Initiation Of Physical Activity Research Articles

The effectiveness of early mobilisation on physical function in patients after heart valve surgery: a systematic review

Background/Aims Literature suggests that early mobilisation, defined as the initiation of physical activity within 48 hours following surgery, improves outcomes after cardiac surgery. This systematic review assessed the effectiveness of early mobilisation on physical function and other outcomes, including length of hospital stay and cost following heart valve surgery. Methods The Physiotherapy Evidence Database, MEDLINE, EMBASE, CINAHL and Cochrane Library were systematically searched from inception until May 2022 using relevant key words. Randomised controlled trials comparing early mobilisation and usual care for patients who had received heart valve surgery were included in the review. Methodological quality was assessed using the Physiotherapy Evidence Database scale and risk of bias using the Cochrane Risk of Bias 2 tool. The data were narratively synthesised. Results The search identified 210 articles, with 98 remaining after duplicates were removed. Upon screening for eligibility, nine articles were assessed in full and three randomised controlled trials involving 161 patients were included in the review. Early mobilisation protocols varied across trials. Two trials (n=124) reported significantly greater improvement in physical function with early mobilisation compared to usual care, including handgrip strength (P=0.001). One study (n=41) found early mobilisation significantly reduced the length of hospital stay (P=0.000), in-hospital care costs (P=0.000) and intensive care unit stay (P=0.000) compared to usual care. Methodological quality scores ranged from six to nine on the Physiotherapy Evidence Database scale. The risk of biased judgement was ‘low’ in one study and ‘some concerns’ in two studies. Conclusions Early mobilisation may improve physical function and reduce hospital and intensive care unit stays after heart valve surgery. However, differences in protocols and limited studies indicate further high-quality research is needed, particularly regarding cost-effectiveness. Establishing clear early mobilisation protocols could enhance recovery in this population. Implications for practice Early mobilisation may require the coordinated effort of a multidisciplinary team of physiotherapists, nurses and possibly other medical professionals. For its seamless and effective implementation, it is essential to understand whether this intervention falls under the domain of physiotherapists or requires broader team collaboration. Given these complexities, strategies targeting early mobilisation that balance both safety and resource considerations are advised to improve physical function after heart valve surgery, especially among patients who are frail.

Facilitators and barriers of initiation and maintenance of physical activity among people with coronary heart disease: a qualitative study

Purpose We aimed to describe the facilitators and barriers of physical activity for patients with coronary heart disease. Methods A qualitative descriptive study using semi-structured interviews was conducted with 15 participants with coronary heart disease. The interview guide was developed based on a multi-theory model. Interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic analysis. Results Two main themes were identified: facilitators of initiation and maintenance of physical activity (behavioral motivation, perceived benefits, behavioral confidence, supportive physical environment, positive emotional experience, self-regulation, supportive social environment, illness perception, and excellent self-control), barriers of initiation and maintenance of physical activity (perceived barriers, restricted physical environment, psychological distress, insufficient social support, and poor self-control). Conclusions This study presents an in-depth theory-based exploration of facilitators and barriers to initiating and maintaining physical activity among people with coronary heart disease. Relevant factors should be taken into account to increase their effectiveness when designing the target interventions to encourage a physically active lifestyle in this population.

Association Between Regular Moderate to Vigorous Physical Activity Initiation Following COPD Diagnosis and Mortality: An Emulated Target Trial Using Nationwide Cohort Data

Moderate to vigorous physical activity (MVPA) in patients with COPD affects their overall health outcomes, including symptom relief and improved quality of life. However, the magnitude of the effect of MVPA initiation on real-world clinical outcomes has not been well investigated. How does MVPA initiation affect mortality and severe exacerbation in patients who have not engaged in MVPA prior to COPD diagnosis? This study included patients with COPD aged≥ 40 years who were not performing MVPA prior to COPD diagnosis and who had at least one health screening visit prior to and following their COPD diagnosis between January 1, 2010, and December 31, 2018. The main exposure was MVPA, defined as vigorous aerobic exercise > 20min per day on≥ 3days per week or moderate aerobic exercise > 30min per day on≥ 5days per week. The primary end point was all-cause mortality, and the secondary end point was initial severe exacerbation as the time to event following COPD diagnosis. In total, 110,097 person-trials were included (27,564 MVPA increases and 82,533 control groups). No differences were observed between the covariates following matching. The adjusted hazards ratio of all-cause mortality for the MVPA group compared with the control group was 0.84 (95%CI, 0.79-0.89). In the subgroup analysis, patients aged > 65 years, female patients, those who had never smoked, and patients with a higher Charlson Comorbidity Index score displayed a stronger effect of MVPA on reducing mortality than younger male patients, those who had ever smoked, and patients with a lower Charlson Comorbidity Index score (Pinteraction< .05). The fully adjusted hazards ratio for the risk of severe exacerbation (MVPA group vscontrol) was 0.90 (95%CI, 0.87-0.94). Initiation of MVPA can potentially reduce mortality and severe exacerbations in patients with COPD, although personalized interventions and further clinical trials are necessary.

Non-consciously processed physical activity for survival versus consciously deliberated exercise for health.

Humans evolved to become dependent on physical activity for their survival, but they have not evolved to exercise today. Because survival in modern society is heavily reliant on conscious thinking, most people (54%) have evolved away from physical activity and become occasional exercisers. This transition from non-conscious to conscious processing prevents people from capitalizing on evolution's wisdom for survival and wellbeing as they consciously deliberate on the utility of health practices to achieve certain outcomes (e.g., weight loss). Unlike in early times, people today have a choice of not engaging in physical activity and yet surviving. As a result, they struggle with the question whether the gains from exercising are greater than losses from not doing it, weighing positive gains and losses against negative gains and losses. Such conscious deliberations, however, can easily be overridden by solving cognitive dissonance (e.g., "exercise is good for my health" vs. "I don't exercise") through conscious rationalizations and non-conscious dismissal. Today's exercise problem can only be solved by individually acquiring the mindset of early times of evolution when the initiation of physical activity was largely a matter of non-conscious thoughts and feelings.

Concealed pregnancy as an act of care? A qualitative analysis of motivations for concealing and non-disclosure of early pregnancy in The Gambia

BackgroundA barrier to achieving first trimester antenatal care (ANC) attendance in many countries has been the widespread cultural practice of not discussing pregnancies in the early stages. Motivations for concealing pregnancy bear further study, as the interventions necessary to encourage early ANC attendance may be more complicated than targeting infrastructural barriers to ANC attendance such as transportation, time, and cost.MethodsFive focus groups with a total of 30 married, pregnant women were conducted to assess the feasibility of conducting a randomised controlled trial to evaluate the effectiveness of early initiation of physical activity and/or yoghurt consumption in reducing Gestational Diabetes Mellitus in pregnant women in The Gambia. Focus group transcripts were coded through a thematic analysis approach, assessing themes as they arose in relation to failure to attend early ANC.ResultsTwo reasons for the concealment of pregnancies in the first trimester or ahead of a pregnancy’s obvious visibility to others were given by focus group participants. These were ‘pregnancy outside of marriage’ and ‘evil spirits and miscarriage.’ Concealment on both grounds was motivated through specific worries and fears. In the case of a pregnancy outside of marriage, this was worry over social stigma and shame. Evil spirits were widely considered to be a cause of early miscarriage, and as such, women may choose to conceal their pregnancies in the early stages as a form of protection.ConclusionWomen’s lived experiences of evil spirits have been under-explored in qualitative health research as they relate specifically to women’s access to early antenatal care. Better understanding of how such sprits are experienced and why some women perceive themselves as vulnerable to related spiritual attacks may help healthcare workers or community health workers to identify in a timely manner the women most likely to fear such situations and spirits and subsequently conceal their pregnancies.

“It’s not time for us to sit down yet”: how group exercise programs can motivate physical activity and overcome barriers in inactive older adults

ABSTRACT Purpose Physical activity and exercise are critical for older adults’ physical and mental health. The purpose of this qualitative study was to richly capture the motivators of and barriers to engaging in physical activity in previously inactive older adults who participated in a three-arm randomized controlled trial (RCT) of eight-week group exercise interventions. Methods We conducted a qualitative content analysis of individual interviews with fifteen participants—five from each study arm: strength training, walking, and inactive control. Participants included nine females and six males ranging from 60 to 86 years of age. Results Key motivators of physical activity included perceived improvements in physical and mental health, positive social influences, observed health deterioration in others, and the desire to spend time with and take care of family members. Barriers to physical activity included existing health conditions, fear of getting hurt, negative social influences, perceived lack of time and motivation, inconvenient times and locations, and monetary cost. Conclusions Our findings add to the body of literature identifying factors that motivate and stand in the way of older adults’ engagement in physical activity. These factors influence older adults’ self-efficacy and should be incorporated into the design of new and existing programs to encourage initiation and maintenance of physical activity.

Personality and change in physical activity across 3–10 years

Objective To examine the association between personality traits, defined by the Five-Factor Model, and the initiation and termination of physical activity across adulthood. Design Longitudinal analysis of participants from nine samples (N > 28,000). Main Outcome Measures Physical activity status at follow-up. Results A random-effect meta-analysis revealed that higher conscientiousness, extraversion, and openness were related to a higher likelihood of initiation of physical activity over time among individuals who were physically inactive at baseline and to a lower risk of termination of physical activity among those who were physically active at baseline. In contrast, higher neuroticism was associated with a lower probability of initiation of physical activity and a higher likelihood of termination over time. Although not hypothesised, agreeableness was also associated with better physical activity outcomes over time. Conclusion This study provides the largest and the longest evidence of a replicable association between personality and change in physical activity status. Personality may motivate both the initiation and termination of physical activity.

THE EFFECT OF PHYSICAL EXERCISE ON CENTRAL VASCULAR FUNCTION IN OVERWEIGHT AND OBESE NORMOTENSIVE ADULTS: INTERIM ANALYSIS OF LONGITUDINAL BEFORE-AND-AFTER STUDY SPANNING 14 WEEKS

Objective: Physical activity is a relevant modifier of cardiovascular risk and is recommended to control BP levels in obese hypertensive patients. This study is aimed at assessing its effect on central vascular function (CVF), a potential preventive target known to impact high-flow end-organs, in overweight and obese normotensive participants. Design and method: We enrolled normotensive overweight and obese (classes 1–3) participants who joined lifestyle modification programme at a local gym. The programme includes two 7-week cycles of 1-hour mixed cardio and strength training, 5 sessions/week. CVF parameters (arterial stiffness and hemodynamics) were measured with the SphygmoCor XCEL device at 4 timepoints: baseline and after 3, 7, and 14 weeks of training; on a day when participants had not exercised for at least 24 hours. We used the Friedman test for repeated measures in data analysis. Results: An interim analysis included 15 participants (median BMI 33, range 27–43). Their median age was 35 years (25–49) and were predominantly women (n = 11). We observed a significant improvement after initiation of physical activity in all assessed parameters of CVF (P &lt; 0.05 for all). The greatest improvement was observed at 3 weeks, which continued to 7 weeks but to a lesser extent. At 14 weeks, parameter values deteriorated, likely due to 8 participants not adhering to the 8–14 week schedule, but values were still significantly better than baseline. The median improvement at 7 weeks included a 0.5 m/s reduction in carotid-femoral pulse wave velocity, a 9% reduction in central augmentation index corrected for changes in HR, and a 5 and 6 mmHg reduction in cSBP and cDBP, respectively. The median weight lost from baseline was 1.8, 2.4 and 5.8 kg at 3, 7, and 14-weeks respectively. Conclusions: Physical activity induced non-trivial improvement in CVF in people at increased risk of CVD. While training was accompanied with weight loss, this likely did not affect CVF outcomes as median body mass loss up to 7 weeks was small (2.8%) and direction of the effect on CVF at week 14 was aligned with exercising, not weight loss.

The Practice of Physical Activity After Breast Cancer Treatments: A Qualitative Study Among Portuguese Women.

BackgroundWomen survivors of breast cancer treatments face significant challenges around initiation or maintenance of physical activity (PA) as they transit to recovery. Embracing their needs and preferences is important to increase adherence. This study aimed to explore the perspectives of Portuguese women survivors of breast cancer regarding regular performance of PA and individual choices and strategies that should be considered in designing effective interventions.MethodsThe individual semi-structured interviews (N = 20) were analyzed through thematic analysis, following an inductive process, seeking to identify the barriers, facilitators, and particular influencing circumstances associated with regular PA.ResultsFour themes and several contextual, emotional, physical, and social factors were identified as determinants of regular PA. Guilt, women’s duties, and altruism to help close relatives were identified as emotional and cultural factors that are less-found in the existing literature. PA showed influence both from health professionals’ counseling and from knowledge and beliefs held by these women.ConclusionWhile confirming the already-known impact of breast cancer diagnosis and treatments on PA, which redefine participants’ availability to be active, the findings highlight beliefs and specific emotional factors that should be considered when planning culturally sensitive interventions.

Relative Effects of Demographic, Psychological, Behavioral, and Social Factors on the Initiation and Maintenance of Leisure-time Physical Activity: Results From a Confirmatory Path Analysis in a Longitudinal Study

BackgroundThere is a lack of evidence of the complicated pathways of underlying determinants in the phases of physical activity. The purpose of this study was to evaluate simultaneously a set of potential determinants on the initiation and maintenance phases of leisure-time physical activity (LTPA).MethodsThe longitudinal data of 54,359 Korean adults aged 40–69 years from the Health Examinees study were used. The median follow-up duration was 4.2 years. The self-reported durations per week of LTPA was repeatedly assessed. Based on previous longitudinal studies, the potential determinants were selected, and hypothetical models were constructed that consider the complex associations between the determinants. The standardized coefficients for direct and indirect effects were estimated using path analysis to differentiate contributions of mediation from the total effects.ResultsIn the total population, age, education, chronic diseases, smoking, depression symptoms, and self-rated health were significantly associated with both initiation and maintenance phases. Income (B = 0.025) and social supports (B = 0.019) were associated only with the initiation phase. Waist-to-hip ratio (B = −0.042) and stress (B = −0.035) were associated only with the maintenance phase. After stratifying by sex, the significant effects of education, chronic diseases, and smoking were found only in men. The initiation phase-specific effects of income and social supports and the maintenance phase-specific effects of stress were found only in women. It was estimated that indirect effects contributed approximately 15% of the total effect.ConclusionThe findings suggested that there were initiation- or maintenance-specific determinants of leisure-time physical activity according to sex.

Effect of Multimedia Messaging Service on Exercise Self-efficacy in Diabetic Patients.

Objectives: To increase patients' self-efficacy for initiation of physical activity, there is a need to include physical activity into patient education in clinic settings. In this study, we aimed to assess the effectiveness of multimedia messaging service (MMS) education on exercise self-efficacy in patients with type 2 diabetes mellitus (T2DM). Methods: We used a quasi-experimental, pretest-posttest design to study 98 patients with T2DM. The intervention group received MMS education targeting exercise self-efficacy for 2 months, and the control group received routine care only. Patients in both groups completed the Exercise Self-efficacy scale at 3 stages (at baseline, at 4 weeks, and at 8 weeks post-intervention). Results: We found a slight increase between baseline, first follow-up, and second follow-up in interpersonal and competing demands factors in the intervention group (p = .002, p = .001, respectively), but no improvement in the control group in any of the 3 factors over time (p > .05). Also, Cohen's d values indicated a medium effect size in all exercise self-efficacy subscales (interpersonal [0.734], competing demands [0.665], and internal feelings [0.696]). Conclusions: Health education using theoretically-based MMS targeting exercise self-efficacy was effective and affordable in promoting and changing patients' beliefs and physical activity behaviors.

Forming Habits, Overcoming Obstacles, and Setting Realistic Goals: A Qualitative Study of Physical Activity Maintenance Among Latinas.

The impact of physical activity interventions for Latina women can be enhanced by identifying and implementing strategies to achieve long-term physical activity maintenance. Physical activity promotion research has mainly focused on physical activity initiation and we know little regarding individual, interpersonal, or environmental factors that influence maintenance of physical activity. This study aimed to qualitatively explore and understand factors associated with maintenance and non-maintenance of physical activity among Latinas. Semi-structured individual interviews were conducted with 21 Latinas who increased their physical activity as a result of an intervention, and who completed a 3-month maintenance period without contact from research staff. Data were analyzed using thematic analysis. Important facilitators of physical activity maintenance described by participants included having made physical activity a habit; the ability to proactively overcome obstacles to engaging in physical activity, and satisfaction with outcomes obtained from engaging in physical activity. Additional facilitators mentioned by both maintainers and non-maintainers included having motivation, social support, and opportunities to be active. Both maintainers and non-maintainers reported high self-efficacy for PA maintenance in the future. Guiding intervention participants to form habits and to set realistic expectations could help them to independently continue engaging in physical activity upon completion of physical activity interventions. Teaching them skills to proactively overcome obstacles may also be important for physical activity maintenance.

Motivational Interviewing to Increase Physical Activity: A Teaching Activity for Exercise Psychology Students

Health behavior change, such as increasing physical activity and reducing sedentary behavior, is difficult. Given the complex nature of adopting new behaviors, exercise psychologists and other professionals need to use more effective psychosocial interventions to help people change. The common use of a directive approach to helping people change has been largely unsuccessful. In contrast, motivational interviewing is a method for improving the initiation of physical activity. The purpose of this paper is to briefly describe motivational interviewing and offer an introductory learning activity that can be applied in various settings (e.g., exercise psychology courses) to help practitioners working with people on improving physical activity.

Understanding Community-Dwelling Chinese Older Adults' Engagement in Physical Activity: A Grounded Theory Study.

Limited information is available on the process of Chinese older adults' initiation, engagement, and maintenance of physical activity (PA), thus limiting the development of effective PA promotion programs. The purpose of the study was to investigate Chinese old adults' perspectives and experiences with PA engagement and to develop a conceptual model illustrating the process of how community-dwelling Chinese older adults engage in PA. This study used grounded theory methodology. Nineteen community-dwelling Chinese older adults aged older than 60 years participated. We conducted semistructured in-depth interviews with participants. Open, axial, and selective coding, along with constant comparative analysis, was performed to analyze the data. Participants described PA engagement as a complex and dynamic process, consisting of 3 stages: Getting started, Participating in PA, and Making PA part of life. The transition from one stage to the next was driven by an increasing internalized motivation toward PA through Seeing benefits. Many participants described that Staying in groups was a key strategy for them to keep physically active. Moreover, Restructuring occurred when Chinese older adults encountered trigger situations. This study identified the stages of how community-dwelling Chinese older adults engage in to perform and maintain PA. The developed conceptual model can inform future interventions for promoting PA among Chinese older adults.

Nutritional Assessment and Preparation for Adult Bariatric Surgery Candidates: Clinical Practice

Bariatric surgery (BS) has proven to be highly efficacious in the treatment of obesity and its comorbidities. However, careful patient selection is critical for its success. Thus, patients should undergo medical, behavioral, and nutritional assessment by a multidisciplinary team. From the nutritional point of view, BS candidates should undergo nutritional assessment, preparation, and education by a registered dietitian in the preoperative period. Currently, detailed specified and comprehensive information on these topics is lacking. The present narrative review aimed to summarize the available literature concerningboth the preoperative nutritional assessment components and the preoperative nutritional preparation and education components of patients planning to undergo BS. Current literature indicates that proper management before BS should include a comprehensive nutritional assessment, in which it is advisable toperform a clinical interview to assess patients' medical background, weight management history, eating patterns and pathologies, oral health, physical activity habits, nutritional status, supplementation usage, BS knowledge, surgery expectations and anthropometric measurements. Nutritional preparation and educational strategies should include an individualized preoperative weight-loss nutrition program, improvement of glycemic control, micronutrients deficiencies correction, eating and lifestyle habits adaptation, physical activity initiation, and strengthening knowledge on obesity and BS. At this stage, more well-designed intervention and long-term cohort studies are needed in order to formulate uniform evidence-based nutritional guidelines for patients who plan to undergo BS, including populations at higher nutritional risk. Moreover, postoperative outcomes of presurgical nutritional intervention programs should be studied.

Effect of Nursing Interventions on the Physical Performance Self-Efficacy among Community Dwelling Older Adults in the Pre-Frail Stage

Background: Prefrailty prevalence increases with age, and can lead to negative healthcare outcomes. Prefrailty prevention and management are very important actions to prolong independence in older adults. Self‑efficacy is one of the psychological factors that are the most reliable predictors of older adults' initiation and uptake of physical activity. Gerontological nurses play a crucial role in the early identification of older adults with pre-frailty and tailoring preventive and rehabilitative multicomponent exercise interventions which are considered a key factor in decreasing, preventing, or even reverse decline associated with prefrailty. Aim of the study: To determine the effect of nursing intervention on the physical performance self-efficacy among community dwelling older adults in the pre-frail stage. Settings: El-Waffa club for older adults which affiliated to the Ministry of Social Solidarity, in Alexandria, Egypt. Subjects: Forty pre-frail community dwelling older adults were included in this study. Tools: Six tools were used to collect data ;Frailty Index for Elders,Short Physical Performance Battery, Socio-demographic and Clinical Data of Community-dwelling Elders, Barthel Index, Instrumental Activities of Daily Living, and Exercise Self-efficacy Scale. Results: statistically significant differences were found in the studied older adults’ pre-frailty status, physical performance, and their self-efficacy after the implementation of the study intervention as (P= 0.000 for all of these variables). Conclusion: physical performance self-efficacy and prefrailty status of all studied pre-frail community dwelling older adults improved after the implementation of the multicomponent exercise program. Recommendations: Prefrailty screening should be performed for all community dwelling older adults. The multicomponent exercise program can be safely and effectively incorporated into standard nursing practice in caring for pre-frail community dwelling older adults.

Autoeficacia para el desempeño de actividad física en personas mayores

La autoeficacia, concebida como la creencia en poder realizar una tarea a pesar de las dificultades, es uno de los más consistentes predictores de iniciación y mantenimiento de la actividad física en las personas de todas las edades, pero más aún, en edad avanzada. Por lo tanto, esta revisión describe primero la autoeficacia y su distinción de construcciones similares e incorpora la autoeficacia dentro de la teoría sociocognitiva donde se describió por primera vez. Luego, se describen los principales abordajes de diferentes disciplinas para promover la autoeficacia, y, en consecuencia, la actividad física; poniendo foco en la evidencia disponible en el área de ciencias de la salud sobre cómo impulsar las fuentes de esta importante autoconfianza en las personas mayores.

Actoprotective activity of some 5-(thiophen-3-ylmethyl)-4-R1-1,2,4-triazole-3-thiols derivatives

Today, the process of body fatigue has many definitions, but in general it is characterized as a feeling of heaviness arising from the initiation or support of voluntary physical or mental activity associated with working at the level of one’s normal abilities. Fatigue of the body, as a physiological norm, can be divided into physical fatigue and mental fatigue. The solution to the problem of therapy for the process of fatigue should be expressed in the creation of new effective compounds that can affect the mechanisms of fatigue development and can be oriented towards restoration of cell function, as well as increase the activity of enzymes of the antioxidant defense system of the body in a certain way. &#x0D; The aim of our work was to investigate the actoprotective activity of new derivatives of 5-(thiophen-3-ylmethyl)-4-R1-1,2,4-triazole-3-thiol and to establish certain patterns between the chemical structure and pharmacological activity of the studied compounds. &#x0D; The studies used new derivatives of 5-(thiophen-3-ylmethyl)-4-R1-1,2,4-triazole-3-thiol, which were first synthesized in the laboratory of organic synthesis of the Department of Natural Sciences for foreign students and toxicological chemistry of Zaporizhzhia State Medical University. o determine the dosage conditions of the studied compounds, a preliminary study was made of the general toxic effect and acute toxicity of the studied compounds, which was carried out according to the well-known express method of V. B. Prozorovsky, and the degree of toxicity was evaluated by K. K. Sidorov. The experiments were performed on a group of white nonlinear rats weighing 230–245 g. In the study of actoprotective activity was used the method of forced immersion in water with a load of 10% of the weight of the rat. &#x0D; The data obtained were processed statistically using the standard Microsoft Office 2007 software package and “STATISTICA @ for Windows 6.0”. The reliability of intergroup differences according to the experimental data was established using Student’s t-test. The level of statistical significance of differences in research results is p &lt; 0.01. Analyzing the results of the experiment, it was found that some compounds that were studied in a number of new derivatives of 5-(thiophen-3-ylmethyl)-4-R1-1,2,4-triazole-3-thiol have a pronounced actoprotective effect. &#x0D; The actoprotective activity of the new derivatives of 5-(thiophen-3-ylmethyl)-4-R1-1,2,4-triazol-3-thiol was studied. A number of compounds have been identified that are superior in activity to the comparison drug riboxin. In some cases, patterns of the influence of various substituents on the indices of the actoprotective action of the synthesized compounds were established.

Reported Barriers Impeding Adherence to a Physical Exercise Program in Patients With Breast Cancer: A Systematic Review

Background: More than 80% of those newly diagnosed with breast cancer are now surviving 5 years or more, which creates a target group that is in need of activity programs to prevent treatment side effects and complications. Purpose: The purpose of our systematic review was to identify patient perceptions, preferences, and barriers as well as the strategies to improve adherence to a physical exercise program. Data Sources: PubMed, Academic Search Complete, MEDLINE, SPORTDiscus, EMBASE, Web of Science, PsycINFO, and CINAHL were searched, yielding 2511 studies. Study Selection: In total, 16 qualitative studies were retained and published from 2013 to 2018 in English. Data Extraction: Three reviewers independently extracted data from the studies, evaluated the evidence, and organized the data into tables for ease of reference and analysis. Data Synthesis: Of the 16 retained studies, 7 used interviews, 6 used surveys/questionnaires, and 3 used a mix of interviews and questionnaires. The CASP (Critical Appraisal Skills Programme) instrument was used to appraise quality. Discussion and Limitations: Patient education, group-based programming, electronic tracking devices, enhancing confidence and self-efficacy, and providing alternatives for exercising at home were identified as strategies that could be used to improve adherence. Publication bias and 100% female participation within the retained studies could have affected the results of this review. Conclusions: The barriers, perceptions, preferences, motivators, and recommendations that have been identified will enable physical therapists to optimize, design, and implement a well-rounded program for the initiation and maintenance of physical activity for women with breast cancer.

Is time preference and present bias associated with the decision to start, quit or maintain physical activity over time?

AimIt is commonly observed that individuals transition into and out of physical activity behaviours over time. A better understanding of the determinants of these transitions is important in order to develop effective interventions. Our focus is on examining the role of time preference and present bias (how present or future oriented individuals are) in the decision to start, quit and maintain physical activity over time.Subject and methodsWe examine changes in different types of physical activity participation over time, allowing us to distinguish between physical activity initiation versus maintenance. We use data from the National Longitudinal Survey of Youth 1979 (NLSY79).ResultsWe show that present bias impacts maintenance but not initiation of physical activity behaviour. The time preference rate impacts maintenance of strengthening exercise in men only.ConclusionThe results of our study suggest that interventions aimed at overcoming present bias, such as commitment devices in the form of deposit contracts, may be effective in maintaining physical activity but not initiating physical activity.