Physical Activity Training Research Articles

Time to embed physical activity within usual care in cancer services: A qualitative study of cancer healthcare professionals’ views at a single centre in England

Purpose An increasing number of people affected by cancer (PABC) are living longer lives as treatment continues to advance. There is growing evidence for physical activity (PA) supporting health in this population before, during and after cancer treatment, but PA advice is not part of usual care. This study investigates views of frontline oncology healthcare professionals (HCPs) in one NHS teaching hospital in England to understand the role of PA advice across cancer services. Materials and methods This was a qualitative study interviewing HCPs and using thematic analysis. Results Four main themes were identified: 1. Awareness of the roles of PA in cancer; 2. Patient-specific factors in rehabilitation; 3. Cancer-specific factors in rehabilitation; 4. Barriers and opportunities to integrating PA within usual care. HCPs’ awareness of the role of PA in cancer rehabilitation was low overall and PA was found not to be embedded within rehabilitation. Contrastingly, there was awareness of PA’s potential to impact disease and treatment-related outcomes positively. Ideas for PA integration included training for staff and giving PA advice within consultations. Conclusions Low awareness of benefits of PA-based rehabilitation and lack of integration in usual care contrasted with HCPs’ interest in this area’s potential. Training HCPs to begin the conversation with patients affected by cancer in teachable moments may increase patient access. Implications for rehabilitation Integrating physical activity education and training for trainees and existing healthcare professionals workforce would help embed physical activity into routine clinical practice. Brief advice intervention training during every consultation, such as providing relevant individualised information and signposting, can be impactful. Physical activity within a broader cancer rehabilitation programme should be integrated as standard for every cancer patient. Individualised plans may include prehabilitation, restorative rehabilitation and palliative rehabilitation. Patient preferences and the patient experience should continue to shape service design. There is a need to ensure physical activity advice is consistent throughout healthcare settings and not fragmented between primary, secondary and tertiary care.

Physical Activity Frequency and Depression in the Spanish Population.

Depression is a concerning mental health disorder. It is the first cause of inability worldwide, which entails high economic costs for the public system. Current evidence suggests that physical activity is an effective tool for the prevention and treatment of depressive symptoms. To examine the relationship between the cases of depressive symptoms and depression presented by the adult Spanish population and the days per week of physical activity and strength training that they perform. It is a cross-sectional study with data from the European Health Survey of Spain 2020 (EESE 2020), consisting of 10,024 males and 11,126 females, between 18 and 84 years, which conformed the sample of 21,150 participants. Depressive symptoms and depression were related to days of PA per week, PA frequency per week and strength training days per week (p < 0.001), depressive symptoms and depression were found to have higher prevalence in the inactive groups than in the active groups (p < 0.05); this phenomenon was found in both sexes and age groups. The prevalence of depressive symptoms and depression were associated with physical activity in the general population, by sex and by age group too. The prevalence of both were higher in the inactive population than in the active population of all ages and sexes. Future studies are required to confirm the relationship between PA and depression prevalence, in order to establish the scope of the effect of PA on depressive symptoms and depression.

Abstract 11667: Physical Activity and Nutrition Self-Efficacy Associates With Self-Reported Cardiovascular Health Behaviors in African Americans: The Washington, DC Cardiovascular Health, and Needs Assessment

Background: Increased self-efficacy may improve health behavior, but little is known about the relationship between physical activity (PA) and nutrition self-efficacy and cardiovascular health behaviors associated with weight loss among African Americans (AAs). Methods: Examined the associations between PA and nutrition self-efficacy and self-reported PA and nutrition behaviors using AA data from the Washington DC CV Health and Needs Assessment, a community-based participatory research study. All completed the PA and Nutrition Self-Efficacy (PANSE) scale with sub-scores measuring participants’ self-efficacy for engaging in PA and nutrition behaviors (higher scores= greater self-efficacy). PA types (moderate-leisure PA, vigorous-leisure PA, and strength training) and dietary (red meat, fast foods, sodas, and vegetables) behavior scores were calculated using the International Physical Activity Questionnaire (IPAQ) for self-report PA or the National Health and Nutrition Examination Survey (NHANES) dietary screener for consumption of specific food products. Linear regression models were used to assess the associations between PANSE sub-scores and corresponding PA or dietary behavior adjusting for covariates. Results: Participants (N=117) were predominantly women (82.1%), mean age=59.4 (SD±12.3) years with mean BMI 32.6 (SD±7.0) kg/m2. While PA self-efficacy remained significantly and positively associated with self-reported moderate leisure PA and strength training, nutrition self-efficacy remained significantly and negatively associated with consumption of fast foods and sodas after adjusting for covariates (Table 1). Conclusion: PA and nutrition self-efficacy are associated with self-reported PA and nutrition behaviors among AAs. Interventions that augment self-efficacy may be particularly important in improving cardiovascular health behaviors by enhancing PA and nutrition behaviors aimed at weight loss among AAs.

Adherence to exercise and fitness following exercise-based outpatient cardiac rehabilitation: a cross-sectional survey for Germany

BackgroundExercise-based cardiac rehabilitation is safe and effective, evidence-based and implemented in national and international cardiac rehabilitation guidelines. Recent data show a decrease in cardiovascular mortality, reduced hospital admissions and an overall improvement in quality of life. To maintain positive effects and to prevent further cardiovascular events a major goal of cardiac rehabilitation is to induce a long-term health behaviour change and the integration of regular physical activity and exercise training in everyday life. The aim of this study is to evaluate the adherence of cardiac patients to exercise-based programs following rehabilitation phase III.MethodsA nationwide online cross-sectional survey was conducted. All outpatient aftercare providers who offer sports rehabilitation programs (heart groups) for cardiac patients in Germany were contacted. The questionnaire comprised 15 questions in five subcategories (general information regarding the outpatient aftercare provider, structure of rehabilitation sport programs, membership structure, content of heart groups, adherence to exercise-based programs).Results560 of 2447 outpatient aftercare providers participated in the survey (response rate: 23%). On average, rehabilitation sport facilities hosted 2 (IQR 2) heart groups per week, and 23 patients (IQR 30) (61% males; 31% females) per facility completed rehabilitation sport prescription in 2018. Almost all providers offer follow-up programs on a self-payer basis after rehabilitation sport prescription ends. Adherence to follow-up programs was at 54% (IQR 65; 55% males and 50% females). With 60% (IQR 71), patients with a statutory health insurance (mainly pensioners) adhere slightly more often to a follow-up program compared to privately insured persons (mainly population with a high income or civil servants) with 50% and significantly more often compared to persons who were insured by the German pension fund (covering working population) with only 9% (IQR 89) adherence.ConclusionAlmost all outpatient aftercare providers offer follow-up programs for cardiac rehabilitation patients but only half of them actually participate. Younger people (working population) do not adhere sufficiently to sport and exercise programs following rehabilitation phase III. This seems critical to address in terms of achieving long-term rehabilitation goals.

The art of forming habits: applying habit theory in changing physical activity behaviour

BackgroundHabits are obtained as a consequence of cue-contingent behavioural repetition. Context cues stimulate strong habits without an individual contemplating that action has been initiated. Because of its health-enhancing effects, making physical activity a part of one’s life is essential. This study examined the associations of physical activity (PA) behaviours with PA habits and the role of autonomous motivation in developing PA habits.MethodsThis study used a cross-sectional design. A structured questionnaire was implemented through emails to 226 university students, where PA levels, habits and autonomous motivation were self-reported.ResultsBinary logistic regression identified age groups, gender and participants who were trying to lose weight as the significant predictors in meeting physical activity guidelines. Path analysis showed that moderate-intensity physical activity (β = 0.045, CI = 0.069–0.248) and strength training exercises (β = 0.133, CI = 0.148–0.674) were significantly associated with PA habits (p < 0.01). Autonomous motivation was directly associated with PA habits (β = 0.062, CI = [0.295–0.541], p < 0.01) and was also significantly related to moderate-intensity physical activity (β = 0.243, CI = [0.078–0.266], p < 0.01) and strength training exercises (β = 0.202, CI = [0.033–0.594], p < 0.05).ConclusionsThe emphasis on experiment-based logic and interest in habit formation in the research community is extensive. As the college years offer an excellent opportunity to establish healthy behavioural interventions, encouraging students in regular PA and exhibiting an autonomous motivation towards PA may be necessary.

Physical activity and sport-specific training patterns in Swedish sporting and working trial dogs-A questionnaire survey.

To explore physical activity patterns, including conditioning exercise and sport-specific training, and management routines utilized by handlers of Swedish sporting and working dogs participating in agility, obedience, rally obedience and working trial disciplines. Dog handlers provided information on competition-level dogs through an internet-based cross-sectional and descriptive survey on physical activity, sport-specific training and management. Results are reported overall and stratified by participation in specific disciplines. We received 1615 replies to the questionnaire. After data cleaning, 1582 dogs (98%) remained for the analysis. Of these, 430 participated in agility, 790 in obedience, 596 in rally obedience, and 847 dogs had competed in a working trial, i.e., messenger, protection, search or tracking. Number of disciplines performed by each dog varied between one and five. Most common was participation in one (n = 767, 48%) or two (n = 541, 34%) disciplines. Out of the dogs competing in one discipline, 38% (n = 294) were considered to be specialized as they actively trained only that discipline for ≥10 months per year. The vast majority of the dogs (n = 1129, 71%) received more than 1 h of daily physical activity, e.g., walks, and only n = 51 (3%) were never exercised off-leash. Preferred self-selected gait was trot (n = 907, 57%) and gallop (n = 499, 32%). A fifth (n = 319, 20%) never played with other dogs. The majority (n = 1328, 84%) received more than 1 h of vigorous physical conditioning exercise per week. Almost three quarters (n = 1119, 71%) participated in physical conditioning exercise. Two thirds (n = 953, 60%) participated in at least 3 h of sport-specific training per week and only a very small portion (n = 35, 2%) trained their specific discipline less than once per week. Median total work load, i.e., all daily physical activity, vigorous physical conditioning exercise and sport-specific training, was 16.5 h per week. We observe physical activity at moderate to high durations and moderate to vigorous intensities among Swedish sporting and working trial dogs. Most dogs received physical conditioning exercise, but not all dogs were warmed up before training and competition. Our study provides veterinary professionals and dog trainers with valuable insights on the physical exposures and management routines of sporting and working trial dogs.

노인의 신체활동량과 근력 운동에 따른 고혈압과 대사 관련 요인 관계 분석

Purpose: The purpose of this study is to assess the influence of the amount of physical activity and strength exercise on hypertension and metabolism-related factors of the Korean elderly using KNHNES data.BR Method: The data were obtained from the KNHNES VI~VIII conducted in 0214~2019. The subjects, a total of 5,059 elderly aged 65 years and older, were classified into three groups based on total physical activity amount and five groups based on strength exercise. The data processor for this study was used as a percentage and mean (M) or standard error (SE) of all measured values. Also, data processor used generalized linear model, chi-square test, and logistic regression analysis.BR Results: The results of this study are as follows. 1) The difference in metabolic factors according to the amount of physical activity in the elderly showed that the high-intensity physical activity group had lower triglyceride levels than the inactive group in the overall group. In the female group, the moderate-intensity and high-intensity physical activity group had a lower triglyceride level than the inactive group. It was found that the fasting blood glucose and HbA1c levels were lower in the high-intensity physical activity group than in the inactive group. 2) There was no significant difference among the groups in the risk of hypertension according to the amount of physical activity in the elderly. 3) In total, the MR and HR groups showed a lower triglyceride level than the N group, and the MR group showed a lower HbA1c level than the N group. In the female group, the MR and HR groups showed lower BMI than the N group, and the MR group showed a lower waist circumference than the N group. In addition, the MR group showed lower triglycerides and HbA1c than the N group, and the HR group showed lower LDL-C and fasting blood glucose than the N group. 4) Regarding the risk of hypertension according to physical activity and strength training in the elderly, the risk of hypertension was 0.933 times in the M group, 0.781 times in the H group, 0.590 times in the HR group, and 0.521 times in the MR group than in the N group in the female group.BR Conclusion: In summary, the findings in this study confirm that the combination of moderate physical activity and strength training twice a week has the lowest risk of high blood pressure and is found to have a positive effect on metabolic factors. Therefore, if moderate-intensity physical activity and strength exercise are combined in the elderly, it is thought that it can help prevent and manage high blood pressure in the elderly.

What Does It Take: The Roles, Responsibilities, and Fidelity to Implement a Physical Activity in Public HealthTraining

Cooperative Extension Service (Extension) Agents are tasked with incorporating physical activity promotion in their work. Physical activity training interventions rarely report specific structures (dose, content) and measures (fidelity, resource cost). The study’s purpose was to evaluate the feasibility and resource costs of Physical Activity in Cooperative Extension (PACE), a training to increase physical activity in public health competency. PACE is a virtual, 9-week, 18-hour general capacity-building training based on the Interactive Systems Framework. Fidelity was calculated as the proportion of objectives delivered as intended and total time to deliver core components. Resource cost was calculated as the time spent on each implementation strategy and responsibility and total time spent delivering PACE. Fidelity was 93% (39/42 planned objectives delivered as intended). PACE required 183 hours to implement, with session delivery (45 hours) and participant communication (40 hours) requiring the most time. Overall, time spent included 37 hours per delivery team member and 18 hours per PACE participant. The personnel time spent was within the standard time spent on other Extension training protocols and perceived as feasible. Fidelity to session components was high and easy to track. Future work should determine the scalability and sustainability of PACE within Extension nationally.

PELATIHAN AKTIVITAS JASMANI ADAPTIF BERBASIS MERDEKA BERMAIN UNTUK ANAK BERKEBUTUHAN KHUSUS BAGI GURU TK

This public submission aims to provide teachers with knowledge and skills in adaptive physical activity training for inclusive Early Childhood Education institutions by referring to the freedom-to-play principle. The initiative implemented physical activity training and adaptive physical activity designing in the framework of freedom to play based on the children’s needs. The community service was limitedly performed offline by imposing safety protocols. It involved 25 teachers who were members of the Kindergarten Education Teachers Association (IGTKI) in Semarang City. All necessary materials, in addition to direct practice of adaptive physical activities and adaptive physical activity designing based on the freedom to play, were given to children with special needs. The public submission activity was smoothly implemented, as it could contribute to providing knowledge for kindergarten teachers in designing and guiding adaptive physical activities for inclusive classes based on the freedom to play.

The rehabilitation including structured active play (RePlay) model: A conceptual model for organizing physical rehabilitation sessions based on structured active play for preschoolers with cancer.

Anti-cancer treatments, as well as cancer itself, reduce children’s cardiorespiratory fitness, muscle strength, and gross motor functions. Early rehabilitation programs, including physical activity for childhood cancer patients, can counteract these adverse effects. Previous studies of school-aged children (6–18 years old) indicate that physical activity, including aerobic and resistance training, is safe, feasible, and effective. The goal of structured physical activity rehabilitation for preschool children (1–5 years old) is to support gross motor development and opportunities to move freely in various ways. Specific rehabilitation for preschoolers diagnosed with cancer is needed to promote physical-, social-, and personal development. This paper introduces a conceptual model—The RePlay (Rehabilitation including structured active play) Model—for organizing physical rehabilitation sessions based on structured active play for preschoolers with cancer. The theory and empirically based model combine knowledge of early childhood development, play, physical activity and rehabilitation for children with cancer, and cancer treatment. With this model, we propose how to structure rehabilitation sessions, including goal-oriented, age-sensitive, fun movement activities that facilitate preschoolers to develop gross motor skills while enhancing their social and personal skills, through four core principles: (1) ritual practices, (2) reinforcement of movement through repetition, (3) development through appropriate challenge, and (4) adjusting activities to accommodate treatment-related side effects. This model holds promise for use with preschoolers diagnosed with cancer, as it is scalable and pragmatic and accounts for the children’s fluctuating physical capacity and daily wellbeing during cancer treatment.

Impact of connected health interventions on psychological wellbeing and quality of life in patients with cancer: Asystematic review and meta-analysis.

Connected health technologies have the potential to improve access to cancer care and support and reduce costs. We aimed to assess the impacts of interventions delivered using connected health technologies on psychological and quality of life (QoL) outcomes in people living with and beyond cancer. PUBMED, PsycINFO, Web of Science, and EMBASE were searched using terms relating to (i) cancer, (ii) connected health, and (iii) QoL/psychological wellbeing. Studies were included if they evaluated interventions using connected health technologies and assessed psychological and/or QoL outcomes for adults at any stage of cancer treatment or survivorship. Thirty-seven studies met the inclusion criteria with a total of 8956 participants. Connected health technologies included web-based applications (n=24), smart applications (n=12), and wearable devices (n=1). Studies were heterogeneous in terms of intervention components. We identified five clusters: (i) Psychosocial support and rehabilitation, (ii) psychoeducation and information support, (iii) symptom monitoring, reporting and self-management, (iv) peer and social support, and (v) health coaching and physical activity training. Due to heterogeneity of outcome measures, the meta-analysis included only seven RCTs; pooled mean estimates showed connected health interventions were moderately effective in reducing symptoms of depression (SMD: -0.226, 95% CI -0.303/-0.149) and anxiety (SMD: -0.188, 95% CI: 0.279/-0.0963) compared with usual care. While the considerable heterogeneity observed highlights the need for more rigorous studies to improve reproducibility and efficiency, results suggest that connected health interventions have the potential to improve psychological wellbeing and QoL outcomes in people living with and beyond cancer.

Parallel randomized controlled feasibility trials of the "Active Brains" digital intervention to protect cognitive health in adults aged 60-85.

IntroductionMultidomain interventions to address modifiable risk factors for dementia are promising, but require more cost-effective, scalable delivery. This study investigated the feasibility of the “Active Brains” digital behavior change intervention and its trial procedures.Materials and methodsActive Brains aims to reduce cognitive decline by promoting physical activity, healthy eating, and online cognitive training. We conducted 12-month parallel-design randomized controlled feasibility trials of “Active Brains” amongst “lower cognitive scoring” (n = 180) and “higher cognitive scoring” (n = 180) adults aged 60–85.ResultsWe collected 67.2 and 76.1% of our 12-month primary outcome (Baddeley verbal reasoning task) data for the “lower cognitive score” and “higher cognitive score” groups, respectively. Usage of “Active Brains” indicated overall feasibility and satisfactory engagement with the physical activity intervention content (which did not require sustained online engagement), but engagement with online cognitive training was limited. Uptake of the additional brief telephone support appeared to be higher in the “lower cognitive score” trial. Preliminary descriptive trends in the primary outcome data might indicate a protective effect of Active Brains against cognitive decline, but further investigation in fully-powered trials is required to answer this definitively.DiscussionWhilst initial uptake and engagement with the online intervention was modest, it was in line with typical usage of other digital behavior change interventions, and early indications from the descriptive analysis of the primary outcome and behavioral data suggest that further exploration of the potential protective benefits of Active Brains are warranted. The study also identified minor modifications to procedures, particularly to improve online primary-outcome completion. Further investigation of Active Brains will now seek to determine its efficacy in protecting cognitive performance amongst adults aged 60–85 with varied levels of existing cognitive performance.

Moving on From the Delphi Study: The Development of a Physical Activity Training Programme Prototype Through Co-produced Qualitative Research.

This research developed from a co-produced project called Moving Social Work. The purpose of this ongoing project is to train social workers in how to promote physical activity for and to disabled people. The first stage of the project consisted of building evidence to design a training programme prototype. As part of this stage, a Delphi study was conducted to ask leading experts about what should be included in the prototype. Questionnaires were sent to participants until consensus was reached. In reflecting on the results, people involved in the study commented that there was more about the experts' opinions than percentages of agreement. Our co-production partners resolved that the Delphi was insufficient and called for detailed conversations with the experts. In response to this call, follow-up interviews with 10 experts who participated in the final questionnaire round of the Delphi were carried out. The interviews were co-produced, dyadic and data prompted. Dialogical inquiry was used to frame and co-analyse data. The results illuminate the capacity of qualitative research to justify, rectify, complicate, clarify, concretize, expand and question consensus-based evidence. The implications of the results for Moving Social Work are discussed. Beyond the empirical border of the project, wider contributions to literature are presented. As part of these, two key statements are highlighted and warranted: dialogical inquiry supports the practice of co-produced research, and Delphi studies should be followed by a Big Q qualitative study.

Six Months Of Objectively Measured Group Exercise Supports Adults Meeting Physical Activity Guidelines

PURPOSE: Physical inactivity is associated with a myriad of negative health outcomes and thus continues to be a public health concern. The COVID-19 pandemic highlights a need for novel health intervention strategies that improve moderate to vigorous aerobic physical activity and resistance training levels. Group exercise is one built environment strategy that should be better leveraged to improve physical activity levels. METHODS: Study participants self-selected to engage in a commercially-available group exercise program. Workouts ranged from 45-90 minutes and included interval training on treadmills, rowers, and total body resistance training. All participants attended at least two classes weekly for 28 consecutive weeks, while wearing heart rate monitors (HRMs) to objectively assess intensity. RESULTS: Participants (n = 295; mean age: 39 ± 11 years; 72% female) attended an average of 4.5 ± 0.9 group exercise sessions per week for 28 weeks. Data from HRMs indicate that participants spent an average of 50 ± 5 minutes in vigorous intensity activity (defined as heart rate > 60% max; VPA) across all classes, with an average working HR of 139 + 10 beats per minute, equating to an average weekly VPA dose of 221 + 46 minutes (range: 134-398 minutes). Age was associated with VPA (r = 0.166, p = 0.04). No significant differences in workout attendance or time spent in VPA were observed between sexes (p = 0.29, p = 0.07, respectively). CONCLUSIONS: This group exercise program provided a sustainable solution for adults to exceed VPA guidelines over a 6-month period. The availability of group exercise facilities in many communities facilitates access to long-term coaching, accountability, equipment, and a safe environment that should be used to improve public health. Future studies that include a control group, as well as pre-and post- data comparisons on key health and performance outcomes of interest, are warranted.

Does Physical Activity Mitigate The Risk Of Frailty-related Bone Fractures Among Cancer Survivors?

Cancer and associated treatments may predispose survivors to a higher risk of frailty-related bone fractures. Whether physical activity offsets some of the excess risk is poorly understood. Prior studies lacked detailed information on physical activity (because it is not well captured by administrative data sources), had small sample sizes, and were limited to certain cancer types. PURPOSE: Investigate associations between cancer history and subsequent risk of frailty-related fractures, and to explore modification by moderate-vigorous intensity aerobic physical activity (MVPA) and weight training. METHODS: Participants from the Cancer Prevention Study-II (CPS-II) were linked to Medicare claims data for years 1999-2017. Cancer history was confirmed via medical record or cancer registry linkage starting at CPS-II enrollment (1992) and modeled as a time-dependent variable in three categories: 1) cancer survivor 1-5 years post-diagnosis (short-term), 2) cancer survivor ≥5 years post-diagnosis (longer-term), and 3) no cancer history. The first year of diagnosis was excluded to reduce the effect of treatment. Total frailty-related (pelvic, radial, vertebral) and site-specific fractures were identified in Medicare claims data using established algorithms. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risk of fractures overall and stratified by MVPA and weight training. RESULTS: Over the course of follow-up, 14,196 frailty-related fractures were identified among 101,543 participants (including 14,159 cancer survivors). Compared to no cancer history, both short- (HR=1.28, CI: 1.18-1.38) and longer-term (HR=1.08, CI: 1.00-1.16) cancer survivors were at higher risk of total frailty-related fractures. Short-term survivors were also at higher risk of pelvic (1.34, 1.18-1.53) and radial (1.33, 1.19-1.48), but not vertebral fractures. Meeting MVPA guidelines (0.87, 0.78-0.97) and weight training (0.85, 0.74-0.99) lowered risk of fractures among longer-term survivors, but not short-term survivors (0.94, 0.81-1.09 MVPA and 0.95, 0.78-1.17 weight training). CONCLUSION: Cancer survivors are at a higher risk of frailty-related fractures, but MVPA and weight training may reduce some of the excess risk.

Effects of Carbohydrate and Protein Administration by Food Items on Strength Response after Training in Stable COPD.

Background: Chronic obstructive pulmonary disease (COPD) is one of the world’s most common diseases and reasons for death. Systemic consequences, especially reduced muscle strength, muscle mass and muscle function, are common and contribute to worsening prognosis and increasing morbidity and mortality. There is strong evidence that physical activity and strength training are effective in prolonging life and lead to better quality of life. Numerous studies have shown that ingestion of protein and carbohydrates after strength training can increase regeneration of strength in young athletes. Recently, we demonstrated that the same effect can be achieved with these macronutrients administered in a meal. Until now, it is not clear if patients with COPD, integrated in regular physical training, respond similarly. Methods: Prescribed strength training, consisting of two sets circular training with machines for big muscle groups was supplemented with a meal rich in protein and carbohydrates. Changes in maximum strength after 24 h were investigated to find out about the impact of this meal on physical capacity. A pilot study was conducted with pragmatic cross-over design. Results: With nutritive intervention, strength in both knee extensor and chest press were significantly higher than in control training. Conclusion: The study showed beneficial effects for the intake of protein and carbohydrates in changes in maximum strength. For now, the underlying mechanism remains unclear. Clinical relevance needs further research. The study design and study protocol can be used for further studies with only small adaptions.

Health care professionals’ understanding of contraindications for physical activity advice in the setting of stem cell transplantation

PurposeMost patients receiving a hematopoietic stem cell transplantation (HSCT) are able to tolerate and benefit from physical activity (PA). Therefore, it is important that health care professionals (HCPs) advise patients to perform PA before, during, and after transplantation. By understanding which medical conditions and safety issues are associated with the (non-) promotion of PA, concrete actions and interventions can be planned and implemented.MethodsPhysicians (N = 51), nurses (N = 52), and physical therapists (N = 26) participated in a nationwide cross-sectional online survey. HCPs’ understanding of 15 medical conditions as contraindications for PA was assessed. Significant group differences were determined using chi-square analysis.ResultsAcute infection was the only condition which was considered as contraindication by all HCPs (62.7%). Cachexia (78%), having a stoma (91%), or port (96.2%), psychological problems (88.4%), and leukopenia (83.3%) were not considered as contraindications. Six conditions were rated inconsistently between the groups, whereas physicians had the least concerns regarding PA. Physicians with an additional training in PA perceived a platelet count of ≤ 50,000/μl significantly less often as contraindication (p < 0.05).ConclusionThe large number of potentially-answers especially in nursing staff and physical therapists might reflect caution or uncertainty. There is a clear need for a good multidisciplinary cooperation between all HCPs in order to support patients to confidently engage in PA. Furthermore, education possibilities and evidence-based courses to build knowledge regarding safety concerns should be the standard practice in the setting of HSCT. The investigative nature of the paper indicates that certain trends should be interrogated in a causal-longitudinal design.

P07-01 Prescription of adapted physical activity: knowledge and needs among general practitioners of Ile-de-France

BackgroundPhysical inactivity is the fourth leading cause of death in the world. In France, the concept of medical prescription of physical activity (PA) adapted now appears in a law which specifies the central role of the family physician since December 2016. The needs of the general practitioners (GP) about prescription of PA has not been studied.AimTo assess the knowledge and needs of GPs regarding the medical prescription of PA.MethodsThis is a transversal observational epidemiological study of GPs working in the departments of Hauts-de-Seine (92) and Val-de-Marne (94) near Paris. A questionnaire was sent by mail or email. A descriptive statistical analysis was conducted to describe the main variables of interest. Then, a multivariate statistical analysis by logistic regression was conducted to look for independent factors of the feeling of competence in the prescription of adapted PA.Results158 physicians were included. 72.2% of GPs rated their knowledge in PA as average to very poor. The initial training in PA is estimated as unsatisfactory by 84.2% of GPs. 81.6% haven't done a postgraduate additional training in PA. A specific skill in sports medicine, the individual practice of PA as well as the speaking about PA in more than 50% of consultations are significantly associated with a feeling of competence in PA prescription (p >0.01).Among the measures favoring the prescription of PA, GPs told that they need information brochures to give to the patient (60.8%), a website of help to the prescription of PA which can be used in consultation (60.1%), or the organization of a specific training on the medical prescription of AP (50,6%).ConclusionThe lack of training seems to be the major obstacle to the generalization of prescription of PA. The organization of training or the creation of specific tools for the attending physician seems to be promising solutions.

P01-06 Physical activity and non communicable diseases in France

France, as a Member State of WHO Europe, plays a major role in the European strategy on physical activity, nutrition and health within a global framework for the fight against non-communicable diseases.France has adopted a National Sport Health Strategy for 2019-2024 intended to promote sports and physical activities (SPA) as a fully-fledged determinant of health and well-being lifelong. It is consistent with other strategies or plans implemented by other ministerial departments.The four axes of the NSHS are: 1/Promoting health and well-being through physical activity and sports, 2/Developing the offer of and participation in adapted physical actvities for therapeutic purposes and prevention of loss of autonomy; 3/Better protecting sports people’s health and improving safety of activities whatever their intensity; 4/Improving and disseminating knowledge on the impacts on physical condition and health of engaging in sports and physical activities.One of the key measure of the NSHS is indexing of “Maisons Sport Santé”, Health Sport-Houses (HSH) aimed at receiving and orientating all those wishing to engage in, develop or resume sport or physical activities for health or wellbeing reasons, whatever their age, state of health or frailty. Following 3 calls for projects, 436 HSH have been recognized since 2019 and cover almost whole French territory. HSH can be integrated within an association, a hospital, a sports establishment or as digital platforms. A particular attention is paid to people with highly sedentary lifestyles and those with limited autonomy. People with chronic or long-term diseases (cancer, diabetes, heart disease, asthma, Alzheimer etc.) to whom physical activities adapted to their limitations have been prescribed are also priority targets.“Month of Sport and Physical Activities” is a large-scale communication campaign to promote the benefits of sport and physical activities to a wide range of population. The aim is to spread recommendations on SPA and the fight against sedentary behavior, to make SPA accessible to everyone and to encourage people and make them aware of the possibilities to practice in their daily life. Another goal is to give visibility to current actions in this area, to enable French people carry out an analysis of their physical condition and to spur them to (re) start a physical activity training.

P04-12 The efficacy and feasibility of the SPRINTT physical activity intervention in Finland

BackgroundOlder adults with frailty and sarcopenia are at high risk of disability. These older adults get benefit from physical activity. However, it is challenging to get them involved in exercise interventions. The SPRINtT trial has investigated the efficacy and feasibility of a multicomponent intervention in the prevention of mobility disability in older adults with frailty and sarcopenia in 11 European countries, under the coordination of the Università Cattolica del Sacro Cuore, Italy. Altogether 1566 candidates were recruited to the SPRINtT RCT, and 142 of them in Finland.MethodsThe participants (n = 70) completed at least two years of physical activity training. The training was performed at moderate intensity and consisted of walking, strength, balance and flexibility exercises. The participants attended training two times a week at the center with the addition of home-based exercises. The training intensity increased gradually. The primary outcome of mobility disability was operationalized as an inability to complete the 400-m walk test. Secondary outcomes of physical performance were the short physical performance battery (SPPB) and handgrip strength.ResultsThe results of the intervention will be revealed in spring 2020. Participants experienced that their physical performance improved during the follow-up. The physical activity program and the home-based exercises can be performed without any equipment and could, therefore, be easily implemented for practice.ConclusionsThe physical activity intervention was feasible and could be further recommended for older people with sarcopenia and physical frailty if the final results support these experiences.