Physical Activity In Patients Research Articles

Efektivitas Latihan Aerobic dan Isometric Berbasis Home-Based Exercise pada Pasien Congestive Heart Failure

This study aims to systematically review several kinds of literature that discuss the impact of training or physical activity of patients with Congestive Heart Failure (CHF) in lowering blood pressure in hypertensive patients. The method used is a systematic review by studying journal literature on the Scopus, CINAHL, Pubmed, ScienceDirect and SAGE Journals databases. The results showed that exercise could be done at home by the patient independently to support pharmacological treatment therapy in the cardiovascular system. The therapy can change the patient's behavior from maladaptive to adaptive. Treatment modalities can be given to patients with cardiovascular disorders: hypertension, namely cardiac exercise because cardiac exercise is an easy, light activity, can be done continuously and reduces the effects of pharmacological use. In conclusion, cardiovascular modality therapy is a home-based exercise program that can be given to patients with heart and blood flow disorders. Therapy that is run regularly can affect lowering blood pressure. 
 Keywords: Aerobic, Hypertension, Exercise Program, Blood Pressure, Therapy

Abstract 14974: Diabetic Cardiomyopathy is Associated With Worsening of Quality of Life Long Before the Development of Overt Heart Failure: Lessons From the Baseline Analysis of the Arise-Hf Study

Introduction: Diabetic Cardiomyopathy (DbCM) is a form of HF occurring in the absence of other causes of cardiac dysfunction such as hypertension, CAD, or valvular diseases in individuals with diabetes. The ARISE-HF study is designed to investigate the efficacy of AT-001, a novel aldose reductase inhibitor, in preventing the worsening of functional capacity in patients with DbCM. Hypothesis: The impact of DbCM on quality of life is greater than previously recognized, as patients with DbCM often adopt lifestyle changes to mitigate the impact of early symptoms. The hypothesis of the present study is that avoidance of physical activities in patients with DbCM may mask the clinical presentation of structural and functional myocardial changes that have occurred. Methods: The objective of the study was to investigate the physical activity levels in individuals with DbCM. We included patients with T2DM, age ≥60 years (or age ≥40 to <60 years with duration of diabetes ≥10 years or eGFR <60 mL/min/1.73 m 2 ), LVEF ≥45% in the presence of either elevated NTproBNP levels or elevated hs-cTn or echocardiographic abnormalities. Patients enrolled in the study had an impaired functional capacity measured as peak VO 2 < 75% of predicted normal. Patients completed the Physical Activity Scale (PASE) questionnaire, a validated test designed to measure the amount of physical activity carried out during the prior week. Exclusion criteria included prior diagnosis of overt HF, history of CVD leading to cardiac dysfunction, elevated BP levels, and uncontrolled 2TDM (HbA1c>8.5%). Results: We evaluated 363 patients (mean age 67.5 + 7.1 years, 47% female, BMI 30.3 + 4.6, NTproBNP 113.4 + 252.7 pg/mL, and HbA1c 7.0 + 0.8%) with diagnosis of DbCM. PASE score (mean 157.9 + 94) was indicative of reduced physical activity and was associated (p<0.001) with peak VO 2 uptake (r= 0.31), underscoring the relationship between functional capacity and physical activity level. Conclusions: DbCM is a form of HF leading to decreased cardiac functional capacity. Many patients with DbCM have reduced their daily physical activities to mitigate the presentation of symptoms of fatigue; however, their quality of life is significantly affected by the disease even before the progression to overt HF.

Impact of COVID-19 Pandemic on Health-Related Quality of Life and Physical Activity of Patients in Hemodialysis.

Chronic dialysis patients have an increased risk of severe COVID-19 infection-related complications. The aim of this study was to quantify the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and physical activity levels of patients undertaking hemodialysis (HD). This was an observational study that compared data from two periods of time, before the COVID-19 pandemic vs pandemic. We used the Medical Outcomes Survey Short Form (SF-36) to measure the HRQoL and the Human Activity Profile (HAP) questionnaire was used to measure the physical activity. Data were analyzed with a mixed ordinal linear regression. A total of 27 eligible participants were interviewed during COVID-19 pandemic (median age 78 years). The linear regression model showed that the pandemic, after controlling for the covariates age, comorbidity, albumin, and hemoglobin, had a significant impact on the HRQoL. Physical function (-15.7) and social functioning subscales (-28.0) worsened (p = 0.001), and the physical component scale also showed a significant decrease (-3.6; p = 0.05). Time had a significant impact on the Human Activity Profile, with an average activity score diminished with the pandemic (-13.9; p = 0.003). The COVID-19 pandemic had a very negative impact on HRQoL and physical activity level of subjects undertaking hemodialysis. Interventions to improve HRQoL and activity levels of patients undertaking HD are recommended.

Physical activity for obstructive sleep apnea after stroke? A pilot study assessing the contribution of body fluids.

Obstructive sleep apnea (OSA) and physical inactivity are common after stroke. Physical inactivity can lead to/or exacerbate edema following stroke, and the resultant overnight fluid shift may increase the risk of OSA. We aimed to investigate the effect of physical activity on nocturnal rostral fluid shift, sleep pattern, and edematous state of hemiparetic patients. Neck circumference (tape measured) and arms, legs, and trunk fluid volume (bioelectrical impedance spectrum analyzer) were measured before and after 2 polysomnography (PSG) examinations. In the lab, a whole night PSG was performed after the intervention. The intervention consisted of inactivity (lying down and sitting) or activity (standing, performing calf muscle contractions while standing, walking, and climbing stairs) between 13 and 21 h, after therandomization of the participants. With a 7-day interval, participants crossed over to the other group. From 126 eligible participants, 8 with hemiparetic post-first-ever ischemic stroke at the subacute phase were recruited (age: 53.2 ± 16.2; 6 women). Physical activity reduced AHI from 19 to 13n°/h and wake after sleep onset from 76.5 to 60.3 min and increased fluid volume of paretic and non-paretic arms and trunk before sleep compared to inactivity. An acute bout of physical activity reduced OSA classification based on AHI (from moderate to mild) and sleep fragmentation. Our results provide preliminary evidence of a possible link between physical activity in patients after stroke as an intervention to counteract OSA severity and improve sleep.

Improving Daily Physical Activity in Patients Undergoing Hemodialysis Using Plantar Electrical Nerve Stimulation: A Randomized Double-Blinded Controlled Trial

Improving Daily Physical Activity in Patients Undergoing Hemodialysis Using Plantar Electrical Nerve Stimulation: A Randomized Double-Blinded Controlled Trial

Prognostic significance of remotely monitored nocturnal heart rate in heart failure patients with reduced ejection fraction

Elevated resting heart rate is a risk factor for cardiovascular events. The purpose of this study was to investigate the clinical significance of nocturnal heart rate (nHR) and 24-hour mean heart rate (24h-HR) obtained by continuous remote monitoring (RM) of implantable devices. We analyzed daily-sampled trends of nHR, 24h-HR, and physical activity in patients on β-blocker therapy for chronic heart failure and with implantable cardioverter-defibrillators or cardiac resynchronization therapy defibrillators (CRT-Ds). Patients were grouped by average nHR and 24h-HR quartile during follow-up to estimate the respective incidence of nonarrhythmic death and device-treated ventricular tachycardia/fibrillation (VT/VF). The study cohort included 1330 patients (median age 69 years [interquartile range 61-77 years]; 41% [n = 550] with CRT-D; median follow-up 25 months [interquartile range 13-42 months]). Compared with patients in the lowest nHR quartile (≤57 beats/min) group, patients in the highest quartile group (>65 beats/min) had an increased risk of nonarrhythmic death (adjusted hazard ratio [AHR] 2.25; 95% confidence interval [CI] 1.13-4.50; P= .021) and VT/VF (AHR 1.98; 95% CI 1.40-2.79; P < .001) and were characterized by the lowest level of physical activity (P≤.0004 vs every other nHR quartiles). The highest 24h-HR quartile group (>75 beats/min) showed an increased risk of VT/VF (AHR 2.13; 95% CI 1.52-2.99; P< .001) and a weaker though significant association with nonarrhythmic mortality (AHR 1.80; 95% CI 1.00-3.22; P= .05) as compared with the lowest 24h-HR quartile group (≤65 beats/min). In remotely monitored patients with implantable cardioverter-defibrillator/CRT-D on β-blocker therapy for heart failure, elevated heart rates (nHR >65 beats/min and 24h-HR >75 beats/min) were associated with increased mortality and VT/VF risk. nHR showed a stronger association than 24h-HR with worst prognosis and lowest physical activity.

123 LEVELS OF PHYSICAL PERFORMANCE AND PHYSICAL ACTIVITY IN OLDER ATTENDEES AT A BONE HEALTH CLINIC

Abstract Background Osteoporosis and sarcopenia are two common conditions seen in community-dwelling older adults. Limited information on physical performance and activity exists in older adults at risk of osteo-sarcopenia. The aim of this study was to examine levels of physical performance and physical activity in patients attending a bone health clinic. Methods A cross-sectional study was conducted. Community-dwelling older adults attending a bone health clinic in an acute Irish hospital were invited to participate. Primary outcome measures for physical performance and activity were: grip strength, the Short Physical Performance Battery (SPPB), the Timed Up and Go test (TUG) and the International Physical Activity Questionnaire (IPAQ). Secondary outcomes included: Bone Mineral Density T-scores, diagnosis of probable sarcopenia, osteo-sarcopenia, frailty, fractures and falls history. Results 104 participants took part in the study. Median age was 76 (IQR 12), ranging from 65 to 91 years. Females accounted for the majority (88.5%) of recruited participants. Osteoporosis was present in 63% and osteopenia in 31%. Low physical activity levels were identified in 29%. Probable sarcopenia ranged from 17 to 37%. Osteo-sarcopenia was identified in 9 to 33% depending on four possible definitions. The most common associations with osteo-sarcopenia were frailty (CFS) and low BMI. Using reduced multivariate regression analysis, physical performance (grip strength, SPPB, TUG) and physical activity (IPAQ) were negatively associated with increased age, comorbidities, frailty and falls. Increased age was associated with all four variables analysed. Comorbidities was associated with grip strength (p=0.005), SPPB (p=0.01), TUG (p=0.041). Frailty (CFS) was associated with SPPB (p&amp;lt; .001), TUG (p&amp;lt; .001), and IPAQ (p&amp;lt; .001). Fall(s) history was associated with SPPB (p&amp;lt; .001) and TUG (p=0.028). Conclusion A high proportion of participants were classified as having osteoporosis, probable sarcopenia and osteo-sarcopenia. Completing physical performance and activity measures could provide useful information to clinicians about patients and their potential risks/deficits.

Physical activity, self-efficacy and quality of life in patients with chronic pain, assessed during and 1 year after physiotherapy rehabilitation – a prospective follow-up study

Purpose The aim of this prospective cohort study was to evaluate the level of physical activity, self-efficacy and health-related quality of life in patients with chronic pain, at baseline and one year after physiotherapy rehabilitation at a specialist pain clinic. Materials and methods All patients who underwent rehabilitation at the physiotherapy unit at the Pain Centre at Sahlgrenska University Hospital/Östra in Gothenburg during a nine-month period were asked to participate in the study. The participants were evaluated regarding self-efficacy, health-related quality of life (HRQoL) and physical activity during physiotherapy treatment and one year later. Physical activity was measured both subjectively (self-reported physical activity) and objectively (accelerometer). Results Out of 42 patients who participated in the baseline evaluation, 28 (19 women and nine men) were included in the one-year follow-up. The patients had increased levels of vigorous physical activity at one-year follow-up, without deterioration of pain. There were no significant changes regarding self-efficacy and HRQoL. Levels of physical activity and perceived physical function may be associated to levels of physical activity 1 year after rehabilitation. Conclusion Patients with chronic pain can increase their level of vigorous physical activity after a period of rehabilitation without deterioration of pain. IMPLICATIONS FOR REHABILIATION Physical activity is an important part of rehabilitation for chronic pain patients, but many patients expect more pain after exercise, which they fear may affect performance and maintenance of physical activity. Patients with chronic pain at a specialist clinic increased their level of vigorous physical activity one year after physiotherapist led rehabilitation without deterioration of pain. Levels of physical activity and perceived physical function during rehabilitation may predict levels of physical activity 1 year after rehabilitation. Physiotherapist led rehabilitation seems to be beneficial for long-term improved physical activity in patients with chronic pain

Exergaming in patients with a left ventricular assist device: a feasibility study.

Exercise games (exergames) have been recently proposed as a mode of facilitating physical activity in patients with chronic diseases. Although patients supported with left ventricular assist devices (LVADs) benefit from physical activity, specific LVAD-related issues hinder their ability to exercise properly. The objective of this study was to assess the feasibility and safety of exergaming in LVAD-supported patients. Eleven LVAD-supported patients were enrolled in a 4week exergaming programme using Nintendo Wii console with five sport games. Patients were instructed to play for 30min a day, 5days a week. Data on exercise capacity and exergaming were collected by using the 6min walk test (6MWT) and a daily self-report diary, respectively. Feasibility of using the console and its safety was assessed by a semi-structured patient interview. Quality of life was assessed by the Minnesota Living with Heart failure Questionnaire (MLHFQ) and the Cantril's Ladder of Life. Safety was assessed by patient's report in interview and diary. The study group consisted of 10 male patients and 1 female patient, mean age of 67±7years, of whom 10 were supported with the HeartMate 3 LVAD for a median of 10 (interquartile range 3, 21) months. Baseline exercise capacity assessed by the 6MWT ranged from 240 to 570m (mean 448±112). After 4weeks of exergaming, 6MWT distance increased from a mean of 448±112 (evaluated in six patients) to 472±113m (P=0.023). Patients' Cantril's Ladder of Life score improved numerically from an average of 6.13 to 7.67, as did their MLHFQ score from 45.9±27 to 38.7±18, with higher and lower scores, respectively, reflecting higher quality of life. No specific LVAD-related safety issues regarding exergaming were reported. Exergaming was found to be a safe and feasible mode for encouraging physical activity in LVAD-supported patients and carries a potential for improving exercise capacity and quality of life in these patients. Larger scale studies are warranted to further investigate the effect of exergaming in this patient population.

Non-emergent Conditions of the Ankle, Hindfoot, and Midfoot in Elderly Patients Are as Mobility Limiting as Congestive Heart Failure.

Mobility limitations are well linked to increased morbidity and mortality. Older patients with chronic pathologies of the foot and ankle can suffer from significant mobility limitations; however, the magnitude of limitation experienced by this cohort is not well characterized. Conversely, the effects of congestive heart failure (CHF) on patient mobility are routinely assessed via the New York Heart Association (NYHA) classification. New York Heart Association classification is determined by a patient's physical activity limitation and is strongly correlated to functional status. We hypothesized that non-emergent conditions of the foot and ankle would be as mobility limiting as CHF. Life-Space Mobility Assessments (LSAs) were prospectively collected from orthopaedic patients at their preoperative visits and from CHF patients at a cardiology clinic. Patients over the age of 50 years were included in this study. Congestive heart failure patients NYHA class II or greater were included. The non-emergent foot and ankle cohort included Achilles tendonitis, ankle joint cartilage defects, ankle arthritis, subtalar arthritis, and midfoot arthritis. Patient demographics and LSA scores were analyzed using Mann-Whitney U and chi-squared tests. A total of 96 elderly, non-emergent foot and ankle operative patients and 45 CHF patients met inclusion criteria. All medical comorbidities, except smoking status, were significantly more prevalent in the CHF cohort. No statistical difference was observed between CHF and preoperative foot and ankle LSA scores (56.1 vs 62.4, P = .320). Life-Space Mobility Assessment scores in the foot and ankle cohort were significantly improved relative to CHF patients, at 6-month and 1-year postoperative visits (P = .028, P < .0001, respectively). Non-emergent ankle, hindfoot, and midfoot pathology is associated with similar mobility limitation to that of NYHA class II and III CHF. Older patients undergoing elective foot and ankle procedures exceeded the mobility of CHF patients at 6 months post-operation, and the mobility gains persisted at 1-year post-operation. Level II: Prospective cohort study.

Enhancing patient self-management after a first stroke: An application of the wearable devices and the health management platform

BackgroundPost-stroke disability restricts a patient's physical activity, affects the patient's quality of life, and leads to higher medical costs. Therefore, it is essential to promote patients' continuous exercise during this period of recovery. ObjectiveThis study aimed to verify the effectiveness of applying a health management platform combined with wearable devices to enhance stroke patients’ self-management of recovery and to allow comparisons with active care intervention management. MethodThis quasi-experimental study aimed at examining those participants who had sustained a stroke for the first time. A 90-day experiment was implemented with the intervention of monitoring and active care from the researchers who also interviewed the selected participants at the end of the study. A total of 26 participants were examined (14 in the experimental group and 12 in the control group). ResultThe participants in the experimental group made significant progress between the pre- and post-tests. Firstly, their six-minute walking distance improved by 89.5 m (p < 0.001). Secondly, their sit-to-stand transfers in 60 s improved 2.85 times (p = 0.017), and their Berg balance test improved by 6.36 points (p = 0.003). Finally, the Partners in Health scale (PIH) scores also improved. According to the data collected in the interviews, the researchers' intervention improved the patients’ self-management ability. ConclusionThe short-term physical performance in the experimental group after the intervention was better than that in the control group. In clinical practice, it is suggested that continuous interaction between medical staff and patients be sustained while applying wearable devices to promote the patient's self-management ability.

Patient-Reported Quality of Life, Depression, Anxiety, and Physical Activity in Patients Receiving an Implantable Cardioverter-Defibrillator for Primary versus Secondary Prevention: A Single-Centre, Prospective, Observational Cohort Study.

Study objectives: The aim of the study was to evaluate of the quality of life, depression, anxiety levels, and physical activity in the groups after the implantation of an ICD or CRT-D. Methods: All subjects (111 CHF patients) underwent tests to assess the quality of life (NHP), the level of physical activity (IPAQ), the level of perceived stress (PSS), and the incidence of depression (BDI). Results: After the implantation, physical activity (PA) of the patients from the primary prevention (PP) group remains unchanged, whereas in the secondary prevention (SP) group, it decreases noticeably. Physical activity is lower in the SP group in comparison with the PP group. There are no statistically significant differences in the level of depression. The scores in the second part of the NHP questionnaire indicate that the SP group significantly more often declare problems with housework and with social life than the PP group. Conclusions: 1. The type of prevention does not have an influence on the level of anxiety, stress, or depression. 2. The patients after implantation as SP are physically less active; lower PA is associated additionally with the higher NYHA class and chronic kidney disease. 3. The quality of life of the patients from SP group is at a lower level than patients from PP group.

The Influence of Diet and Physical Activity on Oxidative Stress in Romanian Females with Osteoarthritis.

Osteoarthritis (OA) is the most prevalent chronic joint disease, increases in prevalence with age, and affects most individuals over 65. The present study aimed to assess the oxidative status in relation to diet and physical activity in patients with OA. We used a cross-sectional study applied to 98 females with OA. Blood samples were collected to determine oxidative stress markers: malonyl dialdehyde (MDA), reduced glutathione (GSH), oxidized glutathione (GSSG), and GSH/GSSG. Diet was estimated with a standardized food frequency questionnaire. We used the International Physical Activity Questionnaire (IPAQ) to assess the females’ physical activity. Multiple regression analyses were executed to determine the association between the oxidative markers and the intake of vegetables and fruit. The study showed that most patients were overweight or obese (88.8%). The level of physical activity was above the recommended level for adults, mainly based on household activities. The intake of vegetables and fruit was low. The MDA marker was inversely, statistically significantly associated with the consumption of vegetables (p < 0.05). Public health policies must address modifiable risk factors to reduce energy intake and obesity and increase the intake of vegetables and fruit. Higher consumption of vegetables and fruit may provide natural antioxidants that can balance oxidative compounds.

Maintenance effects of a gamification intervention on motivation and physical activity in patients with coronary heart disease: intermediate results of a randomized controlled trial

Abstract Background Despite the benefits of cardiac rehabilitation and secondary prevention, patients with coronary heart disease frequently fail to meet their daily physical activity goals. When one is stuck in a cycle of bad habits, changing one's behavior can be very challenging. One of the difficulties to maintaining a healthy lifestyle may be a lack of motivation. The use of game design elements (such as points, leaderboards, progress bars, and badges) in non-game contexts to promote motivation and engagement is known as gamification. It could be a powerful tool for encouraging patients to engage in physical activity. However, solid ideas that utilize the fundamental experience and psychological impacts of gaming mechanics must be built upon. Purpose The aim of this study is to look into the impact of a smartphone-based gamification intervention on physical activity engagement and other related psychological outcomes in patients with coronary heart disease, as well as the 24-week maintenance of effects beyond the 12-week intervention. Methods Participants with coronary heart disease were randomly assigned to three groups (control group, individual group and team group). The individual and team groups received gamified behavior intervention based on behavioral economic principles. Based on the Individual group, the team earned social incentives (collaboration). The intervention lasted 12 weeks, with another 12 weeks of follow-up. The primary outcomes included the change in daily steps and the proportion of patient-days that step goals achieved. The secondary outcomes included competence, autonomous, relatedness and autonomous motivation. Results The follow-up period has now been completed by 65 participants (mean age 52.8+10.3, 18.2% female) completed the follow-up period. Compared with the control group (n=17), participants in the individual group (n=25) had a significantly greater increase in mean daily steps from baseline during the intervention group (difference 956; 95% CI, 243–1623; P&amp;lt;0.01), and had a significantly greater proportion of patient-days that step goals achieved (difference 0.35; 95% CI, 0.03–0.12; P&amp;lt;0.001), competence (difference 0.5, 95% CI, 0.3–0.7; P&amp;lt;0.001), autonomous motivation (difference 3.2; 95% CI, 2.0–4.0; P&amp;lt;0.001). However, no significant difference of change in step counts was found between team group (n=23) and control group. During the follow-up period, mean daily steps and autonomous motivation in the individual declined but remained significantly greater than that in the control arm compared with baseline (steps: difference 452; 95% CI, 138–818; P&amp;lt;0.05) (motivation: difference 1.2; 95% CI, 0.3–1.8; P&amp;lt;0.05). Conclusions A smartphone-based gamification intervention was found to be an effective strategy to enhance motivation and physical activity engagement, as well as having a great maintenance effect. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work is financially supported by a Construction Programme of Independent Innovation Ability of Community Health Nursing Engineering Laboratory in Jilin Province (Study code: 2020C038-8) awarded to FL.

THE RELATIONSHIP OF PAIN LEVEL AND THE QUALITY OF PHYSICAL ACTIVITY IN PATIENTS OF KNEE OSTEOARTHRITIS

Background: Osteoarthritis is the most common disease of arthritis that often occurs in the hands, hips, and knees. OA results in degeneration of the joints and causes pain. OA accounts for 7% or approximately 500 million people worldwide in the global population. The prevalence of OA in Indonesia is relatively high, namely 15.5% in men and 12.7% in women. Complaints that are very often complained of by OA patients are pain when doing various daily activities. Pain felt by OA sufferers can affect the quality of physical activity in OA patients. Objective: This study aims to determine the relationship between pain level and the quality of physical activity in patients with osteoarthritis of the knee joint at PHC Surabaya Hospital. Methods: This study used an observational analytic study carried out with a cross-sectional approach. The sampling technique used was non-probability sampling, purposive sampling with respondents who met the inclusion and exclusion criteria. The population used in osteoarthritis sufferers at PHC Surabaya Hospital with 76 respondents. The measuring instrument used to measure pain is the Numerical Rating Scale (NRS), and the questionnaire used to assess the quality of physical activity is the WOMAC questionnaire. Results: The results of this study obtained a p-value 0.000 (p&lt;0.005) and r = 0.922, which indicates that there is a significant relationship between the level of pain and the quality of physical activity in patients with osteoarthritis. Conclusion: there is a relationship between the level of pain and the quality of physical activity in patients with osteoarthritis.

Effects of a multidisciplinary intervention to promote physical activity in patients with stroke undergoing rehabilitation: study protocol for the ActivePAS pilot randomised controlled trial

IntroductionPhysical activity after stroke is related to functional recovery and outcomes. To optimise physical activity adapted to a patient’s walking ability and characteristics, multidisciplinary support and interventions are required. The...

Physical Activity in Patients With Kidney Cancer: A Scoping Review.

Physical activity (PA) helps many cancer patients improve health-related fitness, treatment-related side effects, quality of life, and possibly survival; however, limited research has been conducted in patients with kidney cancer (KC). The aim of this scoping review focused on PA in patients with KC was to summarize current findings, delineate strengths and limitations, and provide key recommendations for future research. A scoping review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. The electronic databases of PubMed and Cochrane Library were screened for studies on October 14, 2021, and the search was updated on October 31, 2021. The data were abstracted and synthesized by study design. A total of 17 articles from nine independent studies were identified including 1 cross-sectional study (n=8 articles), 1 randomized controlled trial (n=2 articles) and 7 cohort studies (n=7 articles). The cross-sectional study and randomized controlled trial reported on PA participation rates, preferences, social-cognitive correlates, and quality of life in patients with KC. The 7 cohort studies mostly reported on the risk of KC mortality in general population samples. Overall, no conclusions can be drawn from current research on the safety, feasibility, and efficacy (benefits and harms) of PA in patients with KC. Future research is urgently needed on PA in patients with KC, taking into account their unique disease- and treatment-related factors. This research is necessary to inform clinical exercise guidelines in this understudied cancer patient group.

Relationship between SGLT2 inhibitors and physical activity in patients with Type 2 diabetes

Relationship between SGLT2 inhibitors and physical activity in patients with Type 2 diabetes

UK Doctors Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study.

Despite strategies to enable Health Care Professionals (HCPs) to give physical activity (PA) advice to patients, this appears to be rarely done in consultations. The aims of the present study were to gain an understanding of doctors’ awareness of current PA guidelines and to explore their opinions on barriers and solutions. A qualitative approach using semi-structured interviews was adopted. This study included 15 doctors currently working in the UK’s National Health Service (NHS). A thematic analysis approach was used to analyse the transcripts. Four themes and twelve sub-themes were deciphered. Intrinsic factors limiting the delivery of PA advice included a lack of knowledge of PA guidelines and PA being an afterthought. Barriers to delivering PA guidance included a lack of PA education, time pressures, and patient engagement. Solutions included staff training, incorporating PA into undergraduate training, and encouraging staff to be physically active. Methods to optimise PA guidance included individualised PA advice, local exercise services and schemes, utilising online and visual resources, and motivational interviewing. This study provides an updated insight into doctors’ opinions on barriers and solutions to discussing PA with patients. It is clear that further work is needed to ensure greater awareness of PA guidelines amongst clinicians.

Physical activity counseling during and following stem cell transplantation – patients' versus advisors' perspectives

ABSTRACT Background People receiving hematopoietic stem cell transplantation (HSCT) endure long phases of therapy and immobility, which diminish their physical activity (PA) level leading to physical deconditioning. One of the reasons is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. Therefore, our study investigates reported physical activity counseling behavior of health care professionals (HCPs) and the patient perspective on this topic. Methods Physicians (N = 52), nurses (N = 52) physical therapists (N = 26), and patients receiving HSCT (N = 62) participated in a nationwide cross-sectional online-survey. Patients‘ preferred source of information concerning PA was determined. We examined HCPs self-assessed PA counseling behavior and patients‘ PA recall by assessing the use of the 5As (Ask, Advice, Agree, Assist, Arrange). Analysis of survey responses was descriptive. Univariate multinomial logistic regression examined whether sociodemographic factors and patient characteristics influence the response behavior. Results Physicians and PA specialists were patients‘ preferred source of information regarding PA. A large discrepancy between HCPs’ perception and the degree to which HSCT patients recall advice became apparent; profound counseling steps like making referrals were less often recalled in our patient sample. Inactive patients reported to receive less basic PA counseling by physicians. Conclusion Future research should identify the requirements to increase patients’ recall concerning PA counseling in the setting of HSCT. Important messages about PA need to be made more salient to those who are less active and less engaged.