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Developmental Medicine and Child... Nov 2023To identify implementation strategies and safety outcomes (adverse events) of community-based physical activity interventions for adolescents and adults with complex... (Review)
Review
AIM
To identify implementation strategies and safety outcomes (adverse events) of community-based physical activity interventions for adolescents and adults with complex cerebral palsy (CP).
METHOD
Five electronic databases were systematically searched to April 2022. Data were extracted on the implementation and safety of physical activity interventions for adolescents and adults with CP, classified in Gross Motor Function Classification System (GMFCS) levels IV and V, delivered in a community setting.
RESULTS
Seventeen studies with 262 participants (160 participants classified in GMFCS levels IV or V) were included. Community settings included schools (n = 4), participants' homes (n = 3), gymnasia (n = 2), swimming pools (n = 2), and other settings (n = 4). Most studies specified medical or safety exclusion criteria. Implementation strategies included pre-exercise screening, use of adapted equipment, familiarization sessions, supervision, physical assistance, and physiological monitoring. Attendance was high and attrition low. Nine studies reported non-serious, expected, and related events. Four studies reported minor soreness and four studies reported minor fatigue post-exercise. Serious adverse events related to exercise were infrequent (reported for 4 of 160 participants [<2%]: three participants withdrew from an exercise programme and one participant ceased exercise for a short period). Most frequently reported was pain, requiring temporary exercise cessation or programme change, or study withdrawal (three participants).
INTERPRETATION
For most adolescents and adults with CP classified in GMFCS levels IV and V, physical activity interventions can be safely performed in a community setting, without post-exercise pain or fatigue, or serious adverse events.
WHAT THIS PAPER ADDS
Supervised community-based physical activity interventions can be safely performed by people with complex cerebral palsy. Post-exercise pain or fatigue was not common among those classified in Gross Motor Function Classification System levels IV or V. Serious adverse events are infrequent when exercising in community settings, with safety strategies.
Topics: Humans; Adult; Adolescent; Cerebral Palsy; Quality of Life; Exercise; Pain; Fatigue
PubMed: 37032538
DOI: 10.1111/dmcn.15611 -
Scandinavian Journal of Public Health Dec 2023This paper describes the design of the 'Move More' study, which aims to develop and assess the feasibility of a social-prescribing intervention to increase physical... (Review)
Review
AIM
This paper describes the design of the 'Move More' study, which aims to develop and assess the feasibility of a social-prescribing intervention to increase physical activity among physically inactive Danes.
BACKGROUND
Physical inactivity constitutes a public-health challenge in Denmark. Social prescribing may be a promising tool to tackle physical inactivity by linking physical activity support from general practitioners with community-based activities in sports clubs, as this may help physically inactive citizens become more physically active. Given the range of stakeholders and behaviours required for social prescribing of physical activity, an intervention that harnesses this approach may constitute a complex intervention. The methods and decisions made in the stages of developing complex interventions are seldom reported. The present study enabled us to describe how co-creation can be used in a pragmatic development process for a complex intervention that considers the needs of stakeholders and the conditions of the delivery context.
METHODS
The study is based on the core elements of the development and feasibility phases of the Medical Research Council Framework for Developing and Evaluating Complex Interventions. Additionally, it is informed by a framework for the co-creation and prototyping of public-health interventions, drawing from a scoping review, stakeholder consultations and co-creation workshops. Ultimately, a feasibility study will be conducted to refine the programme theory by introducing the proposed intervention in case studies.
PERSPECTIVES
The study will result in a prototype intervention manual and recommendations for implementation of an adapted social-prescribing intervention targeting physical inactivity in Denmark.
Topics: Humans; Exercise; Feasibility Studies; Sedentary Behavior; Sports; Health Promotion
PubMed: 35656623
DOI: 10.1177/14034948221098929 -
BMC Neurology Sep 2023Exercise has various health benefits for people with Parkinson's disease (PD). However, implementing exercise into daily life and long-term adherence remain challenging....
BACKGROUND
Exercise has various health benefits for people with Parkinson's disease (PD). However, implementing exercise into daily life and long-term adherence remain challenging. To increase a sustainable engagement with physical activity of people with PD, interventions that are motivating, accessible, and scalable are needed. We primarily aim to investigate whether a smartphone app (STEPWISE app) can increase physical activity (i.e., step count) in people with PD over one year. Our second aim is to investigate the potential effects of the intervention on physical fitness, and motor- and non-motor function. Our third aim is to explore whether there is a dose-response relationship between volume of physical activity and our secondary endpoints.
METHODS
STEPWISE is a double-blind, randomized controlled trial. We aim to include 452 Dutch people with PD who can walk independently (Hoehn & Yahr stages 1-3) and who do not take more than 7,000 steps per day prior to inclusion. Physical activity levels are measured as step counts on the participant's own smartphone and scaled as percentage of each participant's baseline. Participants are randomly assigned to an active control group with an increase of 5-20% (active controls) or any of the three intervention arms with increases of 25-100% (intermediate dose), 50-200% (large dose), or 100-400% (very large dose). The primary endpoint is change in step count as measured by the STEPWISE smartphone app from baseline to 52 weeks. For our primary aim, we will evaluate the between-group difference in average daily step count change from baseline to 52 weeks. For our second aim, measures of physical fitness, and motor- and non-motor function are included. For our third aim, we will associate 52-week changes in step count with 52-week changes in secondary outcomes.
DISCUSSION
This trial evaluates the potential of a smartphone-based intervention to increase activity levels in people with PD. We envision that motivational apps will increase adherence to physical activity recommendations and could permit conduct of remote clinical trials of exercise for people with PD or those at risk of PD.
TRIAL REGISTRATION
ClinicalTrials.gov; NCT04848077; 19/04/2021.
CLINICALTRIALS
gov/ct2/show/NCT04848077.
Topics: Humans; Smartphone; Parkinson Disease; Exercise; Mobile Applications; Physical Fitness; Randomized Controlled Trials as Topic
PubMed: 37700241
DOI: 10.1186/s12883-023-03355-8 -
Autism Research : Official Journal of... Jul 2023The purpose of this study was to examine the immediate and post effects of a parent-mediated physical activity intervention on the fundamental motor skills of autistic...
The purpose of this study was to examine the immediate and post effects of a parent-mediated physical activity intervention on the fundamental motor skills of autistic children. We randomly assigned parent-child dyads (n = 31) of autistic children aged 4-11 years into three groups (workshop, an online, or control group). Each dyad participated in a 12-week intervention and was given adapted physical activity equipment and over 200 activities via a mobile application. Children were tested at the start and end of the intervention. The effect size (Cohen's ) of the control group for pre-post locomotor and ball skill scores were 0.12 and 0.06, respectively, indicating small effect size. The effect size of the online group for pre-post locomotor and ball skill scores were 49 and 0.26, respectively, indicating medium and small effect sizes. The effect size of the in-person group for pre-post locomotor and ball skill scores were 1.18 and 0.82, respectively, indicating large effect sizes. The outcomes of this physical activity intervention suggest that parents may facilitate the acquisition of fundamental motor skills of their autistic children. Although these results are positive, there is a need to further identify effective interventions for fundamental motor skill development in autistic children. Clinical Trials ID: NCT05159102.
Topics: Humans; Autistic Disorder; Autism Spectrum Disorder; Exercise; Parents; Motor Skills
PubMed: 37357811
DOI: 10.1002/aur.2969 -
The International Journal of Behavioral... Nov 2023Physical activity referral schemes (PARS) are complex multicomponent interventions that represent a promising healthcare-based concept for physical activity (PA)... (Review)
Review
BACKGROUND
Physical activity referral schemes (PARS) are complex multicomponent interventions that represent a promising healthcare-based concept for physical activity (PA) promotion. This systematic review and narrative synthesis aimed to identify the constitutive components of PARS and provide an overview of their effectiveness.
METHODS
Following a published protocol, we conducted a systematic search of PubMed, Scopus, Web of Science, CINAHL, ScienceDirect, SpringerLink, HTA, Wiley Online Library, SAGE Journals, Taylor & Francis, Google Scholar, OpenGrey, and CORE from 1990 to January 2023. We included experimental, quasi-experimental, and observational studies that targeted adults participating in PARS and reported PA outcomes, scheme uptake, or adherence rates. We performed an intervention components analysis using the PARS taxonomy to identify scheme components and extracted data related to uptake, adherence, and PA behavior change. We combined these to provide a narrative summary of PARS effectiveness.
RESULTS
We included 57 studies reporting on 36 PARS models from twelve countries. We identified 19 PARS components: a patient-centered approach, individualized content, behavior change theory and techniques, screening, brief advice, written materials, a written prescription, referral, baseline and exit consultation, counselling support session(s), PA sessions, education session(s), action for non-attendance, structured follow-up, a PA network, feedback for the referrer, and exit strategies/routes. The PARS models contained a mean of 7 ± 2.9 components (range = 2-13). Forty-five studies reported PA outcome data, 28 reported uptake, and 34 reported adherence rates. Of these, approximately two-thirds of studies reported a positive effect on participant PA levels, with a wide range of uptake (5.7-100.0%) and adherence rates (8.5-95.0%).
CONCLUSIONS
Physical activity referral scheme components are an important source of complexity. Despite the heterogeneous nature of scheme designs, our synthesis was able to identify 19 components. Further research is required to determine the influence of these components on PARS uptake, adherence, and PA behavior change. To facilitate this, researchers and scheme providers must report PARS designs in more detail. Process evaluations are also needed to examine implementation and increase our understanding of what components lead to which outcomes. This will facilitate future comparisons between PARS and enable the development of models to maximize impact.
Topics: Adult; Humans; Exercise; Motor Activity; Prescriptions; Referral and Consultation
PubMed: 38012688
DOI: 10.1186/s12966-023-01518-x -
International Journal of Behavioral... Oct 2023There is increasing evidence for the relationship between physical activity (PA), sedentary behaviour and mental health. Limited data exists on sex-specific...
BACKGROUND
There is increasing evidence for the relationship between physical activity (PA), sedentary behaviour and mental health. Limited data exists on sex-specific associations. We aimed to identify associations between PA dose and domain and television time with psychological distress, including sex-stratified models.
METHODS
A total of 22,176 adults from the Melbourne Collaborative Cohort Study follow-up 2 cohort (2003-2007) participated in this cross-sectional study. Occupational, household, transport, leisure PA, hours watching television and psychological distress were assessed. Restricted cubic splines were used to examine the relationships between PA domains, television viewing time and psychological distress.
RESULTS
The relationships between PA and psychological distress were non-linear (p < 0.05) and differed by PA domain. There were dose-dependent, inverse associations between distress with transport (B[95% CI] = -0.39[-0.49, -0.30]) and leisure PA (B[95% CI] = -0.35[-0.46, -0.25]). The effect estimates for transport and leisure PA with distress were larger for women. For household domain, a U-shaped curve with an elongated tail was seen. Median PA was associated with lower distress compared with lower quantities (B[95% CI] = -0.12[-0.22, -0.03]); however, this association was not evident with increasing household PA. There were no clear associations between occupational PA and distress. Higher television viewing was associated with higher distress (B[95% CI] = 0.16[0.02, 0.30]).
CONCLUSIONS
Increasing PA and reducing television viewing may contribute to reduced psychological distress, particularly in women. Future interventions should incorporate leisure and transport PA and decrease television viewing to assess the impact on mental health.
Topics: Adult; Male; Humans; Female; Cross-Sectional Studies; Cohort Studies; Exercise; Leisure Activities; Motor Activity; Television
PubMed: 36180761
DOI: 10.1007/s12529-022-10130-5 -
Journal of Neurology Aug 2023Changes in motor activity are common in individuals with Frontotemporal dementia (FTD). Yet, it remains unclear why some individuals become motorically hyperactive,...
Changes in motor activity are common in individuals with Frontotemporal dementia (FTD). Yet, it remains unclear why some individuals become motorically hyperactive, while others hypoactive even in early stages of the disease. This study aimed to examine the relationship between motor activity level and (1) FTD clinical subtype, and (2) cortical thickness and subcortical volumes. Eighty-two charts were retrospectively reviewed from patients meeting consensus criteria for one of the three main clinical subtypes of FTD: probable bvFTD, semantic variant Primary Progressive Aphasia (PPA), or non-fluent variant PPA. Participants were assigned to one of three groups: (1) hyperactive, (2) hypoactive, or (3) no record of change. Hyperactivity was prevalent among bvFTD (58.5%) and semantic PPA (68.8%) subtypes while hypoactivity was less common in both subtypes (29.3% and 18.8%, respectively). The majority of patients with non-fluent PPA showed no record of change in motor activity (66.7%). The analysis of cortical thickness and subcortical volumes did not identify significant associations with motor activity levels. In conclusion, increased motor activity is highly prevalent among individuals with FTD, especially bvFTD and svPPA subtypes. These findings may inform prognosis and prediction of changes in motor activity, and allow planning for appropriate environmental and behavioural interventions. Future studies with prospective, standardized longitudinal collection of information regarding the type and level of change in motor activity, including wearable measures of actigraphy, may help to further delineate the onset and progression of abnormal motor behaviours and determine neuroanatomic associations in FTD.
Topics: Humans; Frontotemporal Dementia; Retrospective Studies; Motor Activity
PubMed: 37062017
DOI: 10.1007/s00415-023-11713-2 -
Journal of Physical Activity & Health Sep 2023Low prevalence of physical activity (PA) and a high prevalence of mental health problems are common among youth. The aim of this study was to evaluate the association...
BACKGROUND
Low prevalence of physical activity (PA) and a high prevalence of mental health problems are common among youth. The aim of this study was to evaluate the association between PA during adolescence and depression and anxiety disorders in young adulthood.
METHODS
Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed. Leisure-time PA and total PA (leisure plus commuting) were evaluated at 11, 15, and 18 years using self-reported data. PA was evaluated at each age separately and during adolescence, considering the number of times participants reached PA recommendations. Depression and anxiety were assessed through Mini International Neuropsychiatric Interview at 22 years. Crude and adjusted association analyses were performed using Poisson regression with robust error variance, providing prevalence ratios and 95% confidence intervals.
RESULTS
Three thousand two hundred and forty-seven participants were included in the study. In the adjusted analyses, active participants in leisure-time PA (≥300 min/wk) and total PA at 11 years were less likely to be depressed at age 22 (prevalence ratios: 0.54; 95% confidence interval, 0.33-0.89; prevalence ratios: 0.63; 95% confidence interval, 0.41-0.97). For leisure-time PA, the more PA recommendations were met during adolescence, the lower the prevalence of depression. There was no association when PA variables were evaluated separately at 15 and 18 years and between PA and anxiety after controlling for potential confounders.
CONCLUSIONS
Early adolescence appears to be a sensitive period for PA benefits on depression in early adulthood. The more timepoints reaching PA recommendations during adolescence, the lower the risk of depression. On the other hand, PA during adolescence was not associated with anxiety in young adults.
Topics: Adolescent; Young Adult; Humans; Adult; Cohort Studies; Exercise; Mental Health; Motor Activity; Leisure Activities
PubMed: 37558222
DOI: 10.1123/jpah.2022-0658 -
Physiology & Behavior Oct 2023The activity-based anorexia (ABA) animal model has been used in the laboratory to study the role of excessive physical activity in the manifestation of anorexia nervosa...
The activity-based anorexia (ABA) animal model has been used in the laboratory to study the role of excessive physical activity in the manifestation of anorexia nervosa (AN) in humans. Factors of social context are crucial in human health and the emergence of many psychological disorders, which have also been observed in studies using different mammal species that, like human beings, set their lives in groups. In the present study, the animals' social condition was manipulated to observe the effect of socialization in ABA development, and the possible different influence of the variable sex on the phenomenon. Eighty Wistar Han rats were distributed into four male and four female groups with 10 subjects each, manipulating social conditions (group housing or social isolation) and physical activity (access or not to a running wheel). Throughout the procedure, all groups had food restricted to 1 h/day during the light period. Furthermore, ABA experimental groups with access to the running wheel had two periods of access to the wheel of 2 h each, one before and the other after the food period. In this experiment, socialized rats were less vulnerable to weight loss during the procedure, although there were no differences between the ABA groups. Moreover, social enrichment was shown to be an enabling variable of the animals' recovery after their withdrawal from the procedure, with this effect being more pronounced in females. The results in this study suggest the need to further in the analysis of the role of socialization in the development of ABA.
Topics: Rats; Male; Female; Humans; Animals; Anorexia; Socialization; Rats, Wistar; Motor Activity; Anorexia Nervosa; Disease Models, Animal; Mammals
PubMed: 37328022
DOI: 10.1016/j.physbeh.2023.114271 -
Molecular Metabolism Apr 2024There is significant interest in uncovering the mechanisms through which exercise enhances cognition, memory, and mood, and lowers the risk of neurodegenerative...
OBJECTIVES
There is significant interest in uncovering the mechanisms through which exercise enhances cognition, memory, and mood, and lowers the risk of neurodegenerative diseases. In this study, we utilize forced treadmill running and distance-matched voluntary wheel running, coupled with light sheet 3D brain imaging and c-Fos immunohistochemistry, to generate a comprehensive atlas of exercise-induced brain activation in mice.
METHODS
To investigate the effects of exercise on brain activity, we compared whole-brain activation profiles of mice subjected to treadmill running with mice subjected to distance-matched wheel running. Male mice were assigned to one of four groups: a) an acute bout of voluntary wheel running, b) confinement to a cage with a locked running wheel, c) forced treadmill running, or d) placement on an inactive treadmill. Immediately following each exercise or control intervention, blood samples were collected for plasma analysis, and brains were collected for whole-brain c-Fos quantification.
RESULTS
Our dataset reveals 255 brain regions activated by acute exercise in mice, the majority of which have not previously been linked to exercise. We find a broad response of 140 regulated brain regions that are shared between voluntary wheel running and treadmill running, while 32 brain regions are uniquely regulated by wheel running and 83 brain regions uniquely regulated by treadmill running. In contrast to voluntary wheel running, forced treadmill running triggers activity in brain regions associated with stress, fear, and pain.
CONCLUSIONS
Our findings demonstrate a significant overlap in neuronal activation signatures between voluntary wheel running and distance-matched forced treadmill running. However, our analysis also reveals notable differences and subtle nuances between these two widely used paradigms. The comprehensive dataset is accessible online at www.neuropedia.dk, with the aim of enabling future research directed towards unraveling the neurobiological response to exercise.
Topics: Mice; Male; Animals; Motor Activity; Brain; Physical Conditioning, Animal; Cognition
PubMed: 38428817
DOI: 10.1016/j.molmet.2024.101907