Effectiveness Of Physical Activity Interventions Research Articles

Effects of a 16-Week Multimodal Exercise Program on Physical Performance in Individuals With Dementia: A Multicenter Randomized Controlled Trial.

Dementia affects physical as well as cognitive performance. In individuals with dementia (IWD), decline in physical performance increases with disease progression and is associated with higher functional dependence and decreased quality of life. It is paramount to examine factors that potentially preserve physical performance in IWD, particularly in light of conflicting findings on the effectiveness of physical activity interventions on physical performance of IWD, mainly due to limited number of high-quality studies, large heterogeneity in methods used, or insufficient reporting of methods. The aim of this study was to investigate the effects of a 16-week multimodal exercise program (MEP) combining physical and cognitive tasks on physical performance in IWD, and to identify individual characteristics of MEP responders. A multicenter randomized controlled trial with assessment methods identified by an expert panel was conducted. We included 319 IWD of mild to moderate severity, older than 65 years, who underwent a standardized MEP specifically designed for IWD. At baseline and immediately after the MEP, we assessed physical performance (ie, mobility, balance, and strength) and function of lower extremities (primary outcomes). Potential effects of the MEP on physical performance were identified using 2-factor analyses of variance with repeated measurements within 2 samples (ie, intention-to-treat and per-protocol sample). Additionally, we compared characteristics related to physical performance between positive, non-, and negative responders. Neither analysis procedure revealed statistically significant time×group effects. However, 28% to 40% of participants were positive responders with regard to balance, and strength and function of lower extremities; and these persons had statistically significant lower baseline performance in the corresponding assessments. This randomized controlled trial revealed no overall effects of the MEP on physical performance, probably due to high heterogeneity of the study sample. Findings in responder analysis showed that IWD with lower physical performance at baseline tended to benefit more than those with higher baseline performance. Thus, a higher degree of individualization of the MEP depending on baseline performance on IWD may improve overall MEP effectiveness.

The Benefits of Physical Activity in Children and Adolescents with Epilepsy: A Systematic Review

AbstractThe aim of this study was to review the literature about the effect of physical activity intervention in children and adolescents with epilepsy. Articles were searched in the central electronic databases of MEDLINE, Embase, PsycAriticles, and CINAHL for the following keywords: “epilepsy,” “seizure,” “physical activity,” “physical exercise,” “exercise therapy,” “sport,” using the Boolean operator “AND” and “OR.” The quality of the selected articles was evaluated by the Physiotherapy Evidence Database scale. Out of the 22 articles selected, 18 did not involve intervention or did not have pre- and postresults and therefore were excluded from the study. The remaining four were studies from Canada and Korea which comprised two long-period interventions and were included in the analysis. Both programs demonstrated a positive effect of physical activity on variables related to psychological well-being and cognitive function. All the four articles demonstrated a lower score of quality. In conclusion, reviewed studies suggest that physical exercise program induces some benefits in children and adolescents with epilepsy. However, the noncontrolled trials and the varied analyses (quantitative vs. qualitative) make it difficult to establish a consensus about benefits of physical activity in epilepsy.

The effect of physical activity interventions on cognition function in patients with diabetes: A systematic review and meta-analysis.

BackgroundIn recent years, studies have revealed that cognition may be impaired by glucose metabolism disorder. Meanwhile, physical activity has been demonstrated to maintain blood glucose. This meta‐analysis was conducted to assess the effect of physical activity on cognition in patients with diabetes and provide evidence for the treatment of cognition impairment among them.MethodsWe searched studies published in five databases from 1 January 1984 to 29 August 2020. A random‐effect or fixed‐effect meta‐analysis was used to estimate the pooled effect of physical activity on the change of cognition throughout intervention duration and post‐intervention cognition scores by standardized mean difference (SMD) and its 95% confidence interval (CI). We used funnel plots to evaluate the publication bias, I 2 statistic to evaluate the heterogeneity and did subgroup analysis stratified by sample size and follow‐up time.ResultsFive eligible studies involving 2581 patients with diabetes were included. The pooled effect of physical activity on cognition improvement in patients with diabetes was significant (SMD = 0.98, 95% CI: 0.34–1.62), while the effect on post‐intervention cognition scores was not significant (SMD = 0.35, 95% CI: −0.04–0.73). In the subgroup analysis, the pooled effect was significantly higher in studies of follow‐up time less than 1 year (SMD = 2.14, 95% CI: 1.63–2.64), while observing no significant effect in studies of follow‐up time over 1 year (SMD = 0.10, 95% CI: −0.11–0.32).ConclusionsPhysical activity is beneficial to improving cognition in patients with diabetes. However, the long‐term effect needs to be explored in future studies.

Effects of physical activity on vascular function in autoimmune rheumatic diseases: a systematic review and meta-analysis.

To summarize existing evidence and quantify the effects of physical activity on vascular function and structure in autoimmune rheumatic diseases (ARDs). Databases were searched (through March 2020) for clinical trials evaluating the effects of physical activity interventions on markers of micro- and macrovascular function and macrovascular structure in ARDs. Studies were combined using random effects meta-analysis, which was conducted using Hedges' g. Meta-analyses were performed on each of the following outcomes: microvascular function [i.e. skin blood flow or vascular conductance responses to acetylcholine (ACh) or sodium nitropusside (SNP) administration]; macrovascular function [i.e. brachial flow-mediated dilation (FMD%) or brachial responses to glyceryl trinitrate (GTN%); and macrovascular structure [i.e. aortic pulse wave velocity (PWV)]. Ten studies (11 trials) with a total of 355 participants were included in this review. Physical activity promoted significant improvements in microvascular [skin blood flow responses to ACh, g = 0.92 (95% CI 0.42, 1.42)] and macrovascular function [FMD%, g = 0.94 (95% CI 0.56, 1.02); GTN%, g = 0.53 (95% CI 0.09, 0.98)]. Conversely, there was no evidence for beneficial effects of physical activity on macrovascular structure [PWV, g = -0.41 (95% CI -1.13, 0.32)]. Overall, the available clinical trials demonstrated a beneficial effect of physical activity on markers of micro- and macrovascular function but not on macrovascular structure in patients with ARDs. The broad beneficial impact of physical activity across the vasculature identified in this review support its role as an effective non-pharmacological management strategy for patients with ARDs.

A Co-Designed Active Video Game for Physical Activity Promotion in People With Chronic Obstructive Pulmonary Disease: Pilot Trial.

BackgroundPeople with chronic obstructive pulmonary disease (COPD) who are less active have lower quality of life, greater risk of exacerbations, and greater mortality than those who are more active. The effectiveness of physical activity interventions may facilitate the addition of game elements to improve engagement. The use of a co-design approach with people with COPD and clinicians as co-designers may also improve the effectiveness of the intervention.ObjectiveThe primary aim of this study is to evaluate the feasibility of a co-designed mobile game by examining the usage of the game, subjective measures of game engagement, and adherence to wearing activity trackers. The secondary aim of this study is to estimate the effect of the game on daily steps and daily moderate-to-vigorous physical activity (MVPA).MethodsParticipants with COPD who were taking part in the co-design of the active video game (n=9) acted as the experiment group, spending 3 weeks testing the game they helped to develop. Daily steps and MVPA were compared with a control group (n=9) of participants who did not co-design or test the game.ResultsMost participants (8/9, 89%) engaged with the game after downloading it. Participants used the game to record physical activity on 58.6% (82/141) of the days the game was available. The highest scores on the Intrinsic Motivation Inventory were seen for the value and usefulness subscale, with a mean of 6.38 (SD 0.6). Adherence to wearing Fitbit was high, with participants in both groups recording steps on >80% of days. Usage of the game was positively correlated with changes in daily steps but not with MVPA.ConclusionsThe co-designed mobile app shows promise as an intervention and should be evaluated in a larger-scale trial in this population.

Physical activity for pediatric cancer survivors: a systematic review of randomized controlled trials.

PurposeTo collate evidence and evaluate the effects of physical activity interventions on physical activity level among pediatric cancer survivors who had completed active cancer treatment.MethodsRelevant published studies were identified in May 2020 via five databases and reference checking. Searches were limited to randomized controlled trials or controlled clinical trials, published in English involving pediatric cancer survivors aged 18 years or below. Interventions were related to promote physical activity among the survivors. Included studies were assessed using the revised version of the Cochrane’s Risk of Bias Tool.ResultsEight randomized controlled trials (620 pediatric cancer survivors and 53 caregivers of pediatric cancer survivors) were included. All studies investigated interventions for pediatric cancer survivors to increase their physical activity level. The interventions used varied across the eight included studies: three mHealth—medical and public health practice supported by mobile devices; two eHealth—the use of information and communication technologies to improve health care; two adventure-based training; and one educational program. Measures of physical activity level also varied: five used various objective measurements (i.e., accelerometer, pedometer, multisensory activity monitor); three used different self-reported questionnaires. Owing to high variability of the interventions and measures, it was impossible to perform meta-analysis. Overall, eHealth and mHealth interventions showed effectiveness and feasibility to promote physical activity among pediatric cancer survivors.ConclusionseHealth and mHealth interventions appear to be increasingly important strategies to promote physical activity among pediatric cancer survivors.Implications for Cancer SurvivorsFuture larger-scale studies using a core-set of assessment tools are warranted to further promote regular physical activity in pediatric cancer survivors.

A Hybrid Intervention Combining Group-Based Physical Activity and an Individual Goal-Oriented Approach for Children with Developmental Disabilities: A Pre-Post Intervention Study

ABSTRACT This study aimed to examine the outcomes and feasibility of a hybrid group-based intervention combining physical activity and an individual goal-oriented approach for children with developmental disabilities. We employed a single-arm pre-test/post-test repeated-measures design. Outcome measures were based on participants’ achievement of individual goals in daily activities, as well as physical and psychosocial functioning. We also report qualitative data from one example case. The intervention consisted of eight sessions, each incorporating a goal-oriented approach and including group-based physical activities, practice with daily activities, and team meetings. Participants were seven children (all boys; age: 7y 10mo ± 1y 6mo) diagnosed with autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorder, or a combination thereof. Significant improvements were observed in participants’ achievement of individual goals and their physical functioning. No significant changes in psychosocial functioning were noted. The example case showed the changes related to everyday life. No participants dropped out, and no complaints or severe accidents or injuries were recorded. All participants expressed hopes of continuing to participate in this program. This approach has high feasibility and could help to amplify the effects of physical activity interventions.

The Impact of ApoE e4 Allele in the Effects of Physical Activity Interventions on Major Mobility Disability Incidence

The apolipoprotein E (ApoE) e4 polymorphism is traditionally linked to increased rates of cognitive impairments and Alzheimer’s Disease. Recently, however, studies have connected ApoE e4 to self-reported mobility disability in those without cognitive impairment. We aimed to estimate the extent to which ApoE status is associated with incident major mobility disability (MMD) and whether it modifies the known beneficial effects of physical activity on incident MMD. Data were from 1,372 participants 70+ years old at risk for mobility impairments, enrolled in The LIFE Study. Participants were randomized to a structured physical activity (PA) or a health education program. The primary outcome was MMD, defined as the inability to walk 400 meters and measured every 6 months for an average follow-up period of 2.6 years. We used proportional hazards regression to examine the main effect of ApoE allele status and interaction with intervention group on MMD incidence. Cumulative MMD incident rates were similar in ApoE-e2 (31.46%), ApoE e3 (33.41%), and ApoE-e4 (33.33%) carriers. Compared to the common ApoE-e3, MMD risk was similar in ApoE-e2 (hazard ratio [HR], 0.945 [95%CI, 0.70-1.27], P=0.71) and ApoE-e4 carriers ([HR], 1.187 [95%CI, 0.95-1.48], P=0.41). Additionally, ApoE carrier status did not modify the positive effect that a PA intervention had on MMD risk (interaction p-value > 0.20). These results suggest that ApoE carrier status is not associated with incident mobility disability. ApoE carrier status does not impact the effect a structured PA program has on reducing the risk of MMD in older adults.

The effectiveness of physical activity interventions on communication and social functioning in autistic children and adolescents: A meta-analysis of controlled trials.

Difficulty with communication and social functioning are two outstanding core symptoms of autism spectrum disorder, while there is no efficacious pharmacologic treatment available to deal with them. Traditional behavioral therapies usually require specialist therapist and be conducted in specific settings, increasing burdens on families and individuals with autism. Physical activity has long been found to promote physical and mental well-beings, and it is more affordable and versatile than traditional therapies. There is preliminary support for the use of physical activity interventions to improve communication and social functioning in individuals with autism. In this study, we quantitatively aggregate data from existing controlled trials to provide an up-to-date inquiry into the effectiveness of physical activity interventions on communication and social functioning in autistic children and adolescents. We included 12 trials involving 350 participants (8 trials reported communication outcomes and 11 trials reported social functioning outcomes) and found small to moderate benefits on communication and social functioning. Further analyses showed that the benefit of physical activity interventions is greater in younger participants. Results of this study suggest that physical activity interventions are effective to improve communication and social functioning in autistic children and adolescents, and early participation in the interventions can be more beneficial. Given their affordability, versatility, and efficacy, physical activity interventions could be considered a cost-effective option for autism spectrum disorder management in the future.

The effect of physical activity interventions on executive functions in children with ADHD: A systematic review and meta-analysis

BackgroundAttention-deficit hyperactivity disorder (ADHD) is a commonly diagnosed behavioral disorder in school-aged children. A core symptom of ADHD is difficulties with executive functions (EF). Physical activity (PA) interventions are proposed to be a valuable addition to traditional treatment approaches for ADHD. This systematic review examined the evidence for the effect of chronic PA on EF, specifically, inhibition, shifting, working memory, and attention in children with ADHD compared to no treatment. The moderating impact of PA cognitive demand and methylphenidate (MPH) treatment on the effect of PA interventions on EF was also examined. MethodsA systematic review and meta-analyses were conducted following the Cochrane Guidelines for Systematic Reviews. A protocol was published with PROSPERO (CRD42018099617); seven databases were searched, and 3690 results screened by two independent researchers. Based on inclusion and exclusion criteria, 12 eligible studies were included, and separate meta-analyses were conducted for each EF domain, each including subgroups of high vs low cognitive demand, and MPH-intake vs. MPH-free. ResultsResults showed beneficial effects of PA for all EF, with 95%-CI compatible with positive effects for shifting (SMD = −1.58; 95%-CI [−3.12; −0.04]) and working memory (SMD = −0.99; 95%-CI [−1.80; −0.18])only. Cognitive demand of PA differed in its impact depending on the domain of EF. Benefits of PA were lesser in those taking MPH, though subgroup differences were statistically non-significant. ConclusionChildren with ADHD benefit from PA leading to enhanced executive functioning performance. However, the cognitive demands of the PA need to be considered when contemplating PA as an adjunctive treatment option.

The effect of physical-activity intervention on children's health-related quality of life.

Aims: We investigated the effect of a school-based physical-activity intervention on children's health-related quality of life (HRQoL) and the potential influence of moderate to vigorous physical activity (MVPA). Methods: A randomised, controlled trial (Active School) involving fifth-grade children was conducted during the 2014/15 school year. The sample included 435 children (10-11 years old) at five intervention schools and four control schools. The weekly interventions concerned two 45 min of physically active lessons, five 10 min of physically active breaks and five 10 min of physically active homework. The children's HRQoL was measured using KIDSCREEN-27 and a self-report questionnaire, while physical activity was measured using accelerometers. Results: The results of multilevel analysis showed a significant effect on psychological wellbeing (p = 0.005), social support and peers (p = 0.005) and school environment (p = 0.013). No gender differences were observed. Children's MVPA did not influence their KIDSCREEN-27 score. Conclusions: The school-based physical-activity intervention (Active School) shows positive effects on children's self-reported psychological wellbeing, social support and peers, and school environment.

Strengthening the relationship between physical activity and physical self-concept: The moderating effect of controllable attributions

Individuals who are more physically active, compared to those who are less physically active, typically report more favourable perceptions of their physical appearance and functioning (i.e., physical self-concept). However, there is limited empirical evidence examining how psychological processes associated with physical activity can affect the strength of this relationship. In the current study, perceptions of controllability (i.e., controllable attributions) was tested as a moderator of the relationship between physical activity and physical self-concept. A sample of 189 adults (Mage = 23.8 years; nmale = 76, nfemale = 112, nunspecified = 1) read hypothetical scenarios that elicited emotions specific to achievement or failure. Participants completed measures assessing their attributions for each scenario, together with self-report physical activity and physical self-concept. In the final models, the relationship between physical activity and physical self-concept was stronger among those participants who reported higher perceptions of controllability. The effectiveness of physical activity interventions may be improved through attributional retraining to adaptive (controllable) attributions.

Integration of Physical Activity in Reablement for Community Dwelling Older Adults: A Systematic Scoping Review.

BackgroundReablement is a rehabilitative intervention provided to homecare receivers with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement, and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintaining function among older adults, but it is unclear how PA is integrated in reablement.PurposeTo map existing evidence of how PA strategies are integrated and explored in studies of reablement for community dwelling older adults and to identify knowledge gaps.MethodsAn a priori protocol was published. Studies of time-limited, interdisciplinary reablement for community-dwelling older adults were considered for inclusion. Eight databases were searched for studies published between 1996 and June 2020, in addition to reference and citation searches. Study selection and data extraction were made independently by two reviewers.ResultsFifty-one studies were included. Exercise strategies and practice of daily activities were included in the majority of intervention studies, but, in most cases, little information was provided about the intensity of PA. Interventions aiming to increase general PA levels or reduce sedentary behavior were rarely described. None of the studies explored older adults’, healthcare providers’ or family members’ experiences with PA in a reablement setting, but some of the studies touched upon themes related to PA experiences. Some studies reported outcomes of physical fitness, including mobility, strength, and balance, but there was insufficient evidence for any synthesis of these results. None of the studies reported PA levels among older adults receiving reablement.ConclusionThere is limited evidence of how PA is integrated and targeted to older adults’ individual needs and preferences in a reablement setting. The feasibility and effectiveness of PA interventions, as well as experiences or barriers related to PA in a reablement setting, should be further investigated.

195. Fostering physical activity after complex lumbar spine surgery: long-term results of a randomized trial

BACKGROUND CONTEXT Many patients maintain sedentary lifestyles after lumbar surgery because of fear of spine injury, pain, deconditioning and habit, and thus incur potential serious long-term adverse consequences (ie, sedentary death syndrome). The surgical team is uniquely positioned to institute behavioral interventions that both protect the spine and foster prudent physical activity. However, beneficial effects of physical activity interventions often are noted in the short-term, and extinguish with time. We previously showed the effectiveness of an intervention in an RCT to increase prudent physical activity at the 4-month short-term follow-up. PURPOSE To determine the sustainability of an intervention to increased physical activity, primarily walking, after 12 months STUDY DESIGN/SETTING RCT, tertiary spine center PATIENT SAMPLE A total of 230 patients, enrolled 3 months after complex lumbar surgery, cleared by surgeons to increase physical activity, followed for 12 months OUTCOME MEASURES Paffenbarger Physical Activity and Exercise Index (PAEI) at 12 months METHODS During routine 3-month postop visits, 110 intervention patients received 1) a booklet about benefits of physical activity and national activity guidelines 2) instruction on how increase lifestyle walking 3) a calibrated pedometer 4) made a self-contract specifying walking goals and 5) received periodic telephone encouragement early in the trial. 120 controls received information about safe physical activity. At enrollment all patients completed the valid 3-domain PAEI measuring number of blocks walked and stairs climbed daily and sports during the past week. Kcal/week were calculated for each domain and for an overall total. Operative records were reviewed and a Surgical Invasiveness Index (SII) value (reflecting surgical complexity) was calculated (max 10 points/vertebral level). Multivariable analyses considered within-patient enrollment to 12-month follow-up change in Kcal/week, controlling for demographic and clinical characteristics. RESULTS At enrollment intervention and control groups were similar in mean age (64 vs 63), men (55% vs 51%), median SII value (11 vs 11), PAEI walking Kcal/week (1,418 vs 1,311), and PAEI overall total Kcal/week (1,786 vs 1,754) (all p>.05). Mean time from surgery to enrollment was 2.9 months, and from enrollment to long-term follow-up was 12.6 months. The within-patient mean increase in PAEI walking was 860 vs 365 Kcal/week; in multivariable analysis with change in PAEI walking as the dependent variable and controlling for age, sex and surgical complexity, intervention group remained associated (estimate 563, 95% CI 70-1057, p=.03). The increase in PAEI overall total was 1,294 vs 758 Kcal/week; in similar multivariable analysis intervention group remained associated (estimate 642, 95% CI 75-1209, p=.03). CONCLUSIONS A psychosocial intervention in the spine care setting was successful in increasing and then sustaining gains in physical activity up to 12 months after lumbar surgery. Our study highlights the potential for interventions to foster new physical activity habits that diminish sedentary lifestyles and thus promote long-term spine and overall health. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Effects of physical activity interventions on cognitive outcomes and academic performance in adolescents and young adults: A meta-analysis

ABSTRACT The aim was to provide a meta-analysis of studies investigating the effects of physical activity interventions on cognitive outcomes and academic performance in adolescents or young adults. A systematic review with meta-analysis was performed using the following databases: Embase, ERIC, MEDLINE, PsycINFO and Web of Science. Studies had to meet the following criteria: controlled study design, investigating the effects of physical activity interventions on cognitive outcomes and academic performance in healthy adolescents or young adults (12–30 years). Results showed that acute interventions (n=44) significantly improved processing speed (ES=0.39), attention (ES=0.34) and, inhibition (ES=0.32). In a subsequent meta-regression, shorter duration of intervention was significantly associated with greater improvements in attention (β=−0.02) and cognitive flexibility (β=−0.04), whereas age, percentage of boys, intensity and dose were not. Chronic interventions (n=27) significantly improved processing speed (ES=0.30), attention (ES=0.50), cognitive flexibility (ES=0.19), working memory (ES=0.59) and language skills (ES=0.31). In the meta-regression, higher percentage of boys was significantly associated with greater improvements in attention (β=0.02) and working memory (β=0.01) whereas age, duration, frequency, dose and load were not. In conclusion, acute and chronic physical activity interventions might be a promising way to improve several cognitive outcomes and language skills in adolescents and young adults.

What Is the Recommended Dose of Physical Activity in the Treatment of Depression in Adults? A Protocol for a Systematic Review

The accurate measurement of physical activity (PA) in adults with depression is critical to identify important health consequences and determinants of this behavior. This study aimed to propose a protocol for a systematic review investigating the recommended dose of PA in the treatment of depression in adults aged 18 to 65 years. Additionally, we intend to examine the effect of PA interventions on the prevalence of depression. This protocol for a systematic review has been submitted in the Prospective International Register submitted in Register of Systematic Reviews of PROSPERO and is being prepared in accordance with the Declaration of Preferential Items for Systematic Reviews and Meta-Analysis Protocols. This protocol provides justification and planned methods for a systematic review to examine the respective dose of PA and how interventions have a beneficial impact on adults with depression.

Baseline Cognitive Performance Moderates the Effects of Physical Activity on Executive Functions in Children.

Findings regarding the effects of regular physical activity on cognition in children have been inconsistent due to a number of demographic factors and experimental considerations. The present study was designed to examine baseline cognitive performance and executive function demands, as possible factors underlying the lack of consensus in the literature, by investigating the moderating role of those factors on the effects of physical activity on cognition. We reanalyzed data from three randomized controlled trials, in which the effects of regular physical activity intervention on cognition were examined using executive function tasks that included at least two task conditions requiring variable executive function demands, with a cumulative total of 292 participants (9–13 years). The results indicate that cognitive improvements resulting from physical activity intervention were greater in children with lower baseline cognitive performance. The main analysis revealed that beneficial effects of physical activity intervention on cognitive performance were generally observed across executive function conditions. However, secondary analyses indicated that these general effects were moderated by baseline performance, with disproportionately greater effects for task conditions with higher executive function demands. These findings suggest that baseline cognitive performance is an individual difference variable that moderates the beneficial effects of physical activity on executive functions.

Impact Of Marriage On Physical Activity Behavior In Women With Multiple Sclerosis

PURPOSE: Support is critical for individuals with multiple sclerosis (MS) to adopt and continue physical activity (PA). The role that spouses play in the adoption and continuation of PA in women with MS has yet to be explored. METHODS: Four women with MS volunteered for in-depth interviews lasting approximately an hour. The interviews were semi-structured and covered topics such as: marriage context, PA choices and behaviors, PA activities alone and with spouse, etc. Interviews were transcribed (with identifiers removed) and analyzed in case studies, then cross-cases for overlapping themes. RESULTS: Four cases were developed. Theresa is an older woman with MS for which PA is encouraged by her spouse, and some PA is engaged in together, such as walking pets. She states, “It’s not walking like we used to walk, but we are out there together.” Margaret is an older woman with MS for which PA is engaged in completely alone. Intentional PA is performed alone because of her spouse’s lack of motivation. She states, “I always feel like he could use it as much as I could, but there’s no motivation and he has to motivate himself.” Claire is a young woman with MS who engages in PA outdoors with her spouse but feels her choices in PA done together can be dependent on her spouse’s desires over her own. She states, “Maybe sometimes if he’s not with me, I would um⋯ push myself harder I think.” Joanna is a mid-life woman with MS who engages in PA outdoors with her spouse and children, as well as indoors with a personal trainer focused on mobility. She feels that her spouse provides support in both types of PA. She states, “Oh, he so strongly encourages it! He, he is honestly my #1 fan if, if there is something new that I did at the gym that day, he wants to see it, he wants to do it... knowing he has my back and is in my corner lets me know that you know it will be a struggle but it is, it is worth it.” All four women discussed the importance of support in PA, despite differences in spousal engagement in PA. CONCLUSIONS: This study points to the importance of support and perception of support by marriage partners for women with MS. Future physical activity programs for women with MS should consider the role marriage partners play in decisions to be physically active. Effectiveness of PA interventions might be enhanced by increasing the involvement of marriage partners.

What do we know about physical activity interventions in vocational education and training? A systematic review

BackgroundAlthough the health benefits of physical activity (PA) are well known, young people’s level of PA is often insufficient and tends to decline in adolescence. Numerous studies have investigated the effectiveness of PA-promoting interventions among young people, but none have reviewed the effectiveness of PA interventions in the vocational education and training (VET) setting. This systematic review aims to (1) synthesize and review the available literature on PA-promoting interventions in VET and (2) examine the effects of these interventions on PA-related outcomes such as PA level, physical fitness, physiological parameters, or psychological factors.MethodsFive electronic databases were searched for studies involving adolescents aged 15 to 20 years that took place in VET settings and evaluated the effects of interventions with a PA component on PA-related outcomes such as PA level, physical fitness, physiological parameters, or psychological factors. The screening process and the quality assessment were conducted by two independent reviewers; data extraction was conducted by one reviewer and verified by another.ResultsThe literature search identified 18,959 articles and 11,282 unique records. After the screening process, nine studies, all coming from European or Asian countries, met the pre-defined eligibility criteria and were included in qualitative analyses. All but two studies reported significant improvements for at least one PA-related outcome. The interventions substantially differed in their development approaches (top-down vs. bottom-up approaches), complexity (multi- vs. single-component), and addressed behavior (multi-behavioral vs. single-behavioral). The most conspicuous finding was that bottom-up approaches tend to improve outcomes at the psychological level and top-down approaches at the physical level. Regarding the interventions’ complexity and addressed behavior, we did not reveal any conclusive results.ConclusionThis systematic review highlights the varying effects of PA-promoting interventions in VET. Nevertheless, heterogeneous effects, overall weak study quality and availability of studies only from two continents limited our ability to draw clear conclusions about the potentially most effective intervention strategies. Therefore, future research should focus on high-quality studies with long-term follow-ups to make recommendations for practical use.Trial registrationPROSPERO CRD42018109845.

Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

This study is aimed at describing and evaluating physical activity interventions in individuals that have undergone hip or knee joint replacement due to osteoarthritis. A total of 11,873 studies were screened. Seven studies with 627 participants, aged 50 to 85 years, met the review criteria. There are five randomised control trial, one longitudinal quasi-experimental study with a control group, and one pre-/post-test study with control group. Interventions included health coaching, a walking programme, a behavioural change intervention, and an alpine skiing intervention delivered between 6 and 24 weeks. Two studies reported change in physical activity using patient activity diaries and five used objective accelerometer data. All studies showed an increase in time spent being physically active in the intervention groups. One study also reported an increase in vitality. Few studies have investigated physical activity interventions after hip or knee joint replacement, and evidence for the effectiveness of physical activity interventions post-replacement is low. High-quality studies are needed in this area to explore the potential benefits presented within this review.