Physical Activity Behaviour In People Research Articles

Adopting and maintaining physical activity behaviour in people with severe mental illness: The importance of autonomous motivation

BackgroundPhysiotherapy can improve the health of people with serious mental illness (SMI) but many are inactive. Adopting theoretically-based evidence considering the motivational processes linked to the adoption and maintenance of an active lifestyle can assist physiotherapists in facilitating lifestyle changes in people with SMI.PurposeWithin the Self-Determination Theory (SDT) and the Trans-Theoretical Model (TTM) (stages of change) frameworks, we investigated differences in motives for physical activity between different diagnostic SMI groups.MethodsAll participants with SMI from 15 different centers completed the Behavioral Regulation in Exercise Questionnaire 2 (BREQ-2), the International Physical Activity Questionnaire (IPAQ) and the Patient-centered Assessment and Counseling for Exercise (PACE) questionnaire.ResultsOverall 294 persons with SMI (190♀) (43.6 ± 13.6years) agreed to participate. People with affective disorders had higher levels of introjected regulations than people with schizophrenia. No significant differences were found for other motivational regulations. Moreover, no significant differences were found according to gender, setting and educational level. Multivariate analyses showed significantly higher levels of amotivation and external regulations and lower levels of identified and intrinsic regulations in the earlier stages of change. Strongest correlations with the IPAQ were found for motivational regulations towards walking.ConclusionsOur results suggest that in all people with SMI the level of identified and intrinsic motivation may play an important role in the adoption and maintenance of health promoting behaviours.ImplicationsThe study provides a platform for future research to investigate the relationships between autonomy support, motivational regulations and physical and mental health variables within physiotherapy interventions for this population.Disclosure of interestThe author has not supplied his declaration of competing interest.

Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review.

Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.

Exploratory Study of Physical Activity in Persons With Charcot-Marie-Tooth Disease

ObjectivesTo explore and describe the perceived facilitators and barriers to physical activity, and to examine the physical activity correlates in people with Charcot-Marie-Tooth (CMT) disease. DesignCross-sectional survey study. SettingCommunity-living subjects. ParticipantsSwedish people with CMT disease (N=44; men, 54.5%; median age, 59.5y [interquartile range, 45.3–64.8y]). InterventionsNot applicable. Main Outcome MeasuresThe survey included open-ended questions and standardized self-reported scales measuring physical activity, fatigue, activity limitation, self-efficacy for physical activity, fall-related self-efficacy, social support, and enjoyment of physical activity. Physical activity was measured by the Physical Activity Disability Survey–Revised. ResultsQualitative content analysis revealed that personal factors such as fatigue, poor balance, muscle weakness, and pain were important barriers for physical activity behavior. Facilitators of physical activity were self-efficacy for physical activity, activity-related factors, and assistive devices. Multiple regression analysis showed that self-efficacy for physical activity (β=.41) and fatigue (β=−.30) explained 31.8% of the variation in physical activity (F2,40=10.78, P=.000). ConclusionsDespite the well-known benefits of physical activity, physical activity in people with CMT disease is very sparsely studied. These new results contribute to the understanding of factors important for physical activity behavior in people with CMT disease and can guide health professionals to facilitate physical activity behavior in this group of patients.

A mobile phone intervention increases physical activity in people with cardiovascular disease: Results from the HEART randomized controlled trial.

To determine the effectiveness and cost-effectiveness of a mobile phone intervention to improve exercise capacity and physical activity behaviour in people with ischaemic heart disease (IHD). In this single-blind, parallel, two-arm, randomized controlled trial adults (n = 171) with IHD were randomized to receive a mobile phone delivered intervention (HEART; n = 85) plus usual care, or usual care alone (n = 86). Adult participants aged 18 years or more, with a diagnosis of IHD, were clinically stable as outpatients, able to perform exercise, able to understand and write English, and had access to the Internet. The HEART (Heart Exercise And Remote Technologies) intervention involved a personalized, automated package of text messages and a secure website with video messages aimed at increasing exercise behaviour, delivered over 24 weeks. All participants were able to access usual community-based cardiac rehabilitation, which involves encouragement of physical activity and an offer to join a local cardiac support club. All outcomes were assessed at baseline and 24 weeks and included peak oxygen uptake (PVO2; primary outcome), self-reported physical activity, health-related quality of life, self-efficacy and motivation (secondary outcomes). Results showed no differences in PVO2 between the two groups (difference -0.21 ml kg(-1)min(-1), 95% CI: -1.1, 0.7; p = 0.65) at 24 weeks. However significant treatment effects were observed for selected secondary outcomes, including leisure time physical activity (difference 110.2 min/week, 95% CI: -0.8, 221.3; p = 0.05) and walking (difference 151.4 min/week, 95% CI: 27.6, 275.2; p = 0.02). There were also significant improvements in self-efficacy to be active (difference 6.2%, 95% CI: 0.2, 12.2; p = 0.04) and the general health domain of the SF36 (difference 2.1, 95% CI: 0.1, 4.1; p = 0.03) at 24 weeks. The HEART programme was considered likely to be cost-effective for leisure time activity and walking. A mobile phone intervention was not effective at increasing exercise capacity over and above usual care. The intervention was effective and probably cost-effective for increasing physical activity and may have the potential to augment existing cardiac rehabilitation services.

Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care.

BackgroundPhysical activity (PA) and nutrition are the cornerstones of diabetes management. Several reviews and meta-analyses report that PA independently produces clinically important improvements in glucose control in people with Type 2 diabetes. However, it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care.MethodsThis study will determine whether an evidence-informed multifaceted behaviour change intervention (Movement as Medicine for Type 2 Diabetes) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting. An open pilot study conducted in two primary care practices (phase one) will assess acceptability, feasibility and fidelity. Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures. A two-arm parallel group clustered pilot randomised controlled trial with patients from participating primary care practices in North East England will assess acceptability, feasibility, and fidelity of the intervention (versus usual clinical care) and trial processes over a 12-month period. Consultation behaviour involving fidelity of intervention delivery, diabetes and PA related knowledge, attitudes/beliefs, intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals. We will rehearse the collection of outcome data (with the focus on data yield and quality) for a future definitive trial, through outcome assessment at baseline, one, six and twelve months. An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care.DiscussionMovement as Medicine for Type 2 Diabetes will address an important gap in the evidence-base, that is, the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes. The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents, to the best of our knowledge, the first of its kind in the United Kingdom. This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care.Trial registrationMovement as Medicine for Type 2 Diabetes (MaMT2D) was registered with Current Controlled Trials on the 14th January 2012: ISRCTN67997502. The first primary care practice was randomised on the 5th October 2012.

Habitual Physical Activity After Total Knee Replacement

Previous studies on physical activity after total knee arthroplasty (TKA) concentrated mainly on a return to sports activities. The objectives of this study were to determine the habitual physical activity behavior of people who had undergone TKA (TKA group) 1 to 5 years after surgery and to examine to what extent they adhered to international guidelines for health-enhancing physical activity. Additional aims were to compare younger (<65 years old) and older (≥ 65 years old) people as well as men and women in the TKA group and to compare the results for the TKA group with those for a sex- and age-matched normative population (normative group). This investigation was a cohort study. All people who had a primary TKA at 1 of 2 participating hospitals between 2002 and 2006 were sent the Short Questionnaire to Assess Health-Enhancing Physical Activity at least 1 year after surgery. The TKA group spent, on average, 1,347 minutes per week on physical activity, most of which was light-intensity activity (780 minutes per week). Participants younger than 65 years of age spent significantly more time on physical activity than participants 65 years of age or older. There was no significant difference between male and female participants. Compared with the sex- and age-matched normative group, the TKA group spent significantly less time on the total amount of physical activity per week and met the guidelines for health-enhancing physical activity less often (55% versus 64%). A self-administered questionnaire was used to assess habitual physical activity, and presurgery data on physical activity were not available. Almost half of the TKA group did not meet the health-enhancing physical activity guidelines, and the TKA group was not as physically active as the normative group. People who have undergone TKA should be encouraged to be more physically active.

Development of Web-Based Computer-Tailored Advice to Promote Physical Activity Among People Older Than 50 years

BackgroundThe Active Plus project is a systematically developed theory- and evidence-based, computer-tailored intervention, which was found to be effective in changing physical activity behavior in people aged over 50 years. The process and effect outcomes of the first version of the Active Plus project were translated into an adapted intervention using the RE-AIM framework. The RE-AIM model is often used to evaluate the potential public health impact of an intervention and distinguishes five dimensions: reach, effectiveness, adoption, implementation, and maintenance.ObjectiveTo gain insight into the systematic translation of the first print-delivered version of the Active Plus project into an adapted (Web-based) follow-up project. The focus of this study was on the reach and effectiveness dimensions, since these dimensions are most influenced by the results from the original Active Plus project.MethodsWe optimized the potential reach and effect of the interventions by extending the delivery mode of the print-delivered intervention into an additional Web-based intervention. The interventions were adapted based on results of the process evaluation, analyses of effects within subgroups, and evaluation of the working mechanisms of the original intervention. We pretested the new intervention materials and the Web-based versions of the interventions. Subsequently, the new intervention conditions were implemented in a clustered randomized controlled trial.ResultsAdaptations resulted in four improved tailoring interventions: (1) a basic print-delivered intervention, (2) a basic Web-based intervention, (3) a print-delivered intervention with an additional environmental component, and (4) a Web-based version with an additional environmental component. Pretest results with participants showed that all new intervention materials had modest usability and relatively high appreciation, and that filling in an online questionnaire and performing the online tasks was not problematic. We used the pretest results to improve the usability of the different interventions. Implementation of the new interventions in a clustered randomized controlled trial showed that the print-delivered interventions had a higher response rate than the Web-based interventions. Participants of both low and high socioeconomic status were reached by both print-delivered and Web-based interventions.ConclusionsTranslation of the (process) evaluation of an effective intervention into an adapted intervention is challenging and rarely reported. We discuss several major lessons learned from our experience.Trial RegistrationNederlands Trial Register (NTR): 2297; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2297 (Archived by WebCite at http://www.webcitation.org/65TkwoESp).

Recruiting Elderly with a Migration and/or Low Socioeconomic Status in the Prevention Study OptimaHl 60plus

OptimaHl 60plus was a prevention study that included the participatory development and evaluation of an interdisciplinary counseling aid and aimed to improve the nutrition and physical activity behavior of people 60years and older. The direct involvement of this vulnerable group in prevention programs might contribute to a reduction of inequities in health. This article describes the recruitment of the elderly, especially those with low socioeconomic or migration status, to the OptimaH1 60plus study. It presents successful strategies to reach and recruit the elderly. Community partner involvement, focus groups, translated intervention material, and involving the media all facilitated recruitment. The article gives recommendations for research, practice, and policy implications.

Physical Activity Behavior of People With Multiple Sclerosis: Understanding How They Can Become More Physically Active

People with multiple sclerosis (MS) are less physically active than those without the disease. Understanding the modifiable factors that are related to physical inactivity is important for developing effective physical activity programs. The objectives of this study were to determine levels of physical activity and to determine factors related to the physical activity behavior of adults with MS by use of the Physical Activity for People With a Disability (PAD) model. The PAD model combines the International Classification of Functioning, Disability and Health framework of disability and theoretical models of physical activity behavior. This investigation was a cross-sectional study. The study participants were 106 people who had MS and who, since their definite diagnosis, had been participating in a prospective cohort study. Physical activity was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity. The independent roles of disease characteristics and demographic, cognitive-behavioral, and environmental factors were determined using questionnaires for which reliability and validity have been established. The median total level of physical activity of participants with MS (mean age=42.8 years, median Expanded Disability Status Scale score=3, disease duration=6 years) was 10.68 metabolic equivalents x h/d (interquartile range=3.69-16.57). On average, participants spent 30 h/wk on activities with metabolic equivalents of 2 or more (interquartile range=10.7-45.0 h/wk). The regression models predicting physical activity behavior on the basis of demographic (29.4%) and disease-related (28.3%) variables explained more variance than the models based on cognitive-behavioral (12.0%) and environmental (9.1%) variables. Combining significant variables yielded a final regression model that explained 37.2% of the variance in physical activity. Significant determinants were disease severity, a disability pension, and having children to care for. Changes in physical activity behavior were not measured. Participants with MS were less active if their disease was more severe, if they received a disability pension, or if they had children to care for. The PAD model was helpful in understanding the physical activity behavior of participants with MS.

Underlying mechanisms of improving physical activity behavior after rehabilitation

Regular physical activity is beneficial for the health and functioning of people with a disability. Effective components of successful physical activity promotion interventions should be identified and disseminated. To study the underlying mechanisms of the combined sport stimulation program "Rehabilitation & Sports" (R&S) and daily physical activity promotion program "Active after Rehabilitation" (AaR). Subjects in four rehabilitation centers received R&S + AaR (n = 284). Subjects in six control centers (n = 603) received usual care. Physical activity and its determinants were assessed with questionnaires at seven weeks before and nine weeks and one year after rehabilitation. Variables that were determinants of the intervention-induced improvement in physical activity behavior at both follow-up measurements were attitude, the perceived benefits "improved health and reduced risk of disease," "better feeling about oneself," and "improved fitness," and the barrier "limited environmental possibilities." The percentage change in the intervention coefficient caused by these determinants ranged from -35.3% to -16.3% and from -28.4% to -11.3% at nine weeks and one year after rehabilitation, respectively. Personalized tailored counseling interventions can improve physical activity behavior in people with a disability by targeting both personal and environmental determinants of physical activity behavior.

Physical activity consultation for people with Type 2 diabetes. Evidence and guidelines

Physical activity is an important, but often underused, therapeutic strategy within diabetes care. To date, little is known about the best way to promote physical activity in diabetes care. Physical activity consultation is an intervention designed to promote physical activity behaviour change. This article provides guidelines on how to conduct a physical activity consultation with people who have Type 2 diabetes, and reviews the evidence surrounding the effectiveness of this intervention in this population. The trans-theoretical model is the underlying theory of behaviour change for the physical activity consultation intervention. The review identifies research which supports the use of this model for understanding physical activity behaviour in people with Type 2 diabetes. The review outlines a number of modifiable variables associated with physical activity behaviour change in this population. How each of these variables is addressed within the guidelines for conducting a physical activity consultation is identified. Finally, limited but consistent research highlights the effectiveness of physical activity consultation for promoting physical activity in people with Type 2 diabetes.