Physical Activity Counseling Research Articles

The effects of physical activity tele-counseling intervention on physical activity, functional performance, and quality of life in post-COVID-19 conditions: a randomized controlled trial

ABSTRACT Background This study aims to investigate the effectiveness of tele-counseling to promote physical activity in COVID-19 survivors at the persistent phase. Methods Twenty-eight participants who suffered from COVID-19 were randomly assigned to intervention and control groups. Physical activity counseling was applied according to the transtheoretical model to the intervention group during 20 sessions. Second assessments were performed 6 weeks after the intervention. The physical activity, functional performance (4-meter gait speed; 4-MGS and 5-repetition Sit-To-Stand; STS test), exercise behavioral change and processes, quality of life, fatigue, mental health, severity of symptoms, and dyspnea were evaluated in groups. Results The baseline demographic and clinical outcomes were similar (p > 0.05) except for physical role limitations and general health perceptions in groups. Five-repetition STS, 4-MGS, activity dyspnea, step counts, sitting time, physical role limitations, Exercise Processes of Change Scale (EPCS) total, and behavioral processes scores except for self-liberation significantly improved in the counseling group. Five-repetition STS, 4-MGS improved while dramatic relief, self reevaluation, self-liberation, and EPCS total scores deteriorated in the control group. Conclusions The tele-counseling intervention contributes to improving physical activity, functional performance, behavioral change, quality of life, and decreasing common problems related to COVID-19. The results of the tele-counseling intervention are promising in post-COVID-19 conditions. Trial registration (ClinicalTrials.gov) Registration ID: NCT04853966.

Promotion of Physical Activity by Québec Primary Care Physicians: What Has Changed in the Last Decade?

This study aimed to assess the changes in the frequency of physical activity (PA) counseling and in the predictors of primary care PA promotion in Québec primary care physicians (PCPs) between 2010 and 2020. In 2010, we conducted a survey among Québec PCPs. Questions included: frequency of promoting PA to patients, perceived barriers, needs to improve PA promotion practice, frequency of PCPs' PA practice, and sociodemographic information. In 2020, we took over the 2010 questionnaire to document the evolution of the PA promotion practice. The proportion of PCPs discussing PA with their patients significantly increased (P < .05) in 2020 for the following health conditions: depression, low back pain, chronic obstructive pulmonary disease, and cancer; it declined (P < .05) for overweight patients, those with metabolic syndrome, and in primary prevention. Collaboration with PA professionals was the major need identified, and it increased in 2020. PCPs' own practice of PA was a predictor of PA promotion in 2010 (odds ratio = 6.679; P < .001) and in 2020 (odds ratio = 6.679; P < .001). In both 2010 and in 2020, older or more experienced PCPs were more likely to discuss PA with their patients without diagnosed diseases than younger ones or those with less experience. Over the last 10years, there has been a significant increase in PCPs promoting PA in Québec; however, it has been mainly oriented toward secondary prevention. It is concerning that PA counseling in primary prevention has declined, notably among younger PCPs. The stronger claim for closer collaboration with kinesiologists suggests that PCPs are in favor of an interprofessional strategy, namely collaboration with PA specialists.

The role of community pharmacists and pharmacies in physical activity promotion: an interdisciplinary e-Delphi study

BackgroundPhysical activity has a key role in the prevention and control of noncommunicable diseases. Community pharmacists are an accessible source to provide brief advice to people on how to be more physically active. Nonetheless, there is a limited understanding of stakeholders' perspectives on their role in promoting physical activity, to inform policy and practice. The present study addresses this gap.AimTo determine consensus from different health professionals on the role of pharmacists and pharmacies in brief physical activity counselling in Portugal.MethodThis cross-sectional study used a two-round e-Delphi panel. The questionnaire was organised into four domains of physical activity promotion and comprised 37 items. Interdisciplinary experts rated their level of agreement using a 5-point Likert scale. Consensus was set at the outset as 75% or more of participants scoring 4 or 5 (consensus “in”) or 1 or 2 (consensus “out”).ResultsForty-two health professionals involved in promoting physical activity in the ambulatory setting in Portugal were selected through purposive quota sampling. Eighteen out of 37 items were consensual in the first round and five more achieved consensus after the second round (62.2%). Physical activity promotion was seen as the role of all healthcare workforce and pharmacies were considered as suitable spaces for service provision, regardless of remuneration.ConclusionThis study endorses a set of roles for physical activity promotion in community pharmacy from an interdisciplinary perspective. Consensually established perspectives can inform policy making and practice, streamlining the coordination of pharmacies with the national health service.

Trends in Arthritis Prevalence and Associated Chronic Health Indicators Among Adults: Insights From the Behavioral Risk Factor Surveillance System (BRFSS) Database.

Background Arthritis is a prevalent, chronic condition with significant implications for morbidity and healthcare utilization. Understanding trends in arthritis prevalence and associated chronic health indicators is vital for informing public health interventions and healthcare policies. Objective This retrospective study aimed to analyze trends in arthritis prevalence and associated chronic health indicators among adults using data from the Behavioral Risk Factor Surveillance System (BRFSS) database. Methods This retrospective study utilized data from the BRFSS database covering 2019 to 2022. Participants included United States adults aged 18 years and older who completed BRFSS surveys during the specified period. Primary variables included arthritis prevalence and its correlation with chronic health indicators and demographics. Data collection involved standardized telephone questionnaires administered annually, with rigorous attention to data quality and consistency. Prevalence estimates were calculated using weighted proportions, and statistical analysis utilized analysis of variance (ANOVA). Results The study revealed relatively stable arthritis prevalence over the study period, with notable demographic variations. Arthritis prevalence remained stable (2019: 43.3%, 2021: 42.5%). Females consistently had higher rates than males (2019: 45%, 2021: 44.9%). Activity limitation, joint pain, and work limitation were more prevalent in arthritis patients. White, non-Hispanic individuals had higher rates than other groups. Physical inactivity increased from 2019 (29.4%) to 2022 (72.4%), particularly in males. Counseling for physical activity was lower in males. Targeted interventions are needed to address these disparities and improve arthritis management. Conclusion This study provides insights into trends in arthritis prevalence and associated chronic health indicators among United States adults. The findings underscore the importance of considering demographic factors in arthritis prevention and management strategies. Targeted interventions promoting physical activity counseling, particularly among high-risk populations, are warranted to address the rising trend of physical inactivity among individuals with arthritis.

Effectiveness of physical activity counselling and exercise prescription education among medical students: a systematic review

Background: Providing physical activity counselling and prescribing exercise increases patients’ activity and cardiorespiratory fitness, but healthcare providers experience challenges in promoting activity to patients. Implementing educational intervention during medical training may be an effective strategy to promote physical activity and exercise counselling/prescriptions. The purpose of this review was to evaluate the impact of educational interventions on medical students’ physical activity counselling and exercise prescription perceptions and practices. Methods: Systematic review procedures were registered in PROSPERO (ID# CRD42022331755) prior to conducting the study. Studies were included if they conducted an educational intervention to medical students or residents aimed at improving activity practices. Sources were searched in May of 2022 and included Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier (n = 3412 citations without duplicates). The National Institutes of Health quality assessment tools were used. Results: Fifteen interventions were included. The average quality of the included controlled trials (n = 6) and pre-post studies with no control group (n = 9) were 5.0±1.5/12 and 6.2±1.3/14, respectively. Most studies (n = 4/6) that reported the total number of medical students providing activity counselling to patients before and after receiving intervention observed improvements in exercise counselling behaviours. Eleven of twelve, and ten of eleven studies reported increases in confidence and perceptions toward various features of exercise counselling and physical activity promotion, respectively. Conclusion: Despite the heterogeneous nature of intervention designs, this review supports that relatively brief interventions using a structured lecture format incorporated into curriculum promote acute improvements in medical students’ perceptions and confidence in providing exercise counselling, albeit based on low-moderate study quality.

Racial and Ethnic Differences in the Prevalence of Patients With Arthritis and Severe Joint Pain and Who Received Provider Counseling About Physical Activity for Arthritis Among Adults Aged 18 Years or Older-United States, 2019.

This study examined the racial and ethnic differences in individuals with self-reported and doctor-diagnosed arthritis, severe joint pain, and provider counseling for physical activity among US adults with arthritis. We estimated prevalence by race and ethnicity among 31,997 adults aged ≥18 years in the 2019 National Health Interview Survey. We used multiple logistic regression models to investigate associations between outcomes and race and ethnicity. Compared with non-Hispanic White adults (22.9%), we found a significantly higher age-adjusted prevalence of arthritis among American Indian/Alaska Native adults (30.3%). Among adults with arthritis, higher age-adjusted prevalence of severe joint pain among American Indian/Alaska Native (39.1%), non-Hispanic Black (36.4%), and Hispanic adults (35.7% vs 22.5% [White]) and higher provider counseling for physical activity among non-Hispanic Black adults (58.9% vs 52.1% [White]) were observed and could not be fully explained by differences in socioeconomic factors, body mass index, depression history, and comorbid conditions. Additional models also containing inability to pay medical bills and food insecurity did not explain racial and ethnic differences. Our findings highlight a need for multilevel interventions to mitigate social and environmental barriers to physical activity and eliminate disparities in individuals with arthritis and severe joint pain.

Long-term outcomes of physical activity counseling in in-patients with major depressive disorder: results from the PACINPAT randomized controlled trial

Major depressive disorder (MDD) is an increasingly common psychiatric illness associated with a high risk of insufficient physical activity, which in turn is associated with negative mental and physical health outcomes. Theory-based, individually tailored, in-person and remote physical activity counseling has the potential to increase physical activity levels in various populations. Given this, the present study investigated the effect of such a physical activity intervention on the physical activity behavior of in-patients with MDD. This was a multi-center, two-arm randomized controlled trial including initially insufficiently physically active adult in-patients with MDD from four study sites in Switzerland. The sample consisted of 220 participants (Mage = 41 ± 12.6 years, 52% women), 113 of whom were randomized to the intervention group and 107 to the control group. The main outcome, moderate-to-vigorous physical activity (MVPA), was assessed at three time points via hip-worn accelerometer. According to accelerometer measures, there was no significant difference in minutes spent in MVPA over a 12-month intervention period when comparing the intervention with the control group (β = −1.02, 95% CI = −10.68 to 8.64). Higher baseline physical activity significantly predicted physical activity at post and follow-up. This study showed that it is feasible to deliver an individually tailored, theory-based physical activity counseling intervention to in-patients with MDD, however yielding no significant effects on accelerometer-based MVPA levels. Further efforts are warranted to identify efficacious approaches.Trial registration: ISRCTN, ISRCTN10469580, registered on 3rd September 2018, https://www.isrctn.com/ISRCTN10469580.

Mental health clients’ receptiveness to and recommendations for integrating physical activity discussions into therapy: a mixed methods study

Objective The mental health benefits of physical activity are well-established. Integrating physical activity counseling into therapy would expand the reach of this evidence-based treatment for mental illness. This mixed methods study examined mental health clients’ receptiveness and recommendations for effectively discussing physical activity in therapy. Methods A diverse sample of U.S. adults in therapy (N = 478) completed a survey that included the open-ended question: What specific recommendations would you have for your therapist to effectively discuss physical activity with you? We conducted a qualitative content analysis to identify their most common recommendations. Results Most participants indicated they would be comfortable discussing physical activity with their therapist. The content analysis resulted in 26 unique categories; most common recommendations included: provide information about what to do (n = 81), discuss physical activity benefits (n = 63), be understanding and nonjudgmental (n = 49), provide accountability (n = 41), and consider physical/mental health conditions (n = 35). Overarching themes emphasized making mental health central to discussions, tailoring discussions to each client, and reframing physical activity as a feasible, enjoyable activity. Conclusions Mental health clients are open to discussing physical activity during therapy if it is approached in a supportive, understanding, and personalized way. Clients’ recommendations can inform future professional development for therapists.

The co-development and evaluation of an e-learning course on spinal cord injury physical activity counselling: a randomized controlled trial

BackgroundHealth, fitness and lifestyle professionals can play important roles in promoting physical activity in groups at risk of developing an inactive lifestyle, such as people with spinal cord injury (SCI). Tailored counselling is a promising tool to promote and improve physical activity levels. To support professionals to effectively have a conversation about physical activity with clients with SCI, evidence-based training and resources are needed. This project aimed to (1) co-develop an e-learning course on best practices for SCI physical activity counselling and, (2) examine the effectiveness and usability of this course.MethodsGuided by the technology-enhanced learning (TEL) evaluation framework, we used a systematic, multistep approach to co-develop and evaluate an e-learning course. The development process was informed by input and feedback from a diverse group of end-users and experts (n > 160) via online surveys and (think-aloud) interviews. A randomized controlled trial was used to compare learning outcomes (post-knowledge and self-efficacy) between participants who completed the course (intervention group) and the wait-listed control group. Usability, learning experiences, and satisfaction were assessed among all participants.ResultsForty-one participants (21 intervention-group; 20 control-group) with various backgrounds (e.g., lifestyle counsellors, physiotherapists, occupational therapists, recreation therapists, fitness trainers) enrolled in the randomized controlled trial. After completing the course, participants in the intervention group showed significantly improved knowledge on the best practices for SCI physical activity counselling and higher self-efficacy for using these best practices in conversations with clients with SCI compared to the control group (p <.001). Participants reported above average usability scores, positive learning experiences, and high levels of satisfaction when completing the course.ConclusionWe used a systematic, multi-step, theory-informed approach to co-develop and evaluate an evidence-based e-learning course on SCI physical activity counselling to support professionals to promote physical activity in their daily practices. The overall positive findings demonstrate that the e-learning course is feasible and ready for further implementation in various health and community settings. Implementation of the e-learning course can help professionals improve the physical activity support they provide to their clients, and subsequently increase physical activity participation in people with SCI.

Activity counseling early postelective percutaneous coronary intervention (ACE-PCI): Mixed-methods pilot randomized controlled trial.

Physical activity(PA) levels of people with coronary heart disease are low in the first 30 days after percutaneous coronary intervention (PCI), increasing the risk of recurrent cardiac events. Following PCI, PA counseling delivered by a physiotherapist before discharge may increase the PA levels of patients. Preliminary work is required to determine the effects of the counseling session compared to usual care. To investigate the feasibility and potential efficacy of a brief physiotherapist-led PA counseling session immediately after an elective PCI compared to usual care for improved PA early post-PCI. Using concealed allocation and blinded assessments, eligible participants (n = 30) were randomized to a physiotherapist-led PA counseling session (30 min) or usual care (nurse-led PA advice < 5 min). The primary outcome was daily minutes of moderate-to-vigorous PA (accelerometry; 3 weeks). Secondary outcomes included cardiac rehabilitation intention, anxiety and depression levels (Hospital Anxiety and Depression Scale), and quality-of-life (MacNew questionnaire). Recruitment, retention, and attrition were assessed for feasibility. Semistructured interviews were conducted with 13 participants to determine intervention acceptability, and barriers and enablers to PA. Between and within-group comparisons were not significant in intention-to-treat analyses. All feasibility criteria were met except for retention and attrition of participants. At 3 weeks, only 25% of participants were planning to attend cardiac rehabilitation, with no between-group differences. Increased PA at 3 weeks was associated with participants that were younger, without other chronic disease,s and more active immediately following discharge. Interviews revealed personal, environmental, and program-based themes for barriers and enablers to PA. A physiotherapist-led PA counseling session may not improve PA levels early post-elective PCI compared to very brief PA advice delivered by nurses. A larger multicentre randomized controlled trial is feasible with minor modifications to participant follow-up. Further research is required.

EFFECTIVENESS OF AN ONLINE WELLBEING PROGRAM FOR UST CRS STUDENTS: A QUANTITATIVE STUDY

Introduction: The study aimed to determine the effectiveness of the 6-week online wellbeing program in improving the physical and mental wellbeing of University of Santo Tomas College of Rehabilitation Sciences (UST-CRS) students. Methods: This two-arm randomized trial involved 24 UST-CRS students randomly allocated into intervention and waitlist control groups. Participants were selected through purposive sampling and screened with the Physical Activity Readiness Questionnaire and Counseling Center Assessment of Psychological Symptoms. The program covered psychological and physical activities, delivered through the Wix website for six weeks. Pre- and post-assessments included the International Physical Activity Questionnaire and the World Health Organization Well-Being Index (WHO-5). Jamovie was used for descriptive and inferential statistics. Alpha level was set at 0.05. Results: Within-group analysis revealed METS total scores increased for both intervention (mean difference: 597.00) and control groups (mean difference: 275.75). Similarly, an increase in WHO-5 percentage scores (mean difference of 6.00) and control groups (difference of 6.00) was observed. Between-group analysis showed no statistically significant difference in post-test METS total scores between the intervention and control groups (p-value 0.648) and WHO-5 percentage scores (p-value 0.696). Discussion: Initial results demonstrated no significant improvements in UST CRS students' physical and mental wellbeing in the 6-week program. The small sample size may have hindered the inability to detect significant changes in the measured outcomes. However, considering the mean difference, the study suggests regular physical activity, healthy habits, and routine building may still benefit students. Research with larger sample sizes and longer intervention durations could provide more conclusive evidence of the program's impact on UST-CRS students’ well-being.

Physical activity counseling within the «KiKli Fit»-project: Development and first implementation

Introduction Increasing physical activity (PA) levels in children and adolescents with cancer holds promise for enhancing outcomes both during treatment and into survivorship (Stout et al., 2017). Despite this potential, the promotion of PA within Swiss pediatric oncology units remains largely overlooked. To address this gap, the “KiKli Fit” project has been initiated. This program features personalized training sessions during acute care, accompanied by PA counseling during the transition to the post-acute phase. Importantly, it engages not only the patients but also their families, since they play a crucial role in shaping youth’s PA behavior (Cheung et al., 2021). The PA counseling is designed to enhance motivation, volition, enjoyment, family health-climate, and ultimately, foster an active lifestyle (Schorno et al., 2022). This study aims to outline the theoretical development of the counseling approach and present initial findings from its implementation. Methods We plan a two-arm multicenter crossover-controlled trial to investigate the effects of the whole PA program. The trial will compare the PA program (intervention group in Bern, n = 40) with standard treatment (control group in Basel, n = 40). Participants will be aged 6-18, newly diagnosed with cancer and undergoing neurotoxic treatment for at least six weeks. The PA counseling comprises four sessions involving the child or adolescent and their parents. These sessions cover various topics, including parental concerns about their child performing PA, individual preferences in exercise and sports, and ways to be physically active as a whole family. Motivational interviewing techniques are applied across all sessions. The study will start in early 2024. Outcomes will be measured three times (once at admission, after twelve weeks of intervention and for follow-up after six months). Discussion The “KiKli Fit”-project is a complex program that aims to promote PA in and after acute care by combining personalized training sessions with PA counseling. The scalability of the PA counseling is a key advantage, allowing it to reach a wide demographic, including those who have completed treatment. Fostering PA in young cancer patients seems to particularly important because it can set a foundation for a healthier lifestyle as they transition into adulthood.

Behavioral physical activity counselling to promote an active healthy lifestyle among adolescent psychiatric outpatients. The TRANSPAC-study

Introduction&#x0D; Mental health disorders are one of the main reasons for disability in adolescents worldwide (Dahl et al., 2018). Sleep disturbances are an important contributor to a vicious cycle of increased vulnerability during this developmental period. Interventions that improve sleep are suggested to improve psychosocial outcomes. One such intervention may be physical activity (PA), with a beneficial effect on both sleep and mental health. Yet, PA levels are declining during adolescent years, with even higher inactivity levels for individuals with psychiatric disorders. Guidance on how to address PA counselling (PAC) among psychiatric adolescents in routine clinical practice has the potential to improve clinical and psychosocial outcomes.&#x0D; Methods&#x0D; During this ongoing randomized waitlist controlled trial, 18 adolescent psychiatric outpatients have been recruited from local clinics and private practices. Those who met inclusion criteria were aged 12 to 18 years, suffered from sleep problems, and had at least one additional mental health diagnosis. Exclusion criteria included organic sleep and brain disorders and changes in medication. At baseline, participants completed questionnaires related to sleep and psychopathology. For the next seven days, participants wore an Actigraph to track PA and sleep patterns. Participants were serially randomized into two groups after baseline: PAC or Treatment as usual (TAU). At 3-month follow-up, all tests were repeated. Additionally, a semi structured interview was conducted with intervention participants. To assess intervention effects, mixed model ANOVAs were conducted for PA, psychopathology, and composite sleep health.&#x0D; The 6-session intervention builds on previous standardized and theory-based PAC programs (Gerber et al., 2019).&#x0D; Results&#x0D; By 2023, follow-up data were available from 12 participants (Mage 15.33 yrs; 75% females). Preliminary data show a significant trend for increased PA on school days, and composite sleep health (p = .07). Yet, compliance of Actigraph wear time was low. No changes were observed for psychopathology. The post-intervention interview revealed positive experiences.&#x0D; Discussion/Conclusion&#x0D; The preliminary data show the feasibility of the intervention. It is likely that improvements in PA and sleep patterns must first stabilize before they can have a meaningful impact on psychopathology. However, more data is needed to confirm the results. The interviews revealed that the content and mode of delivery were generally accepted. Considering the many other obligations adolescents face in their everyday lives, including homework and psychotherapy, the combination of online and face-to-face sessions was well received. Because of the low compliance rate of Actigraph wear time, alternative devices should be considered for this population.&#x0D; References&#x0D; Dahl, R. E., Allen, N. B., Wilbrecht, L., &amp; Suleiman, A. B. (2018). Importance of investing in adolescence from a developmental science perspective. Nature, 554(7693), 441–450. https://doi.org/10.1038/nature25770&#x0D; Gerber, M., Beck, J., Brand, S., Cody, R., Donath, L., Eckert, A., Faude, O., Fischer, X., Hatzinger, M., Holsboer-Trachsler, E., Imboden, C., Lang, U., Mans, S., Mikoteit, T., Oswald, A., Pühse, U., Rey, S., Schreiner, A. K., Schweinfurth, N., … Zahner, L. (2019). The impact of lifestyle physical activity counselling in IN-PATients with major depressive disorders on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers: Study protocol for a randomized controlled trial. Trials, 20(1), 1–21. https://doi.org/10.1186/s13063-019-3468-3

«KiKli Fit» – The effects of a specifically designed physical activity program on cognitive and motor performance in children with cancer: A multicenter crossover trial

Introduction Children with cancer are at an increased risk for various physical and cognitive challenges due to their illness and its treatment. A concerning observation is that young cancer patients often lead sedentary or even lying lifestyles, clearly failing to meet the WHO’s recommendation of 60 minutes of moderate-to-vigorous physical activity (PA) daily. This is alarming considering that PA is essential for physical and mental health, e.g., for the development of motor skills and cognitive functions (Bull et al., 2020). However, PA promotion in acute care in Swiss pediatric oncology units is hardly existent. Therefore, the aim of this project is to develop and conduct a physical activity program in a pediatric oncology unit and investigate its effects on cognitive and motor performance. Methods Part A of this project involved a qualitative study conducted at the Inselspital Bern’s pediatric oncology unit, aiming to design a tailored PA therapy program. This part included patient interviews and staff surveys. Part B, which is ongoing, focuses on a forthcoming two-arm multicenter crossover-controlled trial. This trial will compare the exercise therapy and PA counseling (intervention group in Bern, n = 40) with standard treatment (control group in Basel, n = 40). Participants will be aged 6-18 years, newly diagnosed with cancer and undergoing cytotoxictreatment for at least six weeks. The 12-week program will consist of thrice-weekly, 45-minute sessions of individualized exercise, aligned with the SK2-guidelines, NAOK, and international Pediatric Oncology Exercise Guidelines (Götte et al., 2022; Wurz et al., 2021). The sessions will focus on motor skills and cognitively challenging PA. In addition, children will receive 4 exercise counseling sessions. To evaluate the study, there will be three measurement points (once at admission, after twelve weeks of intervention and one follow-up after six months). The outcome measures include motor and cognitive performance, physiological and psychosocial functioning. Results Initial findings from the qualitative study indicate a strong patient and staff interest in exercise therapy. The study also provided valuable insights for developing and implementing the intervention. Discussion/conclusion The results will reveal important insights relevant to research and practice. Adopting a research perspective, the results will shed light on the effects of PA on cognitive performance in acute cancer care. Adopting a more applied perspective, PA has been neglected in Swiss pediatric oncology units so far. Therefore, this study may contribute to proof the effectiveness of PA for childhood cancer patients and thus help implementing it in standard care in the long term.

Fostering positive affective exercise experiences and affect-related competencies for a physically active lifestyle: The FEEL project

Introduction&#x0D; Interventions targeting physical inactive individuals have not yielded sufficient impact yet. This may be attributed to two reasons: Firstly, affective processes during physical activity (PA) are often inadequately acknowledged (e. g. shame, feeling bad; Hohberg et al. 2022). Secondly, individuals are often not empowered to PA that positively influences affective wellbeing and mental health (Sudeck &amp; Pfeifer, 2016). The FEEL project addresses these two deficiencies by developing a program promoting pleasant experiences, affect regulation competence, wellbeing and consequently PA.&#x0D; The program is grounded in Ekkekakis et al.’s (2021) conceptual framework on affective exercise experiences and their antecedent appraisals. It consists of [a] an instructor workshop focused on creating an inclusive, socially supportive atmosphere. Additionally, the program features [b] group exercise sessions covering topics such as attentional focus, preferred intensity, and flexible goal setting. Experiential learning is employed during these sessions, encouraging participants to engage not only physically but also to reflect on and in action. Finally, the program incorporates [c] a PA counseling session, during which participants individual motives for exercise are assessed, and suitable activities are discussed (Schorno et al., 2022).&#x0D; Methods&#x0D; We plan a multicenter randomized controlled trial to investigate the impact of the 6-8 week FEEL program. Inactive individuals (meeting less than 75% of recommended PA guidelines) in the age of 16 to 35 will take part in the study. Participants will be recruited via schools, universities, companies, and social work institutions. Around 300 people will be assigned to either the intervention or control group. The control group will undergo a standard fitness program (usual care). The primary outcomes positive affective exercise experiences, affect regulation competence, wellbeing and PA will be measured pre- (0 weeks), post-intervention (6 weeks) and at follow-up (12 weeks). After piloting the FEEL program in April 2024, the main study will start in fall 2024.&#x0D; Discussion&#x0D; This study explores the impact of a multifaceted intervention in a primary care context. It may provide valuable insights for effective considerations of affective processes and related competencies in PA programs. Should the FEEL program showcase positive effects, there may be interest in extending its implementation in diverse settings (e.g., rehabilitation).&#x0D; References&#x0D; Ekkekakis, P., Zenko, Z., &amp; Vazou, S. (2021). Do you find exercise pleasant or unpleasant? The Affective Exercise Experiences (AFFEXX) questionnaire. Psychology of Sport and Exercise, 55, Article 101930. https://doi.org/10.1016/j.psychsport.2021.101930&#x0D; Hohberg, V., Kreppke, J.‑N., Cody, R., Guthold, R., Woods, C., Brand, R., Dunton, G., Rothman, A., Ketelhut, S., &amp; Nigg, C. (2022). What is needed to promote physical activity? Current Issues in Sport Science, 7, Article 005 https://doi.org/10.36950/2022ciss005&#x0D; Schorno, N., Gut, V., Conzelmann, A., &amp; Schmid, J. (2022). Effectiveness of individual exercise and sport counseling based on motives and goals: A randomized controlled trial. Journal of Sport and Exercise Psychology, 44(2), 103-115. https://doi.org/10.1123/jsep.2021-0018&#x0D; Sudeck, G., &amp; Pfeifer, K. (2016). Physical activity-related health competence as an integrative objective in exercise therapy and health sports – Conception and validation of a short questionnaire. Sportwissenschaft, 46, 74–87. https://doi.org/10.1007/s12662-016-0405-4

Koroner Arter Bypass Greft Cerrahisi Sonrası Fiziksel Aktivite Danışmanlığının Erken Dönem Sonuçlarının İncelenmesi

Objective: Physical inactivity, an important risk factor for coronary artery disease, should be increased after coronary artery bypass graft (CABG) surgery. The aim of this study was to examine the effects of early physical acitivity (PA) counseling in CABG patients. &#x0D; Material and Method: Thirty male patients included in the study were randomly divided into two groups. Fifteen patients received PA counseling and routine physiotherapy, while the others received only standard physiotherapy. PA, exercise capacity, daily living activities, sleep quality, depression, and anxiety were assessed before and two weeks after surgery. All patients received an activity monitor (MF-SenseWear Armband) upon discharge for PA and energy expenditure evaluation. Energy expenditure, average MET, PA duration, laying and sleeping time, and daily steps were monitored for seven days after discharge. &#x0D; Results: The 6-minute walking distance decreased from 507.87±77.70 m to 470.46±69.83 m in the PA group (p=0.001) and from 499.80±82.93 m to 448.00±64.25 m in the control group (p=0.002), but the difference was not significant (p=0.610). PA counseling did not significantly affect total energy expenditure (8516.10±1489.75 vs. 8568.75±999.68 joules, p=0.910), active energy expenditure (307.43 joules (min 13.57- max 3300.57) vs. 303.68 joules (min 30.71-max 11.68), p=0.412), mean metabolic equivalent (1.30±0.16 vs 1.17±0.17, p=0.057), PA duration (16.57 minutes (min 0.71-max 180) vs 16.85 minutes (min 3.57-max 58.71), p=0.367), the number of steps (723.86 steps (min 198.57-max 5944.14) vs 796.28 (min73.86-max 4217.86), p=1.000). &#x0D; Conclusion: Our PA counseling did not improve PA and clinical outcomes after CABG surgery more than conventional treatment. Longer follow-ups are needed to demonstrate efficacy.

Physical activity counselling in general practice

Zusammenfassung Hintergrund Regelmäßige Bewegung ist wirksam in der Primär- und Sekundärprävention nicht übertragbarer Krankheiten. Allerdings bewegen sich die meisten Menschen deutlich zu wenig. Fast alle aktuellen Behandlungsleitlinien empfehlen, Patient:innen zu Bewegung zu beraten und zu motivieren. Wie kann solche Beratung wirksam und effizient in der Hausarztpraxis umgesetzt werden? Ziele der Arbeit Übersichtliche Darstellung der Relevanz des Themas, von Studien und Empfehlungen zur Umsetzung und Wirksamkeit hausärztlicher Beratung zu Bewegung sowie Ziehen von Schlussfolgerungen für die hausärztliche Praxis und Forschung. Material und Methoden Nichtsystematische Zusammenfassung wissenschaftlicher und nichtwissenschaftlicher Literatur zum Thema. Ergebnisse Hausärztliche Beratung zu Bewegung kann nachweislich einen Anstoß geben, um Patient:innen zur Bewegungssteigerung zu motivieren. Sie kann als Kurzberatung durchgeführt werden und ist v. a. wirksam, wenn sie ein Unterstützungsangebot, konkrete und für die Patient:innen umsetzbare Empfehlungen sowie fokussierte Folgekontakte enthält. Studien zeigen oft strukturelle Barrieren auf, die der Umsetzung entsprechender Beratung entgegenstehen. Diese Barrieren stellen für die hausärztliche Versorgung relevante Forschungsthemen dar. Schlussfolgerung Mit dem Angebot kurzer Beratung zu Bewegung können Hausärzt:innen einen wichtigen Beitrag zur Reduktion der Krankheitslast durch chronische Krankheiten leisten. Daher sollten wirksame Strategien zur Stärkung der hausärztlich initiierten Bewegungsförderung entwickelt werden. Relevante Ansatzpunkte sind neben der Verbesserung der strukturellen Voraussetzungen auch der Ausbau praktischer Fertigkeiten und des Vertrauens in wirksame Bewegungsberatung seitens der Ärzt:innen.

A Review of Educational Interventions on Physicians’ Exercise Counseling and Prescription Practices

ABSTRACT Context Physicians report various barriers to providing patients with physical activity (PA) counseling and prescriptions. Implementing educational interventions among physicians could be an effective method for the promotion of PA counseling in primary care. Objective The purpose of this study was to review the impact and efficacy of different educational intervention modalities on physicians’ PA promotion outcomes. Design Twenty-one articles were included in this systematic review and were of moderate quality (6.8 ± 3.3 of 14 controlled trials and 6.3 ± 2.3 of 12 uncontrolled trials), assessed via the National Institutes of Health quality assessment tools. Studies ranged in sample size from 9 to 12,945 participants (n = 16,283). Eligibility Criteria For inclusion, studies had to have had interventional experimental design and performed an educational intervention aiming to improve PA counseling or exercise prescription practice, and most of the sample comprised physicians. Study Selection Sources were searched in May 2022 (n = 3422 citations without duplicates) via Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier (Prospero ID: CRD42022331755). Main Outcome Measures Physician PA practice outcomes across studies were categorized in terms of frequency of counseling and prescription, knowledge, and confidence. Results Most studies measuring PA counseling (8 of 13 studies) and prescription practices (8 of 10 studies) exhibited an increased frequency of PA prescription before and after the intervention. Physician confidence surrounding PA increased in most studies (10 of 12 studies), as well as knowledge of PA (6 of 7 studies). Conclusions Studies that were most effective in increasing physician PA promotion outcomes incorporated a practical component (i.e., hands-on) in addition to a theoretical session (i.e., lecture-based) to meet specific goals (e.g., accredited PA guidelines, prescription strategies). This review outlines the strengths and weaknesses of present educational intervention modalities and provides insight into future directions for education models to promote PA counseling and exercise prescription practices among physicians.

Characteristics and counseling strategies for physical activity used by primary health care professionals.

This study aim to describe the characteristics and strategies of counseling for physical activity used by Primary Health Care (PHC) professionals. A survey was carried out with 587 (85.4% women) health professionals who work in PHC in Florianopolis, in the state of Santa Catarina, southern Brazil. Counseling carried out in the last 12 months was considered. Operational aspects related to counseling practices and strategies used for counseling were evaluated. The frequency of physical activity guidance was 86.2% (95%CI = 83.2-88.8%). Counseling was characterized as a brief practice, carried out in individual consultations, aimed at adults and the older adults and people with morbidities. The most used strategy was to guide users to participate in physical activity groups at the Health Center (89.5%) and in relation to the 5As method, giving some "advice" was the most used strategy (99.0%) and the least used. used was to follow strategies (22.6%). Counseling for physical activity has been based on a brief practice, carried out in individual consultations and focused on people with morbidities and on adults and the elderly. The strategies used do not seem to cover the full care of the advised users.

Características e estratégias de aconselhamento para atividade física utilizadas por profissionais da atenção primária à saúde

Abstract This study aim to describe the characteristics and strategies of counseling for physical activity used by Primary Health Care (PHC) professionals. A survey was carried out with 587 (85.4% women) health professionals who work in PHC in Florianopolis, in the state of Santa Catarina, southern Brazil. Counseling carried out in the last 12 months was considered. Operational aspects related to counseling practices and strategies used for counseling were evaluated. The frequency of physical activity guidance was 86.2% (95%CI = 83.2-88.8%). Counseling was characterized as a brief practice, carried out in individual consultations, aimed at adults and the older adults and people with morbidities. The most used strategy was to guide users to participate in physical activity groups at the Health Center (89.5%) and in relation to the 5As method, giving some “advice” was the most used strategy (99.0%) and the least used. used was to follow strategies (22.6%). Counseling for physical activity has been based on a brief practice, carried out in individual consultations and focused on people with morbidities and on adults and the elderly. The strategies used do not seem to cover the full care of the advised users.