32 (46) minutes/day; T3, 35 (58) minutes/day; ANOVA p = 0.008). For both outcomes, post hoc t-tests showed significant improvements from T1 to T2 and from T1 to T3, but not between T2 and T3. Physical activity was low in hospital and significantly improved in the week after discharge but showed no further significant improvement at 6 weeks following a hospitalized AECOPD.

Physical activity levels in people with Parkinson's disease who have deep brain stimulation

Physical activity levels in people with Parkinson's disease who have deep brain stimulation

The comparative ability of three physical function tests for predicting physical activity levels in people with parkinson's disease

The comparative ability of three physical function tests for predicting physical activity levels in people with parkinson's disease

Which factors influence the physical activity levels of people with traumatic brain injury when they are discharged home from hospital?

Restrictions in mobility following moderate to severe traumatic brain injury (TBI) are common. Limited evidence indicates that physical activity levels of individuals with TBI are insufficient for health maintenance. Transition from hospital to home is a challenging period for these individuals. Factors which influence activity levels during this transition period are currently unknown. This study aims to identify which factors were associated with greater activity levels during the transition period from inpatient discharge to home in individuals with TBI.

Promoting physical activity in rheumatoid arthritis: a narrative review of behaviour change theories

Purpose: Despite physical activity having significant health benefits for people with rheumatoid arthritis (RA), current levels of physical activity in this population are suboptimal. Changing behaviour is challenging and interventions aimed at increasing physical activity in this context have had varying levels of success. This review provides an overview of common behaviour change theories used in interventions to promote physical activity and their application for promoting physical activity in people with RA. Method: A scoping, narrative review was conducted of English language literature, using the search terms “physical activity/exercise” and keywords, which are associated with behaviour change interventions. The theoretical basis of such interventions in people with RA was assessed using the “theory coding scheme”. Results: Six theories which have been used in physical activity research are discussed. Further, four studies which aimed to increase physical activity levels in people with RA are explored in detail. Conclusions: To date, behaviour change interventions conducted in RA populations to increase physical activity levels have not had a strong theoretical underpinning. It is proposed that an intervention utilising the theory of planned behaviour is developed with the aim of increasing physical activity in people with RA.Implications for RehabilitationInterventions to promote physical activity in the rheumatoid arthritis (RA) population have failed to change participants' behaviour.A small number of studies have used behaviour change theories in the development and delivery of interventions.The theory of planned behaviour is recommended as the theoretical basis for an intervention to promote physical activity in the RA population.

The effects of Foot Orthoses on Pain Management of People with Plantar Fasciitis

Introduction: Plantar fasciitis is the most common cause of plantar heel pain, accounting for almost 15% of all foot-related complaints. Arch supports and heel pads are the main foot orthotics to manage the heel pain. Despite the high prevalence of plantar fasciitis, information about the effectiveness of different orthoses is still scarce. This study was aimed to compare the effectiveness of using an arch support and a silicone heel pad in the pain management of people with plantar fasciitis. Methods: Forty subjects (mean ± SD age; 44.46 ± 9.7 years) with unilateral plantar fasciitis were recruited in this randomized clinical trial study. They randomly and equally allocated to the intervention groups (the soft arch support insole and silicone heel pad). The primary outcomes were pain and foot function. Outcomes were measured while participants were administrated prior to receiving the allocated intervention and after 6-week follow up period. In the admission and follow-up sessions, the heel pain was scored via visual analogue scale (VAS) and the foot function were measured by foot and ankle outcome score (FAOS) questionnaire. Data were analysed by Mann-Whitney test. Results: Foot orthoses significantly improved the foot function, reduce the heel pain (p<0.001). There was no significant difference between two orthoses in pain relief (p=0.094). The results indicated that both silicone heel pad and soft insole had successful outcomes in the management of plantar fasciitis over a 6-week period. Conclusion: The silicone heel pad and the soft insole with arch support are effective to reduce heel pain and improve the activity level in people with plantar fasciitis.

Motivational interviewing to increase physical activity in people with chronic health conditions: a systematic review and meta-analysis

Objective: A systematic review and meta-analysis of randomized controlled trials to determine if motivational interviewing leads to increased physical activity, cardiorespiratory fitness or functional exercise capacity in people with chronic health conditions. Data sources: Seven electronic databases (MEDLINE, PsychINFO, EMBASE, AMED, CINHAL, SPORTDiscus and the Cochrane Central Register of Controlled trials) were searched from inception until January 2014. Trial selection: Two reviewers independently examined publications for inclusion. Trials were included if participants were adults (>18 years), had a chronic health condition, used motivational interviewing as the intervention and examined physical activity, cardiorespiratory fitness or functional exercise capacity. Data extraction: Two reviewers independently extracted data. Risk of bias within trials was assessed using the Physiotherapy Evidence Database Scale. Data synthesis: Meta-analyses were conducted with standardized mean differences and 95% confidence intervals (CIs) were calculated. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to evaluate the quality of the evidence. Results: Eleven publications (of ten trials) were included. There was moderate level evidence that motivational interviewing had a small effect in increasing physical activity levels in people with chronic health conditions relative to comparison groups (standardized mean differences = 0.19, 95% CI 0.06 to 0.32, p = 0.004). Sensitivity analysis based on trials that confirmed treatment fidelity produced a larger effect. No conclusive evidence was observed for cardiorespiratory fitness or functional exercise capacity. Conclusion: The addition of motivational interviewing to usual care may lead to modest improvements in physical activity for people with chronic health conditions.

From Clinical Expert to Guide: Experiences From Coaching People With Rheumatoid Arthritis to Increased Physical Activity

Physical activity levels in people with rheumatoid arthritis are lower than what are recommended for a healthful lifestyle. To support physical activity, health care professionals may use behavioral change techniques based on a biopsychosocial perspective. Investigating the implementation process may be relevant for understanding how these techniques translate to practice. The study objective was to explore the experiences of physical therapists using behavioral change techniques to coach people with rheumatoid arthritis to health-enhancing physical activity in a 2-year trial, the Physical Activity in Rheumatoid Arthritis 2010 study. This was an exploratory study with qualitative content analysis. Semistructured interviews were conducted with all 12 physical therapists in the study. They were asked about their experiences with an educational program and with their delivery of a health-enhancing physical activity intervention. Codes, subcategories, categories, and an overarching theme were derived from the transcribed interviews by use of qualitative content analysis. The overarching theme (from clinical expert to guide) was based on 3 main categories: challenges in the coaching role, growing into the coaching role, and coach education and support. Early in the process, the physical therapists encountered challenges that needed to be addressed for a smoother transition into their coaching role. Assisted by education and support, they gradually adopted practices that facilitated their use of behavioral change techniques and promoted growth into the role of coach. Adapting to a new role is a challenging process for health care professionals; it requires relevant education and support. The experiences identified in the present study may inform future educational programs targeting the skills of health care professionals in promoting various health-related behaviors.

Do Activity Levels Increase After Total Hip and Knee Arthroplasty?

People with osteoarthritis (OA) often are physically inactive. Surgical treatment including total hip arthroplasty or total knee arthroplasty can substantially improve pain, physical function, and quality of life. However, their impact on physical activity levels is less clear. We used accelerometers to measure levels of physical activity pre- and (6 months) postarthroplasty and to examine the proportion of people meeting the American Physical Activity Guidelines. Sixty-three people with hip or knee OA awaiting arthroplasty were recruited from a major metropolitan hospital. Physical activity was measured using accelerometry before, and 6 months after, surgery. The ActiGraph GT1M (ActiGraph LLC, Fort Walton Beach, FL, USA) was used in this study and is a uniaxial accelerometer contained within a small activity monitor designed to measure human movement through changes in acceleration, which can then be used to estimate physical activity over time. Questionnaires were used to assess patient-reported changes in pain, function, quality of life, and physical activity. Complete data sets (including valid physical activity data) for both time points were obtained for 44 participants (70%). At baseline before arthroplasty, the activity level of patients was, on average, sedentary for 82% of the time over a 24-hour period (based on accelerometry) and self-rated as "sometimes participates in mild activities such as walking, limited shopping, and housework" according to the UCLA activity scale. There was no change in objectively measured physical activity after arthroplasty. The majority of participants were sedentary, both before and after arthroplasty, and did not meet the American Physical Activity Guidelines recommended to promote health. This was despite significant improvements in self-reported measures of pain, function, quality of life, and physical activity after arthroplasty. Despite patient-reported improvements in pain, function, and physical activity after arthroplasty, objectively measured improvements in physical activity may not occur. Clinicians should incorporate strategies for improving physical activity into their management of patients after hip and knee arthroplasty to maximize health status. Future research is needed to explore the factors that impact physical activity levels in people after arthroplasty. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.