Exercise Self-efficacy Research Articles

Feasibility and Potential Effectiveness of a Smartphone Zero-Time Exercise Intervention for Promoting Physical Activity and Fitness in Patients With Coronary Heart Disease: A Pilot Randomized Controlled Trial.

BackgroundZero-time Exercise (ZTEx), a simple strength- and stamina-enhancing physical activity (PA) requiring no extra equipment, can potentially increase PA and fitness. This pilot trial examined the feasibility and potential effectiveness of a smartphone ZTEx intervention to promote PA and fitness in patients with coronary heart disease (CHD).MethodsA parallel-group assessor-blinded pilot randomized controlled trial was conducted on Chinese patients with stable coronary heart disease (CHD) in three cardiology clinics. The experimental group received a 15-min brief individual face-to-face session and a 12-week ZTEx instant messaging with 28 picture e-messages and a smartphone ZTEx application (ZTExApp). The control group received the same duration of individual session and number and format of e-messages, but the content was healthy eating and breathing exercise. The feasibility was assessed based on: attrition rate, usage, response rate and perception of the intervention. The outcome evaluation included primary outcome (PA), fitness, exercise self-efficacy and intention, perceived happiness and health, and quality of life. A linear mixed model was used with intention-to-treat analysis adjusting for sex, age and baseline values. A semi-structured interview was conducted to collect feedback from the experiment group.ResultsOne hundred thirty-nine patients (mean age 59.8 ± 6.6; 71.2% male) were randomized to the experimental group (n = 70) or control group (n = 69), and 80% (56/70) and 82% (57/69) of patients completed the 12-week follow-up assessment, respectively. The attrition rate was 18.7%. The experimental group reported that ZTEx was feasible to integrate PA into their daily life and appreciated the picture e-messages, and 95% of them sent feedback to us, but only 19.6% (13/70) of the participants entered their PA information into the e-diary of the ZTExApp. The experimental group had a significantly greater increase in time spent walking [mean difference (95% CI): 155.3 (10.1, 300.4), P = 0.04, Cohen's d = 0.34] than the control group.ConclusionsThis pilot study showed using a brief ZTEx face-to-face session with picture e-messages empowered patients with CHD to integrate PA into daily life. Future definitive trials with a longer follow-up and a more user-friendly ZTExApp interface are necessary to determine the effectiveness of the smartphone ZTEx intervention in enhancing PA and related outcomes.Trial RegistrationThe research protocol was registered at the Hong Kong University Clinical Trials Registry (HKUCTR) on 22 Jul 2016 (Study identifier: HKUCTR-2165) and was also retrospectively registered at the National Institutes of Health (identifier number: NCT03464331) on 14 March 2018.

Prospective study of beginner running groups: psychological predictors and outcomes of participation

Running is an example of vigorous activity that leads to important health benefits if maintained. Beginner running groups provide supportive training programs to help people progress from walking to sustained running. This study explored the characteristics of individuals joining beginner running groups and the outcomes they achieve. New members of beginner running groups (n = 141; mean age 43 years, 122 female) completed online assessments at the start of their group program with 63 participants (45%) also completing a follow-up assessment at the end of the program. Validated scales were used to assess exercise behavior, mental wellbeing, self-efficacy, running identity and social physique anxiety. The majority of participants had low exercise levels at the start of the program (63%, n = 89). By the program end, 47 participants (75% of those completing the follow-up assessment) reported meeting the training goal (running for 30 minutes continuously) with self-efficacy, program adherence and younger age representing significant predictors of success. Significant improvements in exercise levels, mental wellbeing, self-efficacy, running identity and social physique anxiety were observed by the end of the program. In conclusion, beginner running programs attract low active individuals and may lead to improved levels of exercise and psychological outcomes. Additional research is needed to examine the extent to which improvements are sustained longer term.

Differences in United States college student physical activity and exercise self-efficacy based on gender and race/ethnicity.

Disparities in physical activity (PA) and PA antecedents, such as exercise self-efficacy, based on the intersection of gender and race/ethnicity among college students are poorly understood. This study aimed to examine differences in PA and exercise self-efficacy based on the intersection of gender and race/ethnicity. An online survey collected data on demographics (age, gender, race/ethnicity), PA, and exercise self-efficacy from students (n = 5341) enrolled in general health and wellness at a large Northeastern U.S. University. Differences in PA and exercise self-efficacy based on gender and race/ethnicity were examined using two-way ANOVAs. Analyses revealed significant differences in overall PA and exercise self-efficacy based on gender and race/ethnicity. A significant interaction between gender and race/ethnicity was found in relation to PA, but not exercise self-efficacy. Findings demonstrate the need for universities to tailor PA promotion efforts, and to consider how gender and race/ethnicity may intersect to influence PA participation.

Effects of technology-supported brain breaks videos on exercise self-efficacy among type 2 diabetes mellitus Malaysians

The technology supported Brain Breaks (BB) videos are a series of structured, web-based physical activity (PA) videos designed to promote learning and health. The purpose of this study was to investigate the effect of BB videos on exercise self-efficacy (ESE) among type 2 diabetes mellitus (T2DM) patients using the Malay-versioned exercise self-efficacy scale (ESE-M). The study used a double-blind research design and was randomised into two groups: (1) The Technology Supported BB intervention group, and (2) the control group. 70 T2DM patients with a mean age of 57.6 years (SD = 8.5) were recruited from Hospital Universiti Sains Malaysia. For 4 months, participants in the intervention group were required to undertake PA every day using the BB videos (approximately 10 min). Both groups completed the ESE-M at pre-intervention, the end of the first month, the second month, the third month, and post-intervention. For the data analysis, a mixed factorial analysis of variance was used. The results showed that at the end of the intervention, the two groups’ ESE was significantly different (p < 0.001). From pre- to post-intervention, the intervention group’s ESE-M mean scores improved significantly. Technology-supported BB videos may be an effective strategy for improving ESE in T2DM patients.

A Systematic Review on Physical Health Education Interventions for People with Parkinson’s Disease: Content, Impact, and Implementation Considerations Across the Parkinson’s Trajectory

Educational interventions promoting the role of physical activity (PA) aim to address knowledge, poor exercise self-efficacy, and low outcome expectations, which are well-researched barriers to PA participation in healthy and in people with chronic conditions. However, little is known about the effectiveness of educational interventions in addressing these barriers in people with Parkinson's (PwP). To examine the content of education interventions that promote PA behavior in PwP, and to assess their effectiveness on physical and psychosocial outcomes. An electronic search (12/2021) of MEDLINE, EMBASE, CINAHL, PubMed PsycINFO, the Web of Science and the Cochrane Library was conducted from 1990 to 2021. Education interventions, alone or combined with other strategies, promoting PA in PwP were included. Quality was assessed using the Johanna Briggs Institute and National Institute of Health quality assessment tools. A narrative synthesis was performed. Six studies were identified. Five interventions were comprised of education and exercise sessions. Improvement in physical and psychosocial outcomes were suggested but delineating the exact impact of education was impeded due to lack of assessment. Few interventions exist that provide knowledge, and skills promoting PA participation, and fewer are addressed towards newly diagnosed PwP. There is lack of assessment over the effectiveness of education as a tool to facilitate PA participation in PwP. Lack of assessment poses the risk of potentially disregarding effective interventions or adopting ineffective approaches without the evidence. Education interventions can boost PA engagement by increasing factors such as exercise self-efficacy, but further interventions are required to assess this model of relationship.

A community-based adapted exercise program to increase quality of life and self-efficacy among adults with physical disabilities: A mixed-method study.

Self-efficacy is one of the key constructs that directly influence physical activity, community participation, and mental health while acting as a strong influence on the quality of life (QOL) for adults with physical disabilities (AWPDs). There are relatively few studies focusing on a community-based exercise program in this population. This study aims to quantitatively examine a community-based adapted exercise program on the QOL and self-efficacy of AWPDs. In addition, we explored AWPD's perceived benefits of community-based exercise programming and any factors that may influence those perceived benefits. Adults with physical disabilities (N = 50) participated in a 9-week community-based adapted exercise program (90-minute session, twice per week). QOL (WHOQOL-BREF) and self-efficacy were measured at baseline and at the conclusion of the program. A follow-up focus group (n = 22) was conducted at the postprogram. Quantitative data were analyzed by paired t test (α = 0.05). Qualitative data were analyzed by thematic coding and content analysis. Significant improvement with moderate effect size was found across all variables. Two main themes emerged from the qualitative analysis: 1) perceived benefit of exercise program and 2) factors of an exercise program for AWPD. A community-based exercise program and self-efficacy play a large role in the exercise behaviors and QOL of AWPDs. The benefits of exercise and factors identified as promoting exercise may be carefully considered to improve QOL for this population. The finding of this study offers practical recommendations to community-based exercise specialists, which would assist in establishing an appropriate exercise program for AWPDs.

Correlation between self-efficacy, fear of movement, empowerment, enablement, and number of visits to physiotherapist among patients with musculoskeletal disorders in primary health care: a feasibility study

BackgroundMusculoskeletal disorders are a costly burden for health care and social care services. Patients with musculoskeletal disorders are often treated by physiotherapists in primary health care. Psychosocial variables can be a significant obstacle to recovering from musculoskeletal injuries.The primary aim of this pilot study was to assess the feasibility of performing a prospective study investigating whether self-efficacy, fear of movement, empowerment, or enablement has any relation to the number of visits to physiotherapists among patients with a musculoskeletal disorder in primary health care.MethodsProspective study with a consecutive selection including eleven female and eight male patients age ranged between 22 and 82 years old seeking physiotherapist for the first time for a musculoskeletal disorder in primary health care. Primary outcome measures included operational and practical feasibility regarding recruitment of participants, use of questionnaires, and key variables to be collected as part of the study. Secondary outcomes included the correlation between self-efficacy (Exercise Self-Efficacy Scale (ESES-S)), fear of movement (Tampa Scale for Kinesiophobia (TSK-SV)), empowerment (Making Decisions Scale), enablement (Patient Enablement Instrument (PEI)), and the number of visits to physiotherapists. Statistical analysis was done using IBM SPSS statistics version 28 with analysis of correlation using Spearman’s rank correlation coefficient.ResultsNineteen patients accepted to participate in the study and were included in the final analysis. Between 14 and 18 completed questionnaires were included.There was a statistically significant correlation between the number of visits to the physiotherapist and self-efficacy, rho=0.692 and p=0.006.ConclusionThe results of the study showed that the design is feasible in terms of recruitment of participants and use of questionnaires. New variables to collect in a large-scale study were identified. In a large-scale study, attention needs to be focused on the improvement of the number of completed questionnaires. The results of this study indicate that the present care of patients with a low level of self-efficacy is not optimal.

Recreational Physical Activity in Urban India: Perceptions and a Pilot Intervention

AbstractThe inactive lifestyle of urban Indians has increased their risk of non-communicable diseases (NCDs). A qualitative study was designed to explore barriers and facilitators related to exercise participation among urban Indians. Underpinned by the developmental life course theory, nine focus group discussions (FGDs) were conducted with 29 women and 26 men residing in Mumbai, India. Focus groups were gender and age stratified. Both thematic analysis and content analysis techniques were used to analyse the data. While the lack of time was mentioned as a barrier by all groups, an unstructured schedule was mentioned specifically by women and awareness of physical health benefits emerged as the most popular facilitator for recreational physical activity. Based on the results of the FGDs, a pilot exercise intervention for sedentary women (N = 6) was conducted which consisted of a morning walk six days a week for 10 weeks. Post-intervention, an FGD was conducted to explore participants’ perspectives on their experience in the intervention. The participants reported that the intervention enhanced exercise self-efficacy and well-being. Exercise as relaxation, spousal support, and need for peers to exercise with emerged as primary themes during the follow-up FGD. These findings can inform the development of age and gender-specific as well as culturally appropriate interventions to facilitate active living.

A Study on the Correlation Between Undergraduate Students' Exercise Motivation, Exercise Self-Efficacy, and Exercise Behaviour Under the COVID-19 Epidemic Environment.

The outbreak of COVID-19 epidemic has influenced human beings from various aspects including physical exercise behaviours. This study aims to explore the influence of the COVID-19 epidemic on exercise self-efficacy and exercise behaviour, as well as the intermediary effects of exercise motivation. A sample of 1,115 undergraduate students was investigated using the physical exercise behaviour scale, exercise self-efficacy scale, and exercise motivation scale, combined with the COVID-19 epidemic environment as an influencing factor. SPSS was used for statistical analysis and AMOS for the prediction model building. Logical analysis was undertaken to sort out and analyse the data. The structural equation model reveals that exercise self-efficacy has a positive effect on exercise motivation and exercise behaviour. Meanwhile, the COVID-19 epidemic environment negatively influences exercise behaviour through the intermediary role of exercise self-efficacy and exercise motivation. Moreover, the intermediary effect of exercise self-efficacy is greater than that of exercise self-efficacy and exercise motivation. This study provides both theoretical implications and practical guidelines for society and undergraduate students to improve their exercise behaviour during epidemic.

Self-Efficacy, Exercise Anticipation and Physical Activity in Elderly: Using Bayesian Networks to Elucidate Complex Relationships.

AimTo explore the correlation of exercise anticipation, self-efficacy and lower limb function in the elderly, and identify active predictors of exercise. The time up and go (TUG) has been used to access basic mobility skills, as well as strength, balance and agility, which is used in a range of population.MethodsA cross-sectional survey approach was employed in this study, assessing the functional relationship of the level of exercise anticipation, modified gait efficacy scale (mGES), self-efficacy for exercise scale (SEE), perceived efficacy of patient–physician interactions (PEPPI-10), behavioral regulation in exercise questionnaire (BREQ), and the time up and go (TUG) and International Physical Activity Questionnaire (IPAQ). Consequently, we constructed the Bayesian network model utilizing Genie 2.3, in order to effectively determine clear negative and positive correlations.ResultsThis investigation incorporated a total of 285 patients. The results of Spearman's correlation analysis indicated that the TUG effectively correlated with age (r = 0.158, P < 0.01), drinking (r=−0.362, P < 0.01), mGES (r=−0.254, P < 0.01), PEPPI (r=−0.329, P < 0.01), SEE (r =−0.408, P < 0.01), BREQ (r = 0.676, P < 0.01), EA (r =−0.688, P < 0.01) and IPAQ (r =−0.742, P < 0.01). TUG can be used as the direct influencing factor of IPA, and five nodes in the model can be considered the primary indirect influencing factors of TUG, such as drinking, EA, age, sex and mGES in Bayesian network. The sensitivity analysis of the model confirmed that TUG (0.059), drinking (0.087), EA (0.335), age (0.080), sex (0.164), mGES (0.028) and hypertension (0.030) can become the sensitivity evaluation indicators of IPAQ in the elderly community population, in which the area under the ROC curve (AUC) was 59.6% (2207/3705), indicating a suitable prediction performance.ConclusionExercise anticipation and life behavior habit can effectively predict physical activity capability in the elderly. These findings can help clinicians establish effective intervention to improve the physical activity regularly of the elderly.

Mediating effect of kinesiophobia between self-efficacy and physical activity levels in post-CABG patients: protocol for a prospective, multicentre, cross-sectional study in China

IntroductionPhysical activity (PA) can improve cardiac function, exercise capacity, and quality of life, in addition to reducing mortality by 20%–30% and preventing the recurrence of adverse cardiovascular events in patients...

The Health Effects of a Cherokee Grounded Culture and Leadership Program.

Introduction: Indigenous youth and young adults endure some of the highest rates of physical and mental health problems in the United States compared to their non-Indigenous counterparts. Colonization, oppression, and discrimination play a substantial role in these inequitable disease rates. However, culture (e.g., identity, participation, and connection) relates to the prevention of and recovery from illness in Indigenous populations. The Remember the Removal program aims to teach Indigenous youth and young adults tribally specific culture, history, and language to put them on a trajectory to become informed and culturally connected community leaders. We examined the program’s effects on health. Method: Thirty Remember the Removal program participants, mainly young adults, completed surveys four times: before the program’s start, at the end of the training period, at the program’s end, and at a six-month follow-up. Various indicators of physical, mental, spiritual, and cultural health and well-being were measured at each time period. Paired t-tests were completed to compare baseline scores to each subsequent time interval. Results: At program completion, and as indicated with an asterisk at the six month follow-up, participants had statistically significantly improved diet and exercise measures (e.g., reduced sugary, salty, and fatty foods, reduced soda consumption, increased fruit consumption, and improved self-efficacy for exercise), improved mental health indicators (e.g., reduced stress, anxiety, depression*, anger*, post-traumatic stress disorder, and microaggressions*, and improved positive mental health) and improved social and cultural connection (e.g., social support, Cherokee identity*, Cherokee values). Discussion: This is one of the first quantitative studies to demonstrate the profound effects that cultural learning and connection have on the health and well-being of Indigenous people and practices. It also demonstrates the specificity and effectiveness of a program created by and for tribal citizens. Future programs with Indigenous populations should work to center cultural connection and ensure that programs are created and directed by tribal community members.

Factors Contributing to Physical Activity among University Employees in East Malaysia: A Crosssectional Study

Physical activity (PA) is known to have numerous health benefits. However, despite the frequent emphasis on the importance and benefits of being physically active, the number of people engaged in regular physical activity is still on the low side. This study aims to identify the factors that can influence physical activity levels among staffs from a public university staff in Sarawak, Malaysia. This was a cross-sectional study using a self-administered questionnaire distributed online. A total of 163 of Universiti Malaysia Sarawak (UNIMAS) staffs comprising of 37.4% academician and 62.2% non-academician participated in this study. The participants were selected using a multistage sampling method. Multiple logistic regression (MLR) was performed to examine the factors associated with physical activity level. Majority of the respondents were female (74.2%), Malays (60.1%), married (65.5%), non-academic staffs (62.6%), had tertiary education (85.9%) with mean working hours per day of 8.25 hours. Physical activity (PA) level measured by International Physical Activity Questionnaire (IPAQ) showed the majority of respondents had a moderate PA level (56.4%), followed by a high PA level (33.7%) and a low PA level (9.8%). There were significant findings on the association between exercise attitude barrier (p=0.003) and self-efficacy (p=0.009) with physical activity level. Multiple Logistic Regression analysis showed that exercise attitude barrier (OR=1.170, 95% CI=1.027, 1.334, p=0.019) and self-efficacy (OR= 1.091, 95% CI= 1.015, 1.172, p=0.017) was associated with low and moderate PA level. The findings indicated that exercise attitude barrier and self-efficacy influence the outcome of physical activity level among the respondents.

Digital Coaching Motivating Young Elderly People towards Physical Activity

The share of the elderly population is increasing globally, and it is important to help them to maintain their physical activity levels and ability to function to as late an age as possible. This qualitative intervention study focused on the experiences of young elderly on the ability of a sport and wellness technology digital coach to motivate them towards physical activity as well as on what needs and wishes this group has concerning digital coaching solutions. The findings of the study show that young elderly perceive digital coaching as potential in motivating them towards physical activity by providing instructive information and motivational feedback. It was also perceived to have positive influence on their exercise self-efficacy. However, it was also apparent that digital coaching devices should be tailored for this target group and be easy to learn in order to attract interest among them. Our findings provide insights for professionals and companies in sport technology field as well as to health professionals working in health promotion with young elderly people. Overall, this research aims to address social and economical sustainability of elderly people and their physical activity.

Feasibility and acceptability of a six-month exercise and patient education intervention for patients with hip dysplasia: A mixed methods study

Background and objectivesTo evaluate the feasibility and acceptability of exercise and patient education for patients with hip dysplasia not receiving surgery. DesignFeasibility study. MethodsThe participants received exercise instruction and patient education over six months. Feasibility covered recruitment, retention, and mechanisms of change (MC). MC were measured with Hip and Groin Outcome Score (HAGOS), muscle strength tests, Y-balance test, and hop for distance test (HDT) over six months. Acceptability covered adherence, expectations, perceptions, benefits, and harms. ResultsThirty of 32 were recruited (median age: 30 years); six were lost to follow-up. Twenty-four participants improved by a mean of 11 (95%CI: 5–17) HAGOS pain points, improvements in all subscales were 1–11 points. Mean hip abduction strength improved 0.2 (95%CI: 0.04–0.4) Nm/kg, similar to flexion and extension. Median Y-balance test improvements: anterior: 70 (IQR: 64–74) to 75 (IQR: 72–80) centimetres; posteromedial: 104 (IQR: 94–112) to 119 (IQR: 112–122) centimetres and posterolateral: 98 (IQR: 89–109) to 116 (IQR: 108–121) centimetres (p < .001). Median improvement in HDT was: 37 (IQR: 30–44) to 52 (IQR: 45–58) centimetres (p < .001). Participants adhered to 84% of scheduled sessions (1,581:1,872), expectations were met, and perceptions were characterized by high self-efficacy for exercise. Benefits were reported with no serious harms. ConclusionPatients with hip dysplasia are willing to be recruited for exercise and patient education, with acceptable retention. MC were observed through improvements in pain, strength and function with high acceptance of the exercise and patient education intervention. Thus, it seems feasible to conduct a full-scale randomised controlled trial.

Association Between Exercise Self-Efficacy and Health-Related Quality of Life Among Dialysis Patients: A Cross-Sectional Study.

BackgroundExercise self-efficacy is a vital determinant of an individual’s active participation in regular exercise, and exercise is a critical component of improving health-related quality of life (HRQOL) in dialysis patients. This study aimed to describe the relationship between exercise self-efficacy and HRQOL in dialysis patients.Materials and MethodsA cross-sectional study was conducted in Shanghai, China. Structured questionnaires distributed to the patients collected socio-demographic and disease-related information. Physical activity was assessed by a self-administered questionnaire, and the exercise self-efficacy scale (ESES) was used to measure exercise self-efficacy. HRQOL was evaluated by the kidney disease quality of life instrument-short form version 1.3 (KDQOL-SF™ v1.3). Data were analyzed using a univariate generalized linear model, Spearman correlation, and hierarchical multiple regression.ResultsA positive association was observed between exercise self-efficacy and HRQOL (r = 0.310, p < 0.001). Physical activity as a predictor variable explained 9.8% of the variance in overall HRQOL (p < 0.001). Exercise self-efficacy explained an additional 7.1% of the HRQOL variance. In total, 24.6% of the variation in the HRQOL was explained by the socio-demographic variables, disease-related factors, physical activity, and exercise self-efficacy.ConclusionOverall, only 16.9% of the change in HRQOL was explained by physical activity and exercise self-efficacy. Future research is still needed to further explore the factors influencing the HRQOL in dialysis patients. However, this finding suggests the need to consider the importance of HRQOL and physical activity as well as exercise self-efficacy when developing intervention programs.

Effect of a home-based resistance exercise program in elderly participants with osteoporosis: a randomized controlled trial.

This study aims to evaluate the effect of a home-based resistance exercise (HBRE) program versus control on physical function, exercise self-efficacy, falling efficacy, and health-related quality of life (HRQOL). This randomized controlled trial included 72 elderly participants with osteoporosis. Participants in the intervention group received a 12-week HBRE program, and the control group received usual care. The primary outcome was physical function, including muscle strength and balance ability; secondary outcomes were exercise self-efficacy, falling efficacy, and HRQOL. Within-group and between-group changes in outcome were evaluated by t-test and rank-sum test. A total of 68 subjects were included in the final analysis. Improvement in physical function was significantly greater in the HBRE group compared with controls. On a psychological level, exercise self-efficacy and falling efficacy improved significantly in the HBRE group; no significant change was observed in the control group. Most of the dimensions of HRQOL demonstrated improvements as well. The adherence was 85.29%, with no adverse events related to the exercise. A 12-week HBRE program was safe non-pharmacological therapy for elderly participants with osteoporosis, improving physical function, exercise self-efficacy, reduced fear of falling, and improved HRQOL. Chinese Clinical Trial Register: ChiCTR2100051455. Registered 23.09.21. Retrospectively registered.

Factors influencing kinesiophobia during the “blanking period” after radiofrequency catheter ablation in patients with atrial fibrillation by the fear-avoidance model

BackgroundThe influencing factors of kinesiophobia (fear of movement) in patients with atrial fibrillation(AF)during the post-operative “Blanking Period” are not known. The aims were to investigate the status of kinesiophobia in patients with AF during the post-operative “Blanking Period”, then further describe the occurrence and analyze the influencing factors of patients' kinesiophobia by the Fear-Avoidance Model. Materials and methodsIn total,400 patients diagnosed with atrial fibrillation, during the post-operative “Blanking Period” from the selected hospital were included in this study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Self-efficacy for Exercise (SEE) scale, and the Geriatric Locomotive Function Scale (GLFS) were used to assess kinesiophobia, exercise self-efficacy, and physical function. The study adopted a cross-sectional design. ResultsThe score of kinesiophobia during the “Blanking Period” after operation in patients with atrial fibrillation was (44.06 ± 10.77), and the rate of high kinesiophobia was 71.61%.Logistic regression results showed that age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function influenced the kinesiophobia of patients during the post-operative “Blanking Period”(p<0.05， p<0.01). ConclusionsKinesiophobia is common in patients with atrial fibrillation during the postoperative “Blanking Period”, and the fear of movement is related to age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function. Clinical and nursing staff should pay close attention to the psychological problems in the post-operation “Blanking Period” of exercise rehabilitation in patients with atrial fibrillation, make timely interventions to reduce patients' fear of movement, and improve patients' compliance with exercise rehabilitation.

Immersive Virtual Reality Exergames to Promote the Well-being of Community-Dwelling Older Adults: Protocol for a Mixed Methods Pilot Study.

BackgroundDespite the proven benefits of exercise in older adults, challenges such as access and motivation can deter their engagement. Interactive virtual reality (VR) games combined with exercise (exergames) are a plausible strategy to encourage physical activity among this population. However, there has been little research on the feasibility, acceptability, and potential benefits of deploying at-home VR exergames among community-dwelling older adults.ObjectiveThe objectives of this study are to estimate the feasibility, usability, and acceptability of a co-designed VR exergame in community-dwelling older adults; examine intervention feasibility and assessment protocols for a future large-scale trial; and provide pilot data on outcomes of interest (physical activity, exercise self-efficacy, mood, cognition, perception, and gameplay metrics).MethodsThe study will be a remote, 6-week intervention comprising an experimental and a control group. A sample of at least 12 community-dwelling older adults (with no or mild cognitive impairment) will be recruited for each group. Both groups will follow the same study procedures and assessment methods. However, the experimental group will engage with a co-designed VR exergame (Seas The Day) thrice weekly for approximately 20 minutes using the Oculus Quest 2 (Facebook Reality Labs) VR headset. The control group will read (instead of playing Seas The Day) thrice weekly for approximately 20 minutes over the 6-week period. A mixed methods evaluation will be used. Changes in physical activity, exercise self-efficacy, mood, cognition, and perception will be compared before and after acute data as well as before and after the 6 weeks between the experimental (exergaming) and control (reading) groups. Qualitative data from postintervention focus groups or interviews and informal notes and reports from all participants will be analyzed to assess the feasibility of the study protocol. Qualitative data from the experimental group will also be analyzed to assess the feasibility, usability, and acceptability of at-home VR exergames and explore perceived facilitators of and barriers to uptaking VR systems among community-dwelling older adults.ResultsThe screening and recruitment process for the experimental group started in May 2021, and the data collection process will be completed by September 2021. The timeline of the recruitment process for the control group is September 2021 to December 2021. We anticipate an estimated adherence rate of ≥80%. Challenges associated with VR technology and the complexity of remote assessments are expected.ConclusionsThis pilot study will provide important information on the feasibility, acceptability, and usability of a custom-made VR exergaming intervention to promote older adults’ well-being. Findings from this study will be useful to inform the methodology, design, study procedures, and assessment protocol for future large-scale trials of VR exergames with older adults as well as deepen the understanding of remote deployment and at-home use of VR for exercise in older adults.International Registered Report Identifier (IRRID)DERR1-10.2196/32955

Cognitive perspective of osteoporosis among adults with type 2 diabetes mellitus: The Malaysian case.

IntroductionOsteoporosis and diabetes are highly prevalent diseases. In addition, there is increasing evidence that diabetes is a common risk factor for decreasing bone mineral density and developing osteoporosis and fractures. Data on bone abnormalities in T2DM patients appear to be contradictory and complex, and the exact underlying mechanism is still unclear. Hence, the aims of this study were to assess cognitive perspective of osteoporosis among type 2 diabetes mellitus.MethodsAn observational, cross‐sectional study design was chosen, where data were collected using a self‐report structured questionnaire including osteoporosis self‐efficacy (OSES‐M), knowledge Malay version. Quantitative ultrasound was used as prescreening tool for measuring bone health by applying T‐score.ResultsThe results showed that about 231 (51.30%) were males. The average age of the DM patients was 62.67 ± 9.24 years. Moreover, the majority of T2DM patient (343, 76.20%) had poor glycaemic control. The mean ± SD OSES‐M total score, OSES‐M Exercise subscale and OSES‐M Calcium subscale were 731.26 ± 209.83, 357.55 ± 121.23 and 373.71 ± 118.91, respectively. Overall, participants expressed a low self‐efficacy for both exercise and calcium intake experiences. In addition, a significant and positive correlation was found between OSES‐M and OKT‐M total scores (n = 450, r s = 0.471, p < .05). Also, there were significant correlations between OKT‐M subscales and OSES‐M subscales. Furthermore, significant and positive correlations were found between T‐scores and OSES‐M total score (r = .191), OSES‐M Exercise subscale (r = .209) and OSES‐M Calcium subscale (r = .124). Moreover, significant associations, differences and correlations were found out between OSES‐M with many demographic and clinical data.ConclusionOverall, participants expressed a low self‐efficacy for both exercise and calcium intake experiences. In addition, only 28.70% of the study population was found to have high OSES‐M level. Thus, self‐efficacy is important and effective determinants for gaining positive health behaviours towards osteoporosis.