Exercise Preferences Research Articles

On the personal diet considering qualitative and quantitative issues

This study integrates the analytic hierarchy process method, multi-choice goal programming (MCGP), and multi-segment goal programming (MSGP) as a new model to resolve the problem of customized suggestions on exercise plans and diet meals. For personal diet decision support (PDDS), a model-based system is implemented to solve both the exercise selection and diet meals problems. Moreover, the novel pseudo-integer (PI) technique is proposed to solve the large size of PDDS problem efficiently. Also, the MCGP-U technique is adopted to consider users’ risk attitude in the decision-making of diet and exercise.It is intended to help people design their daily personal diet menus and exercise suggestions in achieving their weight loss goals and satisfying the requirements of a balanced diet. The proposed model has the following contributions: (1) it provides a customized exercise plan according to the user’s personal needs of exercise preference and risk attitudes, (2) it allows users to design their daily diet menu according to their individual needs for calories and nutrients, (3) it offers a novel PI method that can easily solve large-sized PDDS problem efficiently, (4) it adopts the MCGP-U technique to consider PDDS’s qualitative issue, and (5) it provides the total solution of exercise and meal suggestion for users to achieve the goal of weight loss. These advantages are of great help to both diabetic patients and healthy people. This improves the healthcare services in developed and developing countries considering multiple qualitative and quantitative criteria.

Examining the Impact of Gym Closures Due to the COVID-19 Pandemic on Combat Sport Athletes’ Mental Health

Changes in exercise behavior and negative emotional states (i.e., depression, anxiety, and stress) in combat sport (e.g., boxing, wrestling, martial arts) athletes were examined the month prior to gym closures related to the COVID-19 pandemic (February 2020), and approximately 1 month following gym closures (May 2020). A total of 312 combat sport athletes from 33 different countries responded to the study solicitation. Results indicated a significant decrease in combat sport training following gym closures; however, participation in other exercise activities did not significantly change. Significant mean increases in depression, anxiety, and stress were found following combat gym closures. Regression analyses revealed that number of hours of participants participated in combat sport training added significant incremental variance explained in depressive and stress symptoms above and beyond that accounted for by sex differences, preexisting conditions, and training level. Practical implications regarding losses to preferred exercise activities are discussed.

A Delphi-Based Consensus Statement: Recommendation for Physiotherapy Management and Rehabilitation of People Living with Long COVID in Bangladesh

Background: A Delphi-Based Consensus Statement: Recommendation for Physiotherapy Management and Rehabilitation of people living with Long COVID in Bangladesh Background: Covid-19 is a new and deadly virus with global consequences with special vulnerabilities in Bangladesh. The World Health Organization confirmed 22,451,122,614 cases and 4,627,540 deaths, worldwide (13th September 2021). In the United Kingdom, 1.5% of the estimated population of 970,000, suffers from Long COVID. Physiotherapy plays a vital role both in decreasing the number of deaths during the acute stage and improving function for patients across the spectrum of severity in the acute, sub-acute, and long-term context. Objectives: This Delphi-Based Consensus, provides recommendations for physiotherapy management and rehabilitation of people living with Long COVID. It includes recommendations for physiotherapy management for acute and subacute respiratory complications, a specific prescriptive exercise guideline for fatigue and musculoskeletal dysfunction and for improving psychological outcomes through combination of both counseling and rehabilitation. Methods: A team of 8 national and 6 international experts working in different disciplines were provided with studies on physiotherapy interventions in Long COVID-19 and were asked to provide treatment opinions based on the current literature for musculoskeletal, neurorehabilitation, respiratory, cardiac and psychological health domains. Statements were ranked and presented with individual opinions measured on a 10-point Likert Scale. The mean scores for each intervention were calculated and a manuscript with recommended physiotherapy interventions was prepared based on currently available evidence as presented and agreed upon by expert consensus. Findings: Experts recommended the following interventions based on mean agreement scores: diaphragmatic breathing (Mean = 7.5), thoracic expansion (with shoulder elevation) (Mean =8.5) and expiratory muscle training (Mean=6.3) for respiratory rehabilitation. Mild to moderate graded exercise (Mean= 7.7) was suggested for recovery from fatigue and McKenzie directional preference exercises for low back pain (Mean= 8.6), neck pain (Mean =7.9) and knee pain (Mean =8.3). Additionally, communicative and educative strategies were recommended for the rehabilitation of COVID-19. Conclusion: This consensus is structured according to the expert opinions of medical and rehabilitation professionals and based on current literature to recommend a series of rehabilitation interventions for physiotherapy professionals to manage Long COVID cases.Funding: This research has not been funded by any other external organization nor received any grants from commercial or not-for-profit organizations.Declaration of Interests: None declared.Ethics Approval Statement: Ethical permission was obtained from the Centre for the Rehabilitation of the Paralysed (CRP) ethics committee. The reference number CRP-R&E-0401-337.Trial Registration: Trial registration from the WHO Clinical trial registry platform, the reference number CTRI/2020/10/028179.

Preoperative Predictors of Prolonged Hospital Stay in Accelerated Rehabilitation for Patients Undergoing Orthopedic Surgery.

In this study, we performed a retrospective and prospective study of preoperative predictors of the length of stay (LOS) in three groups of surgical patients and conducted a clinical retrospective study of the current research status of preoperative predictors of LOS prolongation in three groups of patients under ERAS (enhanced recovery after surgery) mode, such as patient characteristics and comorbidities. Information such as patients' exercise preferences, exercise time, frequency and duration, footwear, location of knee osteoarthritis, whether there is a past history of knee injury, and smoking and drinking history was collected, and the research data of 312 patients undergoing the three operations were analyzed by SPSS. Meniscal injury-knee arthroscopy sample included a total of 104 people. Surgical sample for anterior cruciate ligament reconstruction included a total of 100 subjects. Knee osteoarthritis-knee replacement surgery sample included 148 people who were divided into two groups in a ratio of 1 : 1: one group used Mailuo Shutong pills during hospitalization (intervention group) and the other group did not (control group). The research conclusions are as follows. Meniscal Knee Arthroscopy. (1) Samples from different causes of injury showed significant differences for all injured sites. (2) Samples with different smoking and drinking histories all showed significant differences for the causes of injury. (3) Exercise hobby, exercise frequency, duration of each exercise and duration of exercise, and warm-up time before exercise all showed positive correlation. Anterior Cruciate Ligament Reconstruction Surgery. (4) Samples from different causes of injury showed significant differences for all the injured sites. (5) Age has a significant negative influence on the wearing of shoes at ordinary times. (6) Exercise hobby: the warm-up time before exercise had a significant negative influence on the injured area. (7) Two groups of analysis items of exercise frequency, exercise duration and exercise duration, preexercise warm-up time, and exercise hobby were typically positively correlated. Total Knee Arthroplasty. (8) There was a significant difference of 0.01 between the hospitalization days of the intervention group and the control group (p < 0.01), and the hospitalization days of the intervention group were significantly lower than those of the control group. These results indicated that Mailuo Shutong pills were of great significance for the treatment of orthopedic patients during the operation period in that it could effectively shorten the hospital stay of all orthopedic patients and strengthen the accelerated rehabilitation. (9) There was a significant positive correlation between the history of knee joint surgery and the use time of Mailuo Shutong pills. (10) There was a markable positive correlation between occupation and sports hobbies, sports time, frequency and duration, and footwear. There was a significant negative correlation between occupation and preexercise warm-up. (11) Exercise time, frequency, and duration have significant positive influence on BMI.

The Stride program: Study protocol for an on-campus physical activity referral program for tertiary students’ experiencing mental health challenges

Background: Tertiary students experience high levels of mental health challenges, and there is a recognition that appropriate on-campus support is important for assisting students’ well-being. However, it has been highlighted that there are areas of growth on university campuses in Australia to provide best practice support for students’ psychological wellbeing. One area of growth is the addition of a physical activity (PA) to support mental health challenges as an adjunct service on campuses. However, more research is needed to understand the effectiveness, acceptability, and sustainability of implementing a PA program on-campus. Methods: Stride is a free 12-week exercise program at the University of Western Australia (UWA) offered to students to support their mental health. It is a referral-based program that complements other established treatment pathways. Stride includes a pre- and post-program assessment led by the program coordinator, an Accredited Exercise Physiologist. The coordinator then matches students (called mentees) with Stride mentors, who are trained Masters of Clinical Exercise Physiology students. Stride is person-centred, providing mentees with autonomy regarding their exercise goals and preferences. This evaluation will assess the feasibility and preliminary efficacy of the Stride program using a mixed-methods convergent design. The primary outcome will assess pre-to-post-program changes in mental health symptomatology. Changes in PA, nutrition, quality of life, student engagement and identity, physiological markers, and self-efficacy are secondary outcomes. Discussion: Currently, few programs exist worldwide delivering physical activity to students experiencing mental health problems. The preliminary results of PA programs are indicating improved mental health symptomatology for students. However, the implementation of PA programs on-campus will add further significance through four distinct future research directions. The research directions include the optimisation of program components, best practice operational structure for future PA programs, beginning to understand PA program effectiveness, and informing future randomised control trials. Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.

Perceptions of Exercise and Its Challenges in Patients With Nonalcoholic Fatty Liver Disease: A Survey-Based Study.

Exercise is a foundational treatment for nonalcoholic fatty liver disease (NAFLD); however, the majority of patients are unable to initiate and maintain effective exercise habits and remain at increased risk for progressive liver disease. Barriers and limitations to exercise in patients with NAFLD have not been fully identified. We performed a single survey of 94 patients with biopsy‐proven NAFLD to understand baseline physical activity and sedentary behavior, self‐perceived fitness, limitations to exercise, potential solutions to increase physical activity behavior, and perception of exercise as a foundational treatment for NAFLD. For exploratory analyses, we evaluated differences in responses to the survey by grouping severity of hepatic fibrosis as follows: nonalcoholic fatty liver (NAFL); early stage (nonalcoholic steatohepatitis [NASH] F0, NASH F1, NASH F2); and late stage (NASH F3, NASH F4). Zero weekly total physical activity was reported by 29% of patients with NAFLD. Late‐stage NASH had significantly lower vigorous (P = 0.024), walking (P = 0.029), total weekly activity (P = 0.043), and current fitness level (P = 0.022) compared to early stage NASH. Overall, 72% of patients with NAFLD reported limitations to exercise, with the greatest proportion citing lack of energy (62%), fatigue (61%), prior/current Injury (50%), and shortness of breath (49%). A preference for personal training to increase their physical activity was indicated by 66% of patients with NAFLD, and 63% preferred exercise over medication to treat NAFLD. Conclusion: The majority of patients with NAFLD have limitations to exercise but prefer exercise as a treatment option for NAFLD in the form of personal training. Patients with NAFLD may have unique physiologic limitations to exercise that worsen with fibrosis severity. Exercise interventions or services that are personalized and scalable may improve sustainability of exercise habits in the long term.

Interest and preferences for physical activity programming and counselling among cancer patients aged over 70 years receiving oncological treatments.

The objective of this study is to assess the physical activity interest and preferences of cancer patients aged over 70 years during oncological treatments and to explore how demographic characteristics may modulate preferences. From April to May 2018, this cross-sectional study collected data from self-administered questionnaire regarding physical activity interest and preferences in cancer patients receiving oncological treatments in a regional cancer centre. A total of 144 patients completed the questionnaire. Two thirds (n= 95) showed interest in participating in dedicated physical activity programme during oncologic treatments. Patients preferred to exercise in group activities, under the supervision of an exercise instructor, once a week, at a moderate intensity, for 30 min session, in a community fitness centre. Women significantly preferred exercises to improve flexibility (p=0.03) and to receive counselling in a group (p=0.03), whereas men preferred to practise strength training (p=0.02) and to receive counselling with brochures (p=0.02). As age increases, participants were significantly more inclined to practise physical activity to improve their balance (p=0.01). These preliminary results will facilitate the design of programmes considering current physical activity preferences in older adults with cancer, which could ensure better adherence to physical activity programmes and, in turn, improved health outcomes.

Physical activity levels, exercise preferences, and exercise barriers in Korean children and adolescents after cancer treatment.

The purpose of the current study was to explore physical activity (PA) levels, exercise preferences, and perceived barriers to PA in childhood cancer survivors. This cross-sectional study surveyed 120 childhood cancer survivors aged 8-18years from the pediatric oncology center in South Korea between March and August 2017. The modified Exercise & Quality of Life questionnaire, Korea Youth Risk Behavior Web-based Survey, and Godin Leisure-Time Questionnaire were used to assess PA levels, preferences, and exercise barriers. Among 120 participants (72 boys, 48 girls) whose average age at the time of the survey was 14.57 ± 3.00years and the average age at diagnosis was 8.22years, the three most common diagnoses were acute leukemia (43.3%), brain tumor (13.3%), and malignant lymphoma (10.8%). Only 16 participants (5%) met the PA recommendations for children (at least 60min of moderate PA per day). The most preferred sporting activities included soccer, basketball, strengthening exercises, badminton, dance, and taekwondo. They generally had positive attitudes toward exercise, and more than 63% of participants intended to exercise the following month. The five most prevalent perceived barriers to exercise were lack of time, poor health, reluctance to sweat, lack of exercise skills, and no exercise partners. While most childhood cancer survivors did not meet the PA recommendation, most of them agreed that exercise was beneficial, and they intended to participate in the exercise. Exercise and PA programs should be tailored to the personal health and preferences of childhood cancer survivors.

Greater Sun Salutation Frequency and Standing Time Predict Increased Rate of Perceived Exertion across Multiple Yoga Styles: A Cross-sectional Yoga Instructor Survey

<h3>Research Objectives</h3> To investigate the relationship between yoga elements and characteristics across multiple yoga styles, including mixed yoga styles, and exertion levels estimated by yoga instructors (YIs) using the 10-point OMNI perceived exertion scale (RPE). <h3>Design</h3> We used a cross-sectional design. <h3>Setting</h3> YIs completed this web-based questionnaire on personal computers. <h3>Participants</h3> 375 YIs from the Northeastern US completed this study. <h3>Interventions</h3> Participants completed a customized, 57-item web-based survey that included questions regarding client exertion levels, yoga styles, practice elements, and other characteristics when teaching yoga. <h3>Main Outcome Measures</h3> The independent variable was the average exertion level that YIs felt their participants experienced in a typical yoga class using a RPE scale. In our analyses this variable was collapsed into three categories: low intensity (1- 4), moderate intensity (5-7), and high intensity (8-9). <h3>Results</h3> Our response rate was 46%. YIs identified greater than eight different styles of yoga that they used in classes with 87% of them using more than one style of yoga/class. Elements of yoga were directly related to exertion level estimated by YIs: time spent in standing/class (rspearman = 0.36, p < 0.001), the frequency of sun salutations performed/class (rspearman = 0.27, p < 0.001) and time performing vinyasa/class (rspearman = 0.22, p = 0.001). We found that estimated RPE reported by YIs was inversely related (rspearman = -0.16, p = 0.004) to the non-performance of sun salutation. An ordinal logistic regression model that included the above variables revealed statistical significance: Χ-squared (4) = 29.411, p = 0.001. Only time spent in standing (p = 0.007) and frequency of performing sun salutation (p = 0.006) during a yoga class were significant predictors of estimated RPE. <h3>Conclusions</h3> If improved cardiorespiratory fitness is the client's goal and yoga is their exercise preference, our findings suggest that health care providers and clients should seek yoga classes, regardless of yoga style, where YIs spend greater time standing and perform a higher frequency of sun salutation sequences. <h3>Author(s) Disclosures</h3> There are no known conflicts of interest to declare by the authors.

Effects of a Yoga-Based Exercise Program on Health-Related Quality of Life in Breast Cancer Survivors

Research Objectives To examine the impact of six months of exercise on a Health Related Quality of Life (HR-QOL) outcomes in post treatment breast cancer survivors in the San Antonio area in Texas. Design Randomized Controlled Trial. Setting The exercise program was run at a comprehensive cancer care facility. Participants Women with breast cancer (n=94) were randomized into one of three groups: yoga-based exercise (YE; n=31); “conventional” comprehensive exercise (aerobic, resistance and flexibility; CE; n=31); or a comparison group allowing participants to choose their own preferred exercise activities (C; n=32). 72 participants completed the 6 month long exercise program (YE: n=20; CE: n=26 and C: n=26). One year retention testing was completed by 64 participants (YE: n=17; CE: n=21, C: n=24). Interventions All groups exercised three hours weekly over six months. The YE group had a structured Hatha yoga exercise program emphasizing breath awareness and postures. The exercise program for the CE group included aerobic, resistance, and flexibility training. The C group could choose from a variety of activities including aerobics, strength training, Tai Chi, and water aerobics. Main Outcome Measures The SF-36 Physical and Mental Component Scales [PCS, MCS] were used to evaluate HrQoL. Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). SF-36 data was collected at baseline, post and retention. PSQI data was collected baseline and post-intervention only. Results At retention testing, PCS scores improved significantly in the YE group compared C and CE groups (p < 0.025). All participants improved PCS and MCS scores with no between group differences. No change was seen in PSQI scores. Conclusions A yoga-based exercise program can positively impact the physical component of HR-QOL in breast cancer survivors, particularly after completion of the intervention. Whether the HR-QOL continues to improve beyond one year needs further research. Author(s) Disclosures The authors would like to acknowledge all the participants for their commitment to the study and support of Dr. Amy Lang, the ThriveWell Cancer Foundation, and the START Center for Cancer Care. The authors have no other conflicts of interest to declare. To examine the impact of six months of exercise on a Health Related Quality of Life (HR-QOL) outcomes in post treatment breast cancer survivors in the San Antonio area in Texas. Randomized Controlled Trial. The exercise program was run at a comprehensive cancer care facility. Women with breast cancer (n=94) were randomized into one of three groups: yoga-based exercise (YE; n=31); “conventional” comprehensive exercise (aerobic, resistance and flexibility; CE; n=31); or a comparison group allowing participants to choose their own preferred exercise activities (C; n=32). 72 participants completed the 6 month long exercise program (YE: n=20; CE: n=26 and C: n=26). One year retention testing was completed by 64 participants (YE: n=17; CE: n=21, C: n=24). All groups exercised three hours weekly over six months. The YE group had a structured Hatha yoga exercise program emphasizing breath awareness and postures. The exercise program for the CE group included aerobic, resistance, and flexibility training. The C group could choose from a variety of activities including aerobics, strength training, Tai Chi, and water aerobics. The SF-36 Physical and Mental Component Scales [PCS, MCS] were used to evaluate HrQoL. Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). SF-36 data was collected at baseline, post and retention. PSQI data was collected baseline and post-intervention only. At retention testing, PCS scores improved significantly in the YE group compared C and CE groups (p < 0.025). All participants improved PCS and MCS scores with no between group differences. No change was seen in PSQI scores. A yoga-based exercise program can positively impact the physical component of HR-QOL in breast cancer survivors, particularly after completion of the intervention. Whether the HR-QOL continues to improve beyond one year needs further research.

Development of Educational Print Materials for Physical Activity in Cancer: Evaluation of Readability and Suitability

Educational health materials may be important tools to increase physical activity in cancer patients. Nevertheless, most of the available resources regarding physical activity for cancer patients were found not suitable, had a low grade of readability, and thus, represent a significant barrier to behavior change. To date, little data about development criteria and evaluation of physical activity resources for cancer before their spread exist. The purposes of this study were (i) to describe the development of a physical activity guidebook designed for cancer patients and (ii) to test its readability and suitability. The guidebook was developed through multi-step passages, including group discussions, a literature review, identification of a motivational theory, and using previous research on exercise preferences, barriers, and facilitators to target the information. Two validated formulae were used to assess the readability, whereas thirty-four judges completed the Suitability of Assessment Materials questionnaire to evaluate the suitability of the guidebook. The guidebook was found readable for patients having at least a primary education, and the judges scored it as “superior” material. Our guidebook, following a rigorous method in the development phase, was considered to be suitable and readable. Further evaluations through clinical trials could investigate its effectiveness for behavior change and its impact on cancer patients.

Characterizing the Exercise Behaviour, Preferences, Barriers, and Facilitators of Cancer Survivors in a Rural Canadian Community: A Cross-Sectional Survey.

Barriers, facilitators, and motivators to exercise for cancer survivors living in urban settings are well described in the literature. However, there is a lack of comparable information for cancer survivors living in rural communities. We describe the exercise behaviours, barriers, facilitators, and motivators to exercise participation of cancer survivors living in a rural Canadian community. Adult cancer survivors with a primary address in a rural region of Ontario, Canada, who had visited a community hospital in the previous five years were mailed a cross-sectional survey assessing current exercise volume (minutes of moderate-to-vigorous aerobic and resistance exercise), as well as exercise preferences, barriers, and facilitators. Seventy-two survivors (mean age 65 years) completed the survey (16% response rate). A majority of respondents were diagnosed with breast cancer (49%) in the last 5 years (61%). Aerobic- and resistance-training guidelines for cancer survivors were met by 38% and 10% of respondents, respectively. Physical side effects were the most common barrier to exercise during treatment (65%) and post-treatment (35%). Being unaware of available exercise programs, time for exercise, distance to exercise services, and cost were commonly reported barriers during and post-treatment (reported by 10–22%). Respondents reported needing information from a qualified exercise professional (46%), access to a gym (33%) and exercise equipment (26%), and social support (25%) to facilitate exercise participation. Consistent with urban-based cancer survivors, most rural survivors surveyed in this study were not meeting the physical-activity guidelines and reported numerous exercise barriers. These findings can serve as a resource for this and similar rural communities when developing community-based exercise-support services for cancer survivors.

Comparison of Joint and Muscle Biomechanics in Maximal Flywheel Squat and Leg Press.

The aim was to compare the musculoskeletal load distribution and muscle activity in two types of maximal flywheel leg-extension resistance exercises: horizontal leg press, during which the entire load is external, and squat, during which part of the load comprises the body weight. Nine healthy adult habitually strength-training individuals were investigated. Motion analysis and inverse dynamics-based musculoskeletal modelling were used to compute joint loads, muscle forces, and muscle activities. Total exercise load (resultant ground reaction force; rGRF) and the knee-extension net joint moment (NJM) were slightly and considerably greater, respectively, in squat than in leg press (p ≤ 0.04), whereas the hip-extension NJM was moderately greater in leg press than in squat (p = 0.03). Leg press was performed at 11° deeper knee-flexion angle than squat (p = 0.01). Quadriceps muscle activity was similar in squat and leg press. Both exercise modalities showed slightly to moderately greater force in the vastii muscles during the eccentric than concentric phase of a repetition (p ≤ 0.05), indicating eccentric overload. That the quadriceps muscle activity was similar in squat and leg press, while rGRF and NJM about the knee were greater in squat than leg press, may, together with the finding of a propensity to perform leg press at deeper knee angle than squat, suggest that leg press is the preferable leg-extension resistance exercise, both from a training efficacy and injury risk perspective.

Patient and health care professional co-development of an Acceptance and Commitment Therapy intervention to support hormone therapy decision-making and well-being in women with breast cancer

Objectives The aim of this work was to co-develop an Acceptance and Commitment Therapy (ACT) intervention to support medication adherence and quality of life in breast cancer survivors (BCSs). The research approach was intervention co-development. Methods The sample consisted of BCS focus groups (n = 24), health care provider (HCP) interviews (n = 10), and a co-development workshop (BCSs, n = 12; HCPs, n = 9).We conducted 6 BCS focus groups and 10 HCP interviews to understand the acceptability of ACT. We co-designed the intervention in a workshop. Results Participants reported high acceptability of an ACT intervention. BCSs preferred ACT exercises focused on values and self-compassion. Both groups recommended face-to-face intervention delivery, by a clinical psychologist, with a mixture of individual and group sessions. BCSs requested advice on side-effect management. Conclusions We effectively used patient and HCP co-design to configure an ACT intervention to support medication adherence and quality of life for BCSs. If feasible and efficacious, this ACT-based intervention could support breast cancer survivorship.

Barriers and facilitators to exercise in haemodialysis patients: A systematic review of qualitative studies.

The purpose of this systematic review is to synthesize the results of qualitative research and to identify the barriers and facilitators to exercise in haemodialysis patients from the perspectives of haemodialysis patients, caregivers and dialysis staff members. Systematic review of qualitative studies. Qualitative studies were extracted from MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, PubMed, CBM, CNKI and WanFang Database from inception of each database until July 2020. Qualitative research and mixed method research including barriers and/or facilitators to exercise in haemodialysis patients were included. The systematic search method SPIDER (sample, phenomenon of interest, design, evaluation, research type) was used. Thematic synthesis of qualitative data was used. 284studies were screened and 10 studies published between 2007 and 2020 were finally included in this review. The review included 180 patients, 70 dialysis staff members and seven caregivers. Five analytical themes were identified: disease distress, perception of exercise, environmental restrictions, spirit strength and hospital management. Barriers include disease distress, perception of exercise (security issue), environmental restrictions and hospital management. Facilitators include perception of exercise (exercise being considered beneficial, preference for exercise) and spirit strength (from religious beliefs). It is the spiritual strength (from family and friends, from dialysis staff members) that is both the barrier and the facilitator. There are many barriers in popularizing exercise among haemodialysis patients. Future intervention measures and health policies should strengthen the facilitators and reduce the barriers, so as to promote the clinical practice of exercise for haemodialysis patients. This review summarizes the barriers and facilitators to exercise in haemodialysis patients. The results of this study have an impact on research, practice and health policy setting. The exercise level of haemodialysis patients can be improved by using the facilitators and solving the barriers.

Impact of Fluoxetine on Behavioral Invigoration of Appetitive and Aversively Motivated Responses: Interaction With Dopamine Depletion.

Impaired behavioral activation and effort-related motivational dysfunctions like fatigue and anergia are debilitating treatment-resistant symptoms of depression. Depressed people show a bias towards the selection of low effort activities. To determine if the broadly used antidepressant fluoxetine can improve behavioral activation and reverse dopamine (DA) depletion-induced anergia, male CD1 mice were evaluated for vigorous escape behaviors in an aversive context (forced swim test, FST), and also with an exercise preference choice task [running wheel (RW)-T-maze choice task]. In the FST, fluoxetine increased active behaviors (swimming, climbing) while reducing passive ones (immobility). However, fluoxetine was not effective at reducing anergia induced by the DA-depleting agent tetrabenazine, further decreasing vigorous climbing and increasing immobility. In the T-maze, fluoxetine alone produced the same pattern of effects as tetrabenazine. Moreover, fluoxetine did not reverse tetrabenazine-induced suppression of RW time but it reduced sucrose intake duration. This pattern of effects produced by fluoxetine in DA-depleted mice was dissimilar from devaluing food reinforcement by pre-feeding or making the food bitter since in both cases sucrose intake time was reduced but animals compensated by increasing time in the RW. Thus, fluoxetine improved escape in an aversive context but decreased relative preference for active reinforcement. Moreover, fluoxetine did not reverse the anergic effects of DA depletion. These results have implications for the use of fluoxetine for treating motivational symptoms such as anergia in depressed patients.

Participation Patterns of Exercise among People with Disabilities in South Korea : Emphasis on 2014 and 2017 Survey Data

Background/Objectives: Although many studies have reported that physical activity (PA) and exercise have significant positive effects on various health aspects, very few have classified persons by their disability types and investigated PA participation patterns, along with obstacle factors. This study aimed to analyze and compare exercise participation patterns and obstacle factors by classifying a large sample of Koreans with various disability types. Methods/Statistical analysis: Data on regular exercise participation patterns and barriers to participation were collected in 2014 and 2017 from 11,815 persons with disabilities (ages 0–99 years) residing in South Korea. A chi-square test was used to examine differences in the subjects’ evaluation of health status, weekly exercise frequency, preferred place, and reasons for non-participation. A repeated measures ANOVA was performed for comparing exercise time per session, and post-hoc analysis was used to confirm differences based on disability types. Findings: The analysis showed significantly different response rates based on the disability type for subjective health status, regular exercise participation, reasons for non-participation, weekly exercise frequency, and preferred exercise place (p .05). Improvements/Applications: In conclusion, regardless of the disability types, the regular exercise participation rate of people with disabilities was significantly lower than that of healthy adults in South Korea. Additionally, this is a basic study confirming that exercise participation patterns and obstacles differ depending on the type of disability. Accordingly, future public health policies should closely identify the characteristics of each type of disability to help promote PA for all.

Amyotrophic Lateral Sclerosis, Resistance Training, Endurance Exercise, Tolerance, and Compliance

Amyotrophic Lateral Sclerosis, Resistance Training, Endurance Exercise, Tolerance, and Compliance

Exercise levels and preferences on exercise counselling and programming among older cancer survivors: A mixed-methods study

ObjectivesTo assess exercise levels and exercise counselling /programming preferences among older cancer survivors. Materials and methodsA mixed-methods study design was employed. Quantitative instruments on exercise levels, exercise counselling and programming preferences, frailty status, and cancer-related symptoms were administered to 290 post-treatment older cancer survivors aged ≥65. Twelve participants with different exercise levels and different views on exercise counselling and programming were purposively selected to participate in semi-structured interviews. ResultsOverall, 58.3% of participants did not meet the recommended exercise guidelines, and 44.1% were not engaging in any vigorous or moderate exercise. Frail survivors were less likely to meet the guidelines (aOR = 0.194, 95%CI = 0.053, 0.712) compared to their robust counterparts. However, 66.9% and 62.8% of participants expressed a definite or possible interest in receiving exercise counselling and participating in an exercise program, respectively. Particularly, survivors who are male, did not receive chemotherapy, are less educated, and have higher symptom burden were less likely to show interest. Most preferred low-intensity exercise (59.8%) and wanted to start the exercise program after treatment (68.2%), which differs from the literature on general adult survivors. The major trigger to initiate and maintain exercise behaviors was the benefits of exercise and a common barrier to exercising was lack of time. ConclusionMost older cancer survivors did not meet the recommended exercise guidelines, but they were open to exercise counselling and programming. Reviewing education on the benefits of exercise is especially important after treatment completion to promote healthy lifestyles.

A Study of Physical Fitness and Enjoyment on Virtual Running for Exergames

Virtual Reality (VR) technology has advanced forward in everyday life where virtual fitness is possible through physically moving around in the real world. Exergame is a video game for exercise aimed at making exercise more fun. VR exergame applies these trends together for virtual fitness with immersive game play. The VR locomotion is traveling in VR, which is commonly used in adventure role-playing games (RPG). Virtual running can be applied as a locomotion technique for VR exergames. The design of virtual running in VR exergames should be considered as an exercise for fitness and also for enjoyment. This paper proposed two motion-based locomotion techniques: ArmSwing and Squat for virtual running, which are considered as aerobic and strength exercise. These two postures were used to study how physical exertion affected players while interacting in the test scene. Usability, motion sickness, and enjoyment were assessed to analyze the differences of each posture. The results showed that motion sickness and enjoyment of ArmSwing and Squat were not different, while usability was different where ArmSwing was rated higher than Squat. The results from the interviews suggest that most players preferred aerobic exercise (ArmSwing) more than strength exercise (Squat) for a long period of exercise. However, for a short period of exercise, players preferred strength exercise more than aerobic exercise. The adventure-based RPG for exercise needs a solution design appropriate for virtual running in VR, and our results can be a guideline for developers in order to handle motion-based locomotion for VR exergames.