Physical Activity Participation In People Research Articles

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.

Co‐designing a research study with people affected by dementia: the conceptualisation and development of the ActivDem study

AbstractBackgroundMaintaining physical activity(PA) following dementia diagnosis may decelerate decline to disability and dependency. It is unclear which socio‐ecological factors influence PA participation in people with dementia(PwD) and therefore may be effective interventional components for promotion of PA. To address this research gap, the ActivDem study was designed(see Table 1 for initial research aims). To ensure ActivDem met the needs of PwD, we aimed to co‐design the research aims, methodology and grant application with public patient involvement contributors.MethodA call for contributors (i.e. people with cognitive impairment/dementia carers, current and former/dementia care professionals) was advertised via dementia research networks, dementia care facilities (e.g. daycares, memory cafés), charities (e.g. Alzheimer’s Society Research Network Volunteers) and social media. Interested contributors were invited to participate in either participatory workshops held on Zoom or a one‐to‐one phone call. Contributors were asked four broad questions(Table 2). Initial study aims and methods were discussed with contributors. Aims and methods were refined based on contributors’ feedback and themes raised during the discussion. Ten contributors reviewed the grant application to ensure aims, methodology and public patient involvement/engagement plans met the priorities of people affected by dementia.ResultThirty contributors participated in workshops/phonecalls. Contributors described experiences of PA decline in PwD post‐diagnosis; common themes expressed included loss of independence and confidence, increased feeling of burden, greater fall risk, frailty, and worse mental health. They identified potential facilitators/barriers for maintaining PA following dementia diagnosis(Table 2). They highlighted the role carers play in facilitating PA by supporting and motivating PwD to stay active and advocated for inclusion of carer‐focused investigations. Contributors felt that PA research for PwD should be prioritised and findings linked in to information/support services for carers. The study’s aims and methods were adapted to include an exploration of carers’ psychosocial wellbeing and care management strategies(Table 1). Scales relating to proposed facilitators/barriers of PA were identified, approved by contributors and implemented in the methods.ConclusionThis work supported the conceptualisation and development of the ActivDem study. Ten contributors formed the ActivDem Public Patient Advisory Group, advising and supporting study management, data collection and interpretation, and dissemination of results.

Associations Between Local Area Deprivation and Physical Activity Participation in People with Cognitive Impairment in the North East of England.

Promoting physical activity, such as habitual walking behaviors, in people with cognitive impairment may support their ability to remain independent with a good quality of life for longer. However, people with cognitive impairment participate in less physical activity compared to cognitively unimpaired older adults. The local area in which people live may significantly impact abilities to participate in physical activity. For example, people who live in more deprived areas may have less safe and walkable routes. To examine this further, this study aimed to explore associations between local area deprivation and physical activity in people with cognitive impairment and cognitively unimpaired older adults (controls). 87 participants with cognitive impairment (mild cognitive impairment or dementia) and 27 older adult controls from the North East of England were included in this analysis. Participants wore a tri-axial wearable accelerometer (AX3, Axivity) on their lower backs continuously for seven days. The primary physical activity outcome was daily step count. Individuals' neighborhoods were linked to UK government area deprivation statistics. Hierarchical Bayesian models assessed the association between local area deprivation and daily step count in people with cognitive impairment and controls. Key findings indicated that there was no association between local area deprivation and daily step count in people with cognitive impairment, but higher deprivation was associated with lower daily steps for controls. These findings suggest that cognitive impairment may be associated with lower participation in physical activity which supersedes the influence of local area deprivation observed in normal aging.

Physical Activity in People With Motor Neuron Disease: Validity of the Physical Activity Scale for the Elderly as a Measuring Tool

ObjectiveThis study aimed to investigate whether the physical activity scale for the elderly (PASE) is a valid tool in measuring physical activity (PA) in people with motor neuron disease (MND) and to identify the demographic and clinical factors that predict PA participation in this population. DesignA prospective, observational study involving 100 ambulant participants with MND. SettingThis study was conducted at a multidisciplinary specialist MND clinic. The clinic is fully funded by the local public health system and patients receiving care here are not expected to pay for their consultation. Participants190 patients with MND who had a physiotherapy appointment at the specialist clinic between July and October 2018 were screened. Of these, 100 participants (mean age 67 years [SD=12], 64% [n=64] men) who were ambulant (with or without assistance) were recruited (N=100). InterventionsNot applicable. Main Outcome MeasuresPASE questionnaire, amyotrophic lateral sclerosis functional rating scale—Revised (ALSFRS-r), forced vital capacity (FVC). ResultsThe results showed that engagement in PA is generally low, with median PASE score of 57. The PASE had fair-moderate correlation with ALSFRS-R total scores (rho=0.607; P<.000) and FVC (rho=0.250; P=.030). Standard multiple regression analyses showed that disease severity (ALSFRS-R total score) was the strongest predictor of PA levels (β= 0.54; 95% confidence interval 0.02,0.06). The most frequently selected physical activities of choice for people with MND were activities around their homes and the biggest barrier to participation is fatigue. ConclusionPresent findings suggest that the PASE can be used to measure PA participation in people with MND. Details about activity of choice and barriers to participation present important considerations in designing exercise programs in this population to maximize compliance and therefore effectiveness.

Tailored Interventions for Supporting Physical Activity Participation in People with Arthritis and Related Conditions: a Systematic Review

Tailored Interventions for Supporting Physical Activity Participation in People with Arthritis and Related Conditions: a Systematic Review

The influence of GLA:D® on physical activity in people with knee osteoarthritis: A qualitative exploration

Introduction: Knee osteoarthritis impacts 250 million people worldwide. Symptoms (pain/stiffness) are associated with impaired quality of life and activity participation, and reduced physical activity. Exercise-therapy and education programs such as Good Life with osteoArthritis: Denmark (GLA:D®) are associated with improved pain, function, and quality of life. Yet, their influence on physical activity is less well known. This qualitative study aims to explore the influence of GLA:D® on (i) physical activity participation; (ii) perceived capability and readiness to increase physical activity; and (iii) barriers and facilitators for physical activity participation in people with knee osteoarthritis. Methods: This qualitative study was conducted with La Trobe Human Ethics approval (#HEC18500). Semi-structured interviews were conducted with people with knee osteoarthritis following completion of GLA:D®. Guided by the Theoretical Domains Framework, Interview questions were developed by physiotherapy and psychology researchers. Interviews were audio recorded and transcribed verbatim. Data categories were developed using inductive thematic analysis by one researcher and refined with the assistance of two experienced qualitative researchers. Results: Nineteen people who completed GLA:D® (12 female, 7 male) were interviewed. Descriptive analysis revealed four overarching themes. Theme-1: ‘Beliefs about physical activity and exercise-therapy’ which included fear of knee pain and damage with exercise; and varying participation and knowledge/beliefs regarding safety and benefits of exercise and physical activity. Theme-2: ‘Influences on knowledge/beliefs about physical activity and exercise-therapy’ which included varied experiences with health professionals providing education; and online information emphasising surgery/pharmacology and was often confusing. Theme-3: ‘Reported changes in prescribed exercise-therapy and physical activity following GLA:D®’ which included varied physical activity and exercise-therapy engagement. Theme-4: ‘Barriers and facilitators of physical activity’ which included persistent pain, lack of opportunity, lack of motivation and comorbidities; change in knowledge/beliefs, increased confidence, varied motivation, and technology and other supports. Discussion: GLA:D® may address some existing barriers to physical activity in people with knee osteoarthritis including misinformed beliefs about the benefits and harms, and confidence to engage in, occupational and recreational exercise. Varying motivation to change, and actual change, following GLA:D® suggests that additional targeted behavioural interventions beyond exercise-therapy may be required to increase physical activity and exercise participation in people with knee osteoarthritis. Conflict of interest statement: Authors acknowledge that we have no conflicts of interest relevant to the submission of this abstract.

Flipping the ICF: Exploring the Interplay of Theory and the Lived Experience to Reconsider Physical Activity in Community-Dwelling People With Multiple Sclerosis.

People with multiple sclerosis (MS) report lower physical activity levels and are at a risk of becoming sedentary. As such, they are at an increased risk of developing secondary health conditions associated with inactivity. This is of major public health concern. Attempts to improve the physical activity levels in people with MS remain a challenge for health professionals. One key reason might be the lack of understanding about the meanings people with MS ascribe to exercise and physical activity. This paper draws on the key findings of a three-phased interconnected mixed methods sequential explanatory study to examine the meanings of exercise and physical activity from the perspectives of people with MS and health professionals. Phase 1 used a four-round Delphi questionnaire to scope and determine the consensus of priorities for exercise and physical activity and the reasons why people with MS (N = 101) engaged in these activities. Phase 2 used face-to-face semistructured interviews of people with MS (N = 16) to explore the meanings ascribed to exercise and physical activity. Phase 3 explored the perceptions of physiotherapists (N = 14) about exercise and physical activity using three focus groups. Using the International Classification of Functioning, Disability, and Health as a theoretical framework to underpin this study, the authors discuss the key factors, for example, emphasis on the contextual factors, that drive decision making around exercise and physical activity participation in people with MS and explore the clinical implications to health professionals.

Perceived barriers and enablers to physical activity participation in people with Alopecia Areata: a constructivist grounded theory study

BackgroundAlopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions.MethodsThe study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved.ResultsThe constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance.ConclusionThe findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model.

Adaptation, self-motivation and support services are key to physical activity participation three to five years after major trauma: a qualitative study.

What are the perceived long-term impacts of major trauma on physical activity participation over time? What factors influence physical activity participation in people recovering from major trauma? Longitudinal qualitative study. Sixty-six people aged ≥ 16 years with non-neurological major trauma. Participants were interviewed 3 years (n= 66), 4 years (n= 63) and 5 years (n= 57) after their injury. A thematic analysis was performed. Despite wanting to be physically active, many participants experienced significant, long-term physical activity restriction after their injury, which persisted over time. Restrictions were often related to a fear of re-injury or of exacerbating pain and fatigue levels. These restrictions were a source of distress and frustration for many participants, given the perceived impacts on their social life, family roles and enjoyment of life. Participants were also concerned about weight gain, health decline and reduced physical fitness. Participants valued the support of insurers and specialised services in facilitating access to modified activities, such as clinical Pilates and hydrotherapy. Many participants also recognised the importance of adaptation, goal-setting, self-motivation and determination to be physically active despite limitations. People recovering from major trauma experienced significant and persistent physical activity restriction after their injury. Given the high prevalence of activity restrictions, distress and health concerns that were reported, there is an urgent need to develop and evaluate support strategies to improve physical activity participation in this group.

What factors influence physical activity participation in people with rheumatoid arthritis?

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by periods of inflammation and remission. Physical activity can reduce disease activity and lower the risks of associated co-morbidities such as cardiovascular disease. Despite the benefits, a high percentage of people with RA do not participate in regular physical activity.Objective: The purpose of this qualitative literature review was to explore and synthesize the experiences of people with RA to develop better insight of the factors that influence physical activity participation.Method: A systematic search was conducted across five online databases; MEDLINE, CINAHL, ScienceDirect, PsycINFO, Web of Science. Studies were assessed for quality, data were extracted and analyzed using thematic synthesis.Results: A total of 186 articles were identified and screened against inclusion/exclusion criteria. Seven studies met the criteria and were included in this review. Five key themes were identified as the most significant factors to physical activity participation: professional knowledge and guidance; part of a community; knowing me, knowing RA; what’s in it for me; and where, when, how much? Professional knowledge and guidance was the underpinning factor influencing physical activity participation.Conclusion: The results identify several internal and external factors that affect physical activity participation. To engage, facilitate and motivate patients to participate in physical activity, ongoing education and support from health care professionals is required. This will promote better symptom management and maintain functional independence. Additionally, health care professionals need to consider individual preferences and abilities when recommending physical activity.

A qualitative exploration of physiotherapists’ perceptions about exercise and physical activity: reflections on the results from a Delphi Study

Purpose: This study explored physiotherapists’ interpretation of exercise and physical activity, examined physiotherapists’ views and opinions about the prioritised physical activity practices of people with multiple sclerosis and its implication for clinical practice.Method: Fourteen physiotherapists (12 females, 2 males) with experience of working with people with multiple sclerosis in the community participated in three focus groups. Physiotherapists commented on the results of a previous Delphi study which highlighted the prioritised exercise and physical activity practices and reasons people with multiple sclerosis engage in exercise and physical activity. The focus groups were audio recorded and transcribed verbatim. Data were analysed using framework analysis.Results: Four themes were developed from the analysis namely, Blurred terminologies, Influencing factors for the meaning of exercise and physical activity, When professional expertise meets experiential expertise and The resolve: resolving professional and experiential tensions.Conclusion: Physiotherapists described exercise and physical activity as movement with a focus on the physiological attributes. Nonetheless they valued and use exercise and physical activity as strategies to manage the symptoms associated with multiple sclerosis. Physiotherapists are strategically placed in the community to initiate discussions, assess, and create opportunities to enhance the physical activity practices of people with multiple sclerosis. However, there is greater scope for the application of physical activity to be embedded in routine clinical practice in the management of multiple sclerosis in the community.Implications for rehabilitationPhysiotherapists should design flexible physical activity programmes which are meaningful, engaging and foster the necessary environment to sustain physical activity participation in people with multiple sclerosis.Health professionals should be aware of and understand the individuals’ priorities as these are key drivers to engaging and sustaining physical activity in community dwelling people with multiple sclerosis.Physiotherapists should be aware of their own beliefs and theoretical principles that guide designs and treatment programmes as these might either enhance or restrict physical activity in people with multiple sclerosis.

Barreiras para a prática de atividade física em pessoas com deficiência visual

The present study examined the barriers to physical activity participation in people with visual impairments. One hundred and fourteen subjects (residents of Brasília‐Federal District) with visual impairment and low levels of physical activity answered a questionnaire over the phone. There are several relevant barriers to physical activity, including sidewalk problems, lack of appropriate spaces, no support from public entities, need of a guide, lack of opportunities for activities from specialized institutions, and no safety precautions at facilities to prevent accidents. It must be implemented appropriate measures to help eliminate or reduce the impact of the main barriers pointed out by the subjects so that health and the well‐being of this population can be promoted.

A technology-enabled Counselling program versus a delayed treatment control to support physical activity participation in people with inflammatory arthritis: study protocol for the OPAM-IA randomized controlled trial

BackgroundBeing physically active is an essential component of successful self-management for people with inflammatory arthritis; however, the vast majority of patients are inactive. This study aims to determine whether a technology-enabled counselling intervention can improve physical activity participation and patient outcomes.MethodsThe Effectiveness of Online Physical Activity Monitoring in Inflammatory Arthritis (OPAM-IA) project is a community-based randomized controlled trial with a delayed control design. We will recruit 130 people with rheumatoid arthritis or systemic lupus erythematosus, who can be physically active without health professional supervision. Randomization will be stratified by diagnosis. In Weeks 1–8, participants in the Immediate Group will: 1) receive education and counselling by a physical therapist (PT), 2) use a Fitbit and a new web-based application, FitViz, to track and obtain feedback about their physical activity, 3) receive 4 biweekly follow-up calls from the PT. Those in the Delayed Group will receive the same program in Week 10. We will interview a sample of participants about their experiences with the intervention. Participants will be assessed at baseline, and Weeks 9, 18 and 27. The primary outcome measure is time spent in moderate/vigorous physical activity in bouts of ≥ 10 min, measured with a portable multi-sensor device in the free-living environment. Secondary outcomes include step count, time in sedentary behaviour, pain, fatigue, mood, self-management capacity, and habitual behaviour.DiscussionA limitation of this study is that participants, who also administer the outcome measures, will not be blinded. Nonetheless, by customizing existing self-monitoring technologies in a patient-centred manner, individuals can be coached to engage in an active lifestyle and monitor their performance. The results will determine if this intervention improves physical activity participation. The qualitative interviews will also provide insight into a paradigm to integrate this program to support self-management.Trial registrationDate of last update in ClinicalTrials.gov: September 18, 2015. ClinicalTrials.gov Identifier: NCT02554474.

A qualitative exploration of facilitators and barriers to physical activity participation in people with severe mental illness in Taiwan

BackgroundIdentifying factors associated with physical activity participation is critical for developing effective programs for individuals with severe mental illness (SMI). Previous studies have focused on western, developed countries; the purpose of this study was to qualitatively identify physical activity facilitators and barriers in people with SMI in Taiwan. MethodThirty-nine community-dwelling participants participated in one of five focus groups. Semi-structured open-ended questions were asked to identify physical activity barriers and facilitators. Qualitative data was organized and analyzed with thematic analysis using ATLAS.ti. software. ResultsParticipants had a mean age of 42 (SD = 11), were primarily female (51.3%), and had a diagnosis of schizophrenia (84.6%). Five facilitators and five barriers related to physical activity participation in the SMI group were identified. Facilitators included motivation by the health benefits of physical activity, engagement in preferred types of activity, support from family and friends, encouragement from health professionals, and convenient access to exercise equipment and facilities. Barriers included poor health, low self-efficacy, low support from family and friends, fear of negative societal attitudes toward mental illness, and an unsupportive physical environment. ConclusionsFactors related to physical activity participation in Taiwanese with SMI are multidimensional and include personal, social and physical environment factors. Future physical activity promotion programs for similar Taiwanese populations with SMI may want to consider targeting multiple levels of influence to help increase physical activity.

Physical Activity Preferences for People Living With Multiple Myeloma: A Qualitative Study.

Although physical activity (PA) has significant benefits for people living with multiple myeloma (MM), participation rates are low. Examination of PA preferences will provide important information to clinicians and assist in the development of interventions to increase participation in PA for people living with MM. The aim of this study is to gain an in-depth understanding of the PA preferences for people living with MM, including the preferred role of clinicians. Semistructured interviews were conducted with patients treated for MM within the preceding 2 to 12 months. Interviews were analyzed using content analysis, where coding categories were derived directly from the text data. Twenty-four interviews were conducted (women, 54%; age: mean [SD], 62 [8.8] years); 16 (67%) participants had an autologous stem cell transplant. Light- to moderate-intensity PA during and after treatment was feasible, with the strongest preference for a program 2 to 8 months after treatment. The timing of information delivery was important, as was input from clinicians and organizations with knowledge of MM. Preferences for location, structure, and timing of programs varied. Low- to moderate-intensity PA after treatment is likely to interest people with MM. Programs need to be flexible and consider individual differences in PA preferences, functional status, and treatment schedules. An individually tailored PA program should form part of clinical care, involving clinicians and organizations with expertise in MM. Options for home-based PA are also important. Further research, including a population-based study of people living with MM, is necessary to further quantify PA preferences.

Physical Activity in People With Posttraumatic Stress Disorder: A Systematic Review of Correlates.

People with posttraumatic stress disorder (PTSD) are more likely than the general population to be physically inactive. The present review systematically evaluated correlates of physical activity across the socioecological model for people with PTSD. Two independent reviewers searched Embase, PubMed, PsycARTICLES, and CINAHL from inception until June 2015, combining the medical subject heading "posttraumatic stress disorder" or "PTSD," with "physical activity" or "exercise." Data were extracted by the same independent researchers and summarized according to the socioecological model. Eight papers involving 1368 (994 men) participants (age range = 18-70 years) were eligible and enabled evaluation of 21 correlates. The only correlate (n ≥ 4) consistently associated with lower physical activity participation in people with PTSD was symptoms of hyperarousal. No consistent facilitators were identified. Hyperarousal symptoms are associated with lower physical activity participation among people with PTSD and should be considered in the design and delivery of individualized exercise programs targeting this population. The role of social, environmental, and policy factors on physical activity participation among people with PTSD is unknown and should be addressed by future research.

The effectiveness of behaviour change interventions to increase physical activity participation in people with multiple sclerosis: a systematic review and meta-analysis

Objective: A systematic review and meta-analysis was conducted to illustrate whether people with multiple sclerosis engage in more physical activity following behaviour change interventions. Data resources: MEDLINE, CINAHL, PubMed, Web of Sciences, Cochrane Library, SCOPUS, EMBASE and PEDro were searched from their inception till 30 April 2015. Trial selection: Randomized and clinical controlled trials that used behaviour change interventions to increase physical activity in people with multiple sclerosis were selected, regardless of type or duration of multiple sclerosis or disability severity. Data extraction: Data extraction was conducted by two independent reviewers and the Cochrane Collaboration’s recommended method was used to assess the risk of bias of each included study. Results: A total of 19 out of 573 studies were included. Focusing on trials without risk of bias, meta-analysis showed that behaviour change interventions can significantly increase physical activity participation (z = 2.20, p = 0.03, standardised main difference 0.65, 95% confidence interval 0.07 to 1.22, 3 trials, I2 = 68%) (eight to 12 weeks’ duration). Behaviour change interventions did not significantly impact on the physical components of quality of life or fatigue. Conclusion: Behaviour change interventions provided for relatively short duration (eight to 12 weeks) may increase the amount of physical activity people with multiple sclerosis engage in, but appear to have no effect on the physical components of quality of life and fatigue. Further high quality investigations of the efficacy of behaviour change interventions to increase physical activity participation that focus on dose, long-term impact and method of delivery are warranted for people with multiple sclerosis.

The association between symptom severity and physical activity participation in people seeking care for acute low back pain.

To investigate the association between symptom severity and physical activity participation in people with acute non-specific low back pain (LBP). The sample included a total of 999 patients who presented to primary care with an acute episode of low back pain. Symptom severity, in terms of activity limitation and severity of pain; and physical activity participation before (habitual) and after pain onset were assessed using self-report questionnaires. All participants were interviewed within 14 days of pain onset. At interview most of the participants (87.5 %) reported having moderate to extreme activity limitation due to back pain. There was a significant decrease in physical activity participation after pain onset (mean difference: -176 min, 95 % CI 327-400; p < 0.0001) but no association between habitual or change in physical activity participation and symptom severity was observed (p > 0.21). Pain onset causes a significant and immediate decrease in physical activity participation, but this change does not seem to be associated with symptom severity.

Interventions to promote physical activity in people with cystic fibrosis

Background In individuals with cystic fibrosis there are no established targets for participation in physical activity, nor have any ideal strategies to promote participation in physical activity been identified Objectives To evaluate the effect of treatment to increase participation in physical activity in people with cystic fibrosis. Search methods We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register using the terms 'physiotherapy and exercise'. Date of the most recent search: 05 December 2013. Additionally, we conducted searches of the electronic databases MEDLINE, CINAHL (Ebscohost), PsycINFO (OvidSP) and the Physiotherapy Evidence Database (PEDro). We also searched for potentially relevant, completed but unpublished studies, on several clinical trials registers. Date of the most recent searches: 10 September 2012. Selection criteria All randomised and quasi-randomised controlled studies which investigated strategies designed to promote increased participation in daily physical activity for individuals with cystic fibrosis. Data collection and analysis Two authors independently selected studies for inclusion, assessed the risk of bias and extracted data. Any disagreements were resolved by discussion and consensus, or in arbitration with a third author. Main results Four studies (199 participants) met the inclusion criteria and were predominantly conducted in children with cystic fibrosis. Only one study had a combined cohort of adult and paediatric participants. The description of study methods was inadequate to assess the risk of bias, particularly with regard to blinding of assessors and selective reporting. One study was conducted in an inpatient setting with follow up in the outpatient setting; while the remaining three studies were conducted in individuals with stable respiratory disease in the outpatient setting. All included studies used exercise training to promote participation in physical activity, with the duration of the intervention period ranging from 18 days to three years. No improvement in physical activity participation was reported with any intervention period less than or equal to six months. Improvements in physical activity participation were only seen where follow up occurred beyond 12 months. There was no significant impact on quality of life from any of the intervention strategies. Authors' conclusions Although participation in physical activity is generally regarded as beneficial for people with cystic fibrosis, there is a lack of evidence regarding strategies to promote the uptake and the continued participation in physical activity for this population. This review provides very limited evidence that activity counselling and exercise advice, undertaken over at least six months, to engage in a home exercise programme may result in improved physical activity participation in people with cystic fibrosis. Further research is needed to determine the effect of strategies such as health coaching or telemedicine applications, in promoting the uptake and adherence to regular participation in physical activity. In addition, establishing the ideal duration of any interventions that promote physical activity, including exercise training programmes, will be important in addressing issues relating to participation in physical activity for people with cystic fibrosis.

Interventions for promoting physical activity in people with cystic fibrosis.

In individuals with cystic fibrosis there are no established targets for participation in physical activity, nor have any ideal strategies to promote participation in physical activity been identified To evaluate the effect of treatment to increase participation in physical activity in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register using the terms 'physiotherapy and exercise'.Date of the most recent search: 05 December 2013.Additionally, we conducted searches of the electronic databases MEDLINE, CINAHL (Ebscohost), PsycINFO (OvidSP) and the Physiotherapy Evidence Database (PEDro). We also searched for potentially relevant, completed but unpublished studies, on several clinical trials registers.Date of the most recent searches: 10 September 2012. All randomised and quasi-randomised controlled studies which investigated strategies designed to promote increased participation in daily physical activity for individuals with cystic fibrosis. Two authors independently selected studies for inclusion, assessed the risk of bias and extracted data. Any disagreements were resolved by discussion and consensus, or in arbitration with a third author. Four studies (199 participants) met the inclusion criteria and were predominantly conducted in children with cystic fibrosis. Only one study had a combined cohort of adult and paediatric participants. The description of study methods was inadequate to assess the risk of bias, particularly with regard to blinding of assessors and selective reporting. One study was conducted in an inpatient setting with follow up in the outpatient setting; while the remaining three studies were conducted in individuals with stable respiratory disease in the outpatient setting. All included studies used exercise training to promote participation in physical activity, with the duration of the intervention period ranging from 18 days to three years. No improvement in physical activity participation was reported with any intervention period less than or equal to six months. Improvements in physical activity participation were only seen where follow up occurred beyond 12 months. There was no significant impact on quality of life from any of the intervention strategies. Although participation in physical activity is generally regarded as beneficial for people with cystic fibrosis, there is a lack of evidence regarding strategies to promote the uptake and the continued participation in physical activity for this population. This review provides very limited evidence that activity counselling and exercise advice, undertaken over at least six months, to engage in a home exercise programme may result in improved physical activity participation in people with cystic fibrosis. Further research is needed to determine the effect of strategies such as health coaching or telemedicine applications, in promoting the uptake and adherence to regular participation in physical activity. In addition, establishing the ideal duration of any interventions that promote physical activity, including exercise training programmes, will be important in addressing issues relating to participation in physical activity for people with cystic fibrosis.