General Physical Activity Research Articles

Associations between social isolation and diet quality among US adults with disability participating in the National Health and Nutrition Examination Survey, 2013–2018

Social isolation and disability are established risk factors for poor nutrition. We aimed to assess whether social isolation is associated with diet quality specifically among adults with disabilities.This cross-sectional analysis used data from the National Health and Nutrition Examination Survey, 2013–2018. Adults with a disability, who were not pregnant, breastfeeding, or missing dietary intake data were included (n = 5,167). Disability was defined as a physical functioning limitation based on difficulty with any activities of daily living, instrumental activities of daily living, lower extremity mobility activities, or general physical activities. The Healthy Eating Index (HEI)-2015 measured diet quality; higher scores correspond to higher diet quality. We computed a social isolation index by summing single status, living alone, and two social engagement difficulty measures (one point for each component met; maximum 4 points). Multivariable linear regression, controlling for demographic and health covariates, estimated differences in HEI scores for dietary intake data, by social isolation score.Over half of HEI scores were < 51, corresponding to “poor” diet quality. Higher social isolation score was associated with lower vegetable and seafood/plant proteins intake. Single status and one of two social engagement measures were associated with lower scores on certain adequacy components. Differences were modest. There was little evidence of effect modification by age or gender.Adults with disabilities are not meeting national dietary standards; improving diet quality is a priority. Whether social isolation is associated with specific dietary components in this population requires further investigation. Further research is also needed among younger adults.

Physical activity and health-related quality of life among adults living in Jeddah city Saudi Arabia.

Physical activity can improve health-related quality of life (HRQoL) in adults. However, the effect of physical activity on quality of life is unclear among the Saudi adult population. The study aimed to determine the association between physical activity and HRQoL in apparently healthy adults in Jeddah, Saudi Arabia. This cross-sectional study was conducted among visitors of shopping malls, walking tracks/fitness centres/gyms and governmental hospitals in Jeddah from March to September 2022. Physical activity was measured with the electronic template of the general practice physical activity questionnaire (GPPAQ), while the HRQoL was measured using the 36-Item Short Form Survey (SF-36) questionnaire. A multiple linear regression model investigated the relationship between physical activity and HRQoL. A total of 693 individuals participated in this study, with a mean age of 36 (±11). Individuals who fall in the active category of the physical activity level were mostly younger men (37% vs 21%), were non-smokers (30% vs 10%) and had no comorbid condition (29% vs 15%). After adjusting for covariates, men (adjusted β 4.43, 95% CI [1.44-7.41]) with higher physical activity levels (active-adjusted β 10.11, 95% CI [5.44-14.77]) had better scores on the physical component summary (PCS). Similarly, mental component summary (MCS) scores for men (adjusted β 6.51, 95% CI [3.40-9.63]) and physical activity levels (active-adjusted β 9.77, 95% CI [4.90-14.64]) were high. The article reinforces how physical activity contributes towards each dimension of HRQoL. Physical inactivity is a growing public health challenge in Saudi Arabia, affecting all age groups. Investing in innovative strategies and establishing targeted health education programs for academic institutions and communities are required to enhance healthy habits. Additionally, constructing more local sports facilities and concession packages, especially for the females at the gyms, can motivate individuals and promote physical activity.

General Health Status and Physical Activity Level of Pregnant Women in Bojnord, Iran During the COVID-19 Pandemic

Background and Aims Major changes to lifestyle due to the COVID-19 pandemic increased the potential risk of psychological disorders among pregnant women. This study aims to investigate the general health status of pregnant women in Bojnord, Iran, and assess its relationship with their physical activity level. Methods This is a descriptive-correlational study. The statistical population consists of all pregnant women referred to prenatal care centers in Bojnord city, of whom 55 were selected as the study samples. The instruments were the pregnancy physical activity questionnaire and the 28-item general health questionnaire (GHQ-28). Spearman correlation test was used to analyze the correlation between the two variables. Results The mean scores for the GHQ-28 subscales of somatic symptoms, severe depression, social dysfunction, and anxiety/insomnia were 11.90, 11.91, 12.97, and 16.49, respectively. There was a significant positive correlation between general health status and level of physical activity (r=0.54; P&lt;0.001). Regarding the four dimensions of GHQ-28, the results showed that physical activity had a negative and significant relationship with somatic symptoms (r=-0.61) and severe depression (r=-0.33), but it had no significant relationship with anxiety/insomnia and social dysfunction. Conclusion Pregnant women in Bojnord, Iran, are at risk of problems in several domains of general health during the COVID-19 pandemic. It is recommended that they stay active or engage in physical activity to regulate the psychological effects of the pandemic and quarantine.

Diabetes Self-Care Activities and Their Relationship With Glycemic Control in Patients Visiting Hayatabad Medical Complex, Peshawar.

Background A significant portion of the Pakistani population is affected by diabetes, which has emerged as a global healthcare concern. Objective This study aimed to assess the correlation between glycemic control in diabetes patients and their engagement in diabetes self-care activities (DSCA). Methodology Cross-sectional research was conducted at Hayatabad Medical Complex in Peshawar between June 2019 and May 2020. A total of 280 carefully selected patients with type 2 diabetes mellitus (T2DM) were included. Data collection involved an interviewer-administered questionnaire encompassing sociodemographic information, diabetes-related data, and the summary of the Diabetes Self-Care Activities (SDSCA) scale. Descriptive statistics and Pearson's chi-square test were employed for data analysis. Results The study observed that the majority of participants (40.36%) were females, and the age range of the participants was between 42 and 53 years (68.22%).According to the study, 55.00% of participants had a normal body mass index (BMI), and 71.08% of participants had diabetes in their family. Regarding glycemic control, 55.71% of individuals exhibited good control based on fasting blood sugar (FBS) levelswhile 74.64% showed poor control according to hemoglobin A1C (HbA1c) values. HbA1c was substantially linked with a general diet (healthy eating plan), physical activities, and adherence to medication ((odds ratios (OR): 3.12), (95% confidence interval (CI): 1.02 - 8.78), (P value: 0.031)); ((OR: 2.19, 95%), (CI:1.18 - 3.79), (P value: 0.003)); ((OR: 2.85), (95% CI: 1.22 - 6.59), P value: 0.021)). Conclusion The findings indicated that health professionals need to create health education programs on DSCA in order to increase DSCA adherence in people with T2DM while maintaining glycemic control.

Impact of Plantar Fasciitis on Foot-Specific and Generic Health-Related Quality of Life in King Khalid University Hospital, Saudi Arabia.

Objectives The objective is to assess the extent of foot-specific and generic health-related quality of life (HRQoL) impairment among individuals diagnosed with plantar fasciitis (PF) at King Khalid University, Saudi Arabia, and to determine the influence of various sociodemographic and clinical factors. Methods In this cross-sectional study, we administered an online survey from March to June 2023 to patients with PF at King Khalid University Hospital. This questionnaire covered sociodemographic, and clinical characteristics, and included the translated Foot Health Status Questionnaire (FHSQ). Further, patient data were obtained from hospital records between 2016 and 2023 using the E-SIHI system. Results We recruited 209 patients for the study. Lower FHSQ scores were found in unemployed and low-income participants indicating a worse quality of life (QoL) in the Foot Pain domain, while those aged over 40 years and with low income showed greater impairment in the General Foot Health domain. No single factor influenced the Foot Function or Footwear domains. Worse General Health and Physical Activity scores were associated with low-education and low-income participants and those who did not exercise. Women exhibited a lower QoL than men in all domains except for General Health. Conclusion The QoL of Saudi women with PF was similar to that of women in other countries. However, the patients in the present study reported poorer footwear scores but better General Health scores. Therefore, focusing more on proper footwear-related treatments may help improve the QoL of patients with PF.

Symptom Duration, Recurrence, and Long-Term Effects of Swimming-Induced Pulmonary Edema: A 30-Month Follow-Up Study

Swimming-induced pulmonary edema (SIPE) has been reported to subside within 24 to 48 h, but comprehensive follow-up studies on symptom duration and long-term effects are missing. What are the symptom duration, recurrence, and long-term effects of SIPE? A follow-up study was conducted, based on 165 cases of SIPE from Sweden's largest open-water swimming event with 26,125 individuals participating during 2017-2019. Data on patient characteristics, clinical findings, and symptoms were collected at admission. Telephone interviews at 10days and 30months were performed to explore symptom duration, recurrence of SIPE symptoms, need for medical evaluation, and long-term effects of self-assessed general health and physical activity level. Follow-up at 10days was performed for 132 cases and at 30months for 152 cases. Most of the patients were women, and their mean age was 48 years. At the 10-day follow-up, symptom duration > 2days after the swimming race was reported by 38%. The most common symptoms were dyspnea and cough. In patients at 30-month follow-up, recurrence of respiratory symptoms during open-water swimming was reported by 28%. In multivariable logistic regression, asthma was independently associated with both symptom duration > 2days and recurrence of SIPE symptoms (P= .045 and P= .022, respectively). Most participants reported equal or improved general health (93%) and physical activity level (85%) after experiencing SIPE, but 58%had not swum in open water since the event. The present large cohort study challenges the established hallmark of SIPE symptom duration< 48 h, whereas SIPE recurrence was in the previously reported range. At 30months, most patients reported unchanged self-assessed general health and physical activity level. These findings add to our understanding of the course of SIPE and can provide evidence-based information to swimmers and health care professionals.

Musculoskeletal pain, kinesiophobia, and quality of life in obese patients

Objectives: This study aims to examine musculoskeletal pain, kinesiophobia, and quality of life in individuals with normal body mass index and in individuals with obesity, and to determine the relationship between the variables. Methods: In the study; individuals aged between 20-65 years, with a body mass index of 30 kg/m2 and above (Group obesity) with obesity, and individuals with a range of 18.5-24.9 kg/m2 (Group normal) were included. General Practice Physical Activity Questionnaire, Orebro Musculoskeletal Screening Questionnaire, Short Form-12 Health Survey, and Kinesiophopia Causes Scale were applied to the participants for primary care. Results: When the descriptive characteristics of the individuals in the sample which were divided into two groups as the Group normal (n = 82; 22.6 ± 1.7 kg/m2) and Group obesity (n = 92; 33.0 ± 2.8 kg/m2 were analyzed; while a difference was determined in terms of sex, education level and presence of chronic disease (p ˂ 0.05), no difference was found in terms of age, marital status and regular drug use for the treatment of chronic disease (p ˃ 0.05). Although the activity level rates of Group obesity were lower according to the physical activity questionnaire classification for primary care, no statistically significant difference was found between the groups (p = 0.090). More musculoskeletal pain was found in the individuals of the obesity group (p = 0.003), the physical sub-dimension score of the general quality of life questionnaire was negatively affected (p = 0.014), and a difference in favor of phobia was determined in all domains of the kinesiophobia causes scale (p &amp;lt; 0.001). There was a weak positive correlation between body mass index and musculoskeletal pain, while a moderate positive correlation with kinesiophobia. Conclusions: Although physical activity level is similar to individuals with normal body mass index, musculoskeletal pain and kinesiophobia are higher in individuals with obesity, and their quality of life is negatively affected.

Patient perspectives on home-based rehabilitation exercise and general physical activity after total hip arthroplasty: A qualitative study (PHETHAS-2)

Background: Home-based rehabilitation exercise following Total Hip Arthroplasty (THA) shows similar outcomes compared to supervised outpatient rehabilitation exercise. Little is known about patients' experiences with home-based rehabilitation, and this study aimed to investigate how patients perceived home-based rehabilitation exercise and general physical activity after THA, focusing on facilitators and barriers. Methods: Semi-structured interviews of qualitative design were conducted with 22 patients who had undergone THA and who had performed home-based rehabilitation exercise. The study took place in a regional hospital in Denmark between January 2018 and May 2019. Data were analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept ‘conduct of everyday life’. The study is embedded within the Pragmatic Home-Based Exercise Therapy after Total Hip Arthroplasty-Silkeborg trial (PHETHAS-1). Results: The main theme, ‘wishing to return to the well-known everyday life’, and four subthemes were identified. Generally, participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their well-known everyday life and performing their usual general physical activities, though some lacked contact to physiotherapist. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises. Both pain and the absence of pain were identified as barriers for doing home-based rehabilitation exercise. Pain could cause insecurity about possible medical complications, while the absence of pain could lead to the rehabilitation exercise being perceived as pointless. Conclusions: The overall goal of returning to the well-known everyday life served as a facilitator for undertaking home-based rehabilitation exercise after THA along with the flexibility regarding time and place for performing exercises. Boring exercises as well as both pain and no pain were identified as barriers to the performance of home-based rehabilitation exercise. Participants were motivated towards performing general physical activities which were part of their everyday life.

Assessment of Lifestyle, Eating Habits and the Effect of Nutritional Education among Undergraduate Students in Southern Italy

Background: The years spent at university represent a critical period that can influence both the quality of lifestyle and the eating habits of subsequent adulthood, and also, in the long term, the health of the individual. The aim of this study was to investigate the lifestyle of university students living away from home. Methods: Each subject recruited for the study was given a questionnaire to obtain general information, eating habits and physical activity levels before (T0) and after six month of training seminars (T1). Blood pressure, body composition and questionnaire responses were investigated. Results: The main findings of this study are a significant decrement in blood pressure; an increment in physical activity practice; an increased number of subjects who pay attention to the calorific value of food and also an improvement in BIA parameters. Conclusions: In conclusion, this study demonstrated the challenges that university students face in leading a healthy lifestyle and caring for their nutritional needs, particularly when they are away from their families. No intervention specifically targets young adults, even though much emphasis is placed on the promotion of a healthy lifestyle based on a varied and balanced diet and sufficient exercise. Our study showed that it is possible to improve lifestyle through educational events aimed at making students aware of the health risks deriving from unhealthy lifestyles.

Association of digital measures and self-reported fatigue: a remote observational study in healthy participants and participants with chronic inflammatory rheumatic disease.

Fatigue is a subjective, complex and multi-faceted phenomenon, commonly experienced as tiredness. However, pathological fatigue is a major debilitating symptom associated with overwhelming feelings of physical and mental exhaustion. It is a well-recognized manifestation in chronic inflammatory rheumatic diseases, such as Sjögren's Syndrome and Systemic Lupus Erythematosus and an important predictor of patient's health-related quality of life (HRQoL). Patient reported outcome questions are the key instruments to assess fatigue. To date, there is no consensus about reliable quantitative assessments of fatigue. Observational data for a period of one month were collected from 296 participants in the United States. Data comprised continuous multimodal digital data from Fitbit, including heart rate, physical activity and sleep features, and app-based daily and weekly questions covering various HRQoL factors including pain, mood, general physical activity and fatigue. Descriptive statistics and hierarchical clustering of digital data were used to describe behavioural phenotypes. Gradient boosting classifiers were trained to classify participant-reported weekly fatigue and daily tiredness from multi-sensor and other participant-reported data, and extract a set of key predictive features. Cluster analysis of Fitbit parameters highlighted multiple digital phenotypes, including sleep-affected, fatigued and healthy phenotypes. Features from participant-reported data and Fitbit data both contributed as key predictive features of weekly physical and mental fatigue and daily tiredness. Participant answers to pain and depressed mood-related daily questions contributed the most as top features for predicting physical and mental fatigue, respectively. To classify daily tiredness, participant answers to questions on pain, mood and ability to perform daily activities contributed the most. Features related to daily resting heart rate and step counts and bouts were overall the most important Fitbit features for the classification models. These results demonstrate that multimodal digital data can be used to quantitatively and more frequently augment pathological and non-pathological participant-reported fatigue.

#5042 ASSOCIATIONS BETWEEN SARCOPAENIA, CARDIOVASCULAR HEALTH AND HABITUAL PHYSICAL ACTIVITY IN PATIENTS ON HAEMODIALYSIS

Abstract Background and Aims Patients with end-stage kidney disease (ESKD) show skeletal muscle abnormalities such as sarcopenia (presence of low muscle mass, strength, and physical performance). Severe sarcopenia and its components are associated with poor clinical outcomes, decreased quality of life (QoL), and mortality. The direction of the relationships between sarcopenia and cardiovascular disease are less clear as are the impact of exercise interventions in patients with severe sarcopenia. Method This is a post-hoc analysis of the CYCLE-HD study, which was a randomised controlled trial assessing the effects of a 6-month structured intradialytic cycling intervention on cardiovascular health in those on haemodialysis. Presence of sarcopenia was established using the European Working Group of Sarcopenia in Older People (EWGSOP) definition. A cut off of &amp;lt;17.5 kg/m2 in men and &amp;lt;14.5 kg/m2 in women were used for fat free mass to establish muscle quantity using bioimpedance. The cut off of 15 seconds on the sit to stand 5 tests was used to establish muscle strength and a score of ≤8 on the short physical performance battery was used to assess physical performance. If all three criteria were met, severe sarcopenia was confirmed. Accelerometery assessed habitual physical activity (PA) and the general practice physical activity questionnaire assessed self-reported PA. Magnetic resonance imaging (MRI) measured left ventricular mass, pulse wave velocity, and global native T1 mapping (measure of myocardial fibrosis). Mann - Whitney U or unpaired t-tests explored differences in cardiac MRI, and physical activity (PA) outcomes between sarcopenic and non-sarcopenic patients. Linear regressions were used to investigate whether sarcopenia or its components predict cardiovascular health, and habitual PA outcomes cross-sectionally at baseline and following the 6-month programme of intradialytic exercise. Multinomial regressions were used to explore if sarcopenia or its components predicted self-reported PA. Results 130 patients (57 [±15] years, 95 [73.08%] male) were included in the analysis of whom 65 patients underwent the intradialytic cycling intervention. 31 (23.85%) patients had severe sarcopenia. 107(82.31%) had low muscle mass, 92(70.77%) had low strength, and 48 (36.92%) had low physical performance. Severe sarcopenia was a significant predictor for self-reported PA status (p = .042, Pseudo R2 = 0.043) at baseline but not for any other outcomes. However, low muscle mass was a significant predictor for LV mass (p = .014, R2 = 0.04, Β = -6.76). Low muscle strength was a significant predictor for higher pulse wave velocity (p = .010, R2 = 0.056, Β = 2.57) and global native T1 (p = .001, R2 = 0.091, Β = 26.79). Low fat mass (p = .005, R2 = 0.07, Β = -2198.63) and physical performance were significant predictors for mean steps (p&amp;lt;.001, R2 = 0.12, Β = -209.16). Baseline severe sarcopenia or its components were not predictors for cardiovascular or habitual PA changes following intradialytic exercise. Conclusion Severe sarcopenia was present in nearly quarter of the participants, but the majority showed at least one muscle health related abnormality (low muscle mass, strength or physical performance). These markers of sarcopenia showed associations with habitual PA and structural markers of cardiovascular disease. However, the presence of sarcopenia may not limit the benefits offered by intradialytic exercise. Patients with sarcopenic traits should be encouraged to participate in appropriate interventions to improve health and wellbeing.

Enhancing Cognition in Older Adults with Mild Cognitive Impairment through High-Intensity Functional Training: A Single-Blind Randomized Controlled Trial.

Physical exercise is a very promising non-pharmacological approach to prevent or reduce the cognitive decline that occurs in people aged 60 years or older. The objective of this study was to determine the effect of a high-intensity intervallic functional training (HIFT) program on cognitive functions in an elderly Colombian population with mild cognitive impairment. A controlled clinical trial was developed with a sample of 132 men and women aged >65 years, linked to geriatric care institutions, which were systematically blind randomized. The intervention group (IG) received a 3-month HIFT program (n = 64) and the control group (CG) (n = 68) received general physical activity recommendations and practiced manual activities. The outcome variables addressed cognition (MoCA), attention (TMTA), executive functions (TMTB), verbal fluency (VFAT test), processing speed (Digit Symbol Substitution Test-DSST), selective attention and concentration (d2 test). After the analysis, improvement was found in the IG with significant differences with respect to the CG in the level of cognitive impairment (MoCA), attention (TMTA), verbal fluency and concentration (p < 0.001). Executive functions (TMTB) showed differences in both groups, being slightly higher in the IG (p = 0.037). However, no statistically significant results were found for selective attention (p = 0.55) or processing speed (p = 0.24). The multiple analysis of covariance (MANCOVA) showed the influence of the education level on all cognition assessments (p = 0.026); when adjusting for sociodemographic variables, the influence of the intervention remained significant (p < 0.001). This study empirically validates that the implementation of a HIFT program has a positive effect on cognitive functions in elderly people with mild cognitive impairment. Therefore, professionals specialized in the care of this population could consider including functional training programs as an essential part of their therapeutic approaches. The distinctive features of this program, such as its emphasis on functional training and high intensity, appear to be relevant for stimulating cognitive health in the geriatric population.

Physical activity and injurious falls in older Australian women: adjusted associations and modification by physical function limitation and frailty in the Australian Longitudinal Study on Women's Health.

To investigate associations between leisure-time physical activity (LPA) and injurious falls in older women and explore modification of associations by physical function and frailty. Women born during 1946-51 from the Australian Longitudinal Study on Women's Health, injurious falls (self-reported fall with injury and/or medical attention) and self-reported weekly LPA (duration and type). We undertook cross-sectional and prospective analyses using data from 2016 [n = 8,171, mean (SD) age 68 (1)] and 2019 surveys (n = 7,057). Associations were quantified using directed acyclic graph-informed logistic regression and effect modification examined using product terms. Participation in LPA as recommended by World Health Organization (150-300min/week) was associated with lower odds of injurious falls in cross-sectional (adjusted Odds Ratio (OR) 0.74, 95% CI 0.61-0.90) and prospective analyses (OR 0.75, 95% CI 0.60-0.94). Compared with those who reported no LPA, cross-sectionally, odds of injurious falls were lower in those who reported brisk walking (OR 0.77, 95% CI 0.67-0.89) and vigorous LPA (OR 0.86, 95% CI 0.75-1.00). No significant association was found between different types of LPA and injurious falls prospectively. Only cross-sectionally, physical function limitation and frailty modified the association between LPA and injurious falls, with tendencies for more injurious falls with more activity in those with physical limitation or frailty, and fewer injurious falls with more activity among those without physical function limitation or frailty. Participation in recommended levels of LPA was associated with lower odds of injurious falls. Caution is required when promoting general physical activity among people with physical limitation or frailty.

Use of the ‘cuidando do pé’ app for risk classification and orientation regarding diabetic foot

1. Shah SZA, Karam JA, Zeb A, et al. Movement is improvement: The therapeutic effects of exercise and general physical activity on glycemic control in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Diabetes Therapy. 2021;12:707–732. https://doi.org/10.1007/s13300.... CrossRef Google Scholar

Long-term effects of type 2 diabetes on quality of life

Background: This study aimed to investigate the long-term effect of Type 2 diabetes on the quality of life of 100 patients in the Department of Diabetes and Endocrinology at the Hayatabad Medical Complex in Peshawar, Pakistan. The patients’ demographic information, medical history and associated comorbidities, and quality of life were collected and recorded. The quality of life was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) tool. The results showed that Type 2 diabetes had a significant negative impact on the physical, psychological, and social domains of the patients’ quality of life. There were significant differences between males and females in terms of physical health, psychological health, and social relationships. In addition, elderly patients reported lower scores on general health and physical activities than younger participants. These results demonstrate that Type 2 diabetes has a long-term negative effect on the quality of life of those affected and should be taken into consideration when developing treatment and prevention strategies. Objectives: The main objective of this study was to investigate the long-term effect of Type 2 diabetes on the quality of life of 100 patients in the Department of Diabetes and Endocrinology at the Hayatabad Medical Complex in Peshawar, Pakistan.

Narrative review – Barriers and facilitators to promotion of physical activity in primary care

AbstractThe objectiveto provide an overview of the literature on the barriers and facilitators to physical activity (PA) promotion in primary care, as experienced by practitioners and patients.MethodA search strategy of the English‐language literature was conducted in EMBASE, MEDLINE and the COCHRANE LIBRARY. Search terms were primary care OR general practice OR family medicine OR family practitioner AND physical activity OR exercise AND barriers OR facilitators. Databases were searched from inception until 21 October 2022.ResultsAfter screening, 63 articles were included within the summary and content analysis of this review. Analysis of the barriers to the implementation of PA highlighted four main themes perceived by practitioners: time, knowledge/skills, resources/support and financial implications. Analysis of the patient perspective identified themes which were categorised into individual (pre‐existing health conditions, knowledge of benefits of PA, time/capacity), societal (social support and cultural norms) and environmental (availability of facilities and weather).ConclusionsAs the importance of PA increases through the manifestation of sedentary behaviour‐related disease, a combined primary care and public health approach to increase PA is required. By identifying the main barriers to PA promotion in primary care, resources and funding can be directed to address this. This is particularly relevant in the United Kingdom, with the re‐negotiation of the primary care contract and the changes to healthcare delivery as a consequence of the Covid‐19 pandemic. Throughout this review, we have explored ways of addressing the identified barriers through evidence‐based interventions.

Sarcopenia parameters in active older adults – an eight-year longitudinal study

BackgroudSarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population.MethodsThe 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants’ overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements.ResultsIn the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and − 48.5%; p < .001, respectively).ConclusionsDespite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature.Trial registrationThe clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531.

Improving the Effectiveness of Exercise Therapy for Adults With Knee Osteoarthritis: A Pragmatic Randomized Controlled Trial (BEEP Trial)

ObjectiveTo investigate whether knee osteoarthritis (OA) related pain and function can be improved by offering enhanced physical therapist-led exercise interventions. DesignThree-arm prospectively designed pragmatic randomized controlled trial. SettingGeneral practices and National Health Service physical therapy services in England. Participants514 adults (252 men, 262 women) aged ≥45 years with a clinical diagnosis of knee osteoarthritis (N=514). Mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at baseline were 8.4 for pain and 28.1 for function. InterventionsParticipants were individually randomized (1:1:1 allocation) to usual physical therapy care (UC control: up to 4 sessions of advice and exercise over 12 weeks), individually tailored exercise (ITE: individualized, supervised, and progressed lower limb exercises, 6-8 sessions over 12 weeks), or targeted exercise adherence (TEA: transitioning from lower limb exercise to general physical activity, 8-10 contacts over 6 months). Main Outcome MeasuresPrimary outcomes were pain and physical function measured by the WOMAC at 6 months. Secondary outcomes were measured at 3, 6, 9, 18, and 36 months. ResultsParticipants receiving UC, ITE, and TEA all experienced moderate improvement in pain and function. There were no significant differences between groups at 6 months (adjusted mean differences (95% confidence intervals): pain UC vs ITE, -0.3 (-1.0 to 0.4), UC vs TEA, -0.3 (-1.0 to 0.4); function UC vs ITE, 0.5 (-1.9 to 2.9), UC vs TEA, -0.9 (-3.3 to 1.5)), or any other time-point. ConclusionsPatients receiving UC experienced moderate improvement in pain and function; however, ITE and TEA did not lead to superior outcomes. Other strategies for patients with knee osteoarthritis to enhance the benefits of exercise-based physical therapy are needed.

The combined associations of depression and cognitive impairment with functional disability and mortality in older adults: a population-based study from the NHANES 2011-2014.

The present study aimed to explore the combined associations of depression and cognitive impairment with functional disability and mortality, and whether the joint effects of depression and cognitive impairment on mortality were influenced by functional disability. A total of 2,345 participants aged 60 and above from the 2011-2014 cycle of the National Health and Nutrition Examination Survey (NHANES) were included in the analyses. Questionnaires were used to evaluated depression, global cognitive function and functional disability (including disability in activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activity (GPA)). Mortality status was ascertained up to December 31, 2019. Multivariable logistic regression was performed to investigate the associations of depression and low global cognition with functional disability. Cox proportional hazards regression models were conducted to evaluate the effect of depression and low global cognition on mortality. Interactions between depression and low global cognition were observed when exploring associations of depression and low global cognition with IADLs disability, LEM disability, and cardiovascular mortality. Compared with normal participants, participants with both depression and low global cognition had the highest odds ratios of disability in ADLs, IADLs, LSA, LEM, and GPA. Besides, participants with both depression and low global cognition also had the highest hazard ratios of all-cause mortality and cardiovascular mortality, and these associations remained after adjusting for disability in ADLs, IADLs, LSA, LEM, and GPA. Older adults with both depression and low global cognition were more likely to have functional disability, and had the highest risk of all-cause mortality and cardiovascular mortality.

Sense of coherence and its context with demographics, psychological aspects, lifestyle, complementary and alternative medicine and lay aetiology.

For patients with a cancer diagnosis, coping abilities are of high importance. Cancer patients with a high sense of coherence may cope better. The purpose of this study is to learn more about the correlation of sense of coherence and different aspects, such as demographics, psychological factors, lifestyle, complementary and alternative medicine (CAM) and lay aetiology. A prospective cross-sectional study was performed in ten cancer centres in Germany. The questionnaire consisted of ten sub-items, collecting information about sense of coherence, demographics, general life satisfaction, resilience, spirituality, self-efficacy, physical activity and sports, nutrition, CAM methods and cancer causes. As many as 349 participants were evaluable. The mean sense of coherence score was M = 47.30. Significant associations were shown for sense of coherence and financial situation (r = 0.230, p < 0.001), level of education (r = 0.187, p < 0.001), marital status (η = 0.177, p = 0.026) and time interval since diagnosis (r = - 0.109, p = 0.045). Sense of coherence and resilience correlated on a high level, as well as spirituality, self-efficacy and general life satisfaction(r = 0.563, r = 0.432, r = 0.461, r = 0.306, p's < 0.001). Several aspects, such as demographics and psychological factors, have a great influence on the sense of coherence. To help patients to cope better, physicians should try to strengthen sense of coherence, resilience and self-efficacy and, at the same time, consider patients' individual background such as level of education, financial capacity and emotional support by family members.