scholarly journals Patient Perspectives on Home-Based Rehabilitation Exercise and General Physical Activity after Total Hip Arthroplasty: A qualitative study (PHETHAS-2)

2020 ◽  
Author(s):  
Anne Groendahl Poulsen ◽  
Janni Dahlgaard Gravesen ◽  
Merete Noergaard Madsen ◽  
Lone Ramer Mikkelsen ◽  
Thomas Bandholm ◽  
...  
Keyword(s):  
Physical Activity ◽  
Everyday Life ◽  
Exercise Program ◽  
Main Theme ◽  
Structured Interviews ◽  
Theoretical Underpinning ◽  
Home Based ◽  
Facilitators And Barriers ◽  
General Physical ◽  
Rehabilitation Exercise

Abstract Objectives To investigate patient-perceived facilitators and barriers to home-based rehabilitation exercise and general physical activity after THA. Design Using a qualitative design, twenty-two semi-structured interviews were conducted and analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept conduct of everyday life. The study is embedded within the PHETHAS-1 trial, quantitatively investigating recovery outcomes after a home-based rehabilitation exercise program. Setting A regional hospital in Denmark between January 2018 and May 2019. Participants Twenty-two patients who had undergone THA and performed home-based rehabilitation exercise. Results The main theme Wishing to return to the well-known everyday life and the subtheme General physical activity versus rehabilitation exercise were identified. Generally, the participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their habitual conduct of everyday life and perform their usual general physical activities. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises. Both pain and no pain were identified as barriers for doing the home-based rehabilitation exercise. Pain could cause insecurity while no pain could cause the rehabilitation exercise to be perceived as pointless. Conclusions The overall goal for the THA patients was to return to their habitual everyday life. This goal served as a facilitator for undertaking home-based rehabilitation exercise. Being able to perform their usual activities paradoxically became a barrier for some of the participants, as they were more motivated towards general physical activity than the rehabilitation exercise.

scholarly journals Patient perspectives on home-based rehabilitation exercise and general physical activity after total hip arthroplasty: A qualitative study (PHETHAS-2)

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 382
Author(s):  
Anne Grøndahl Poulsen ◽  
Janni Dahlgaard Gravesen ◽  
Merete Nørgaard Madsen ◽  
Lone Ramer Mikkelsen ◽  
Thomas Bandholm ◽  
...  
Keyword(s):  
Physical Activity ◽  
Total Hip Arthroplasty ◽  
Everyday Life ◽  
Hip Arthroplasty ◽  
Outpatient Rehabilitation ◽  
Main Theme ◽  
Total Hip ◽  
Home Based ◽  
General Physical ◽  
Rehabilitation Exercise

Background: Home-based rehabilitation exercise following Total Hip Arthroplasty (THA) shows similar outcomes compared to supervised outpatient rehabilitation exercise. Little is known about patients' experiences with home-based rehabilitation, and this study aimed to investigate patient-perceived facilitators and barriers to home-based rehabilitation exercise and general physical activity after THA. Methods: Semi-structured interviews of qualitative design were conducted with 22 patients who had undergone THA and who had performed home-based rehabilitation exercise. The study took place in a regional hospital in Denmark between January 2018 and May 2019. Data was analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept ‘conduct of everyday life’. The study is embedded within the Pragmatic Home-Based Exercise Therapy after Total Hip Arthroplasty-Silkeborg trial (PHETHAS-1), which aims to quantitatively investigate recovery outcomes after a home-based rehabilitation exercise program. Results: The main theme, ‘wishing to return to the well-known everyday life’, and the subtheme ‘general physical activity versus rehabilitation exercise’ were identified. Generally, participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their habitual conduct of everyday life and performing their usual general physical activities. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises.  Both pain and the absence of pain were identified as barriers for doing home-based rehabilitation exercise. Pain could cause insecurity about possible medical complications, while the absence of pain could lead to the rehabilitation exercise being perceived as pointless. Conclusions: The overall goal for the THA patients was to return to their habitual everyday life. This goal served as a facilitator for undertaking home-based rehabilitation exercise. Being able to perform usual activities paradoxically became a barrier for some participants, as they were more motivated to engage in general physical activity than the rehabilitation exercise.

scholarly journals Investigating Parental Beliefs Concerning Facilitators and Barriers to the Physical Activity in Down Syndrome and Typical Development

SAGE Open ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 215824401668779 ◽  
Author(s):  
Marianna Alesi
Keyword(s):  
Physical Activity ◽  
Down Syndrome ◽  
Intervention Programs ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Home Based ◽  
Semistructured Interviews ◽  
The Family ◽  
Sport Activities ◽  
Facilitators And Barriers

Family is a crucial factor to determine the amount, the duration, and the complexity of children’s sport activities. This study aims at comparing the beliefs concerning the involvement in sport activities among parents of children with Down syndrome (DS) and parents of typically developing children (TDC). A phenomenological theoretical framework was adopted to realize semistructured interviews with the parents. The participants were 35 parents: 19 with children and adolescents with DS and 16 with TDC. The main facilitation/barrier themes identified by the parents of children with DS were the family and the expert at Adapted Physical Activity (APA) instructors. Conversely, the parents of TDC identified social factors related to family as the only barrier. One of the issues that emerge from this study is the lack of home-based physical activity (PA) intervention programs aimed at involving families and children.

A phase II-III, multicenter, randomized, open study evaluating the feasibility and efficacy of a supervised home-based standard physical exercise program for metastatic cancer patients receiving oral targeted therapy: The UNICANCER SdS 01 QUALIOR study (ID-RCB: 2015-A01922-47).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. TPS10126-TPS10126
Author(s):  
Florence Joly Lobbedez ◽  
Laurence Vanlemmens ◽  
Jean-Marc Descotes ◽  
Sophie Abadie-Lacourtoisie ◽  
Claude Boiron ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Exercise ◽  
Cancer Patients ◽  
Phase Ii ◽  
Metastatic Cancer ◽  
Exercise Program ◽  
Well Being ◽  
Phase Iii ◽  
Ethic Committee Approval ◽  
Home Based

TPS10126 Background: Fatigue is a frequent side effect with oral targeted therapies (OTT). Physical activity has been reported to improve fatigue and quality of life (QoL). However, few studies focused on metastatic cancer patients and mainly among patients treated with chemotherapy. Furthermore, recent guidelines recommend evaluation and optimization of standardized exercise programs. The aim of our study is to evaluate home-based standard physical exercise program (SPEP) for metastatic cancer patients treated with OTT. Methods: This phase II-III study will randomize (2:1) patients starting first-line OTT for metastatic cancer between an individualized SPEP supervised by a personal coach, and recommended physical exercises via a booklet. Eligible patients will have received ≤2 lines of metastatic chemotherapy, ECOG PS ≤2, controlled pain (VAS < 3/10), and life expectancy ≥3 months. The phase II part (120 patients) will evaluate the feasibility of a 3-month SPEP using the rate of patients performing ≥50% of SPEP (2-stage Fleming: one-sided α = 5%; β = 85%). An interim analysis is planned after the phase II. The phase III will compare the efficacy of an SPEP as opposed to recommendations to reduce fatigue and/or improve physical well-being (PWB) dimensions of QoL (evaluated with FACT-G and FACT-F questionnaires). To show a difference of ≥5 points in PWB and 2.5 for fatigue (α = 2.5%; β = 80%), 312 patients are required in the phase III trial. . Secondary objectives include: PFS, OS, other dimensions of QoL, tolerability and observance of OTT, change in body composition, physical benefits, and a medico-economic study. The SPEP was developed by specialized coaches involved in physical activity and cancer. The study has Ethic committee approval and accrual is planned in 18 French centers in April 2017, for 30 months. This is the first randomized trial dedicated to patients with metastatic cancer treated with OTT evaluating the feasibility and the efficacy of a well design home based SPEP on fatigue and physical well-being.

scholarly journals Informing the real-world implementation of a home-based physical activity program for mothers at risk of postnatal depression: Perspectives from key stakeholders.

2020 ◽  
Author(s):  
Megan Teychenne ◽  
Maria Apostolopoulos ◽  
Kylie Ball ◽  
Ellinor K Olander ◽  
Rachelle S Opie ◽  
...  
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Real World ◽  
Postnatal Depression ◽  
Scale Up ◽  
Stakeholder Involvement ◽  
Relative Advantage ◽  
Structured Interviews ◽  
Organisational Capacity ◽  
Home Based

Abstract Background Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform development and implementation of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up.Methods In September to November 2019, representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia (n = 11) participated in semi-structured interviews exploring their perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Thematic analyses were used for qualitative data.Results The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose; translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services.Conclusions While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.

scholarly journals Efficacy and Safety of an mHealth App and Wearable Device in Physical Performance for Patients With Hepatocellular Carcinoma: Development and Usability Study

10.2196/14435 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e14435 ◽  
Author(s):  
Yoon Kim ◽  
Jinserk Seo ◽  
So-Yeon An ◽  
Dong Hyun Sinn ◽  
Ji Hye Hwang
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Body Composition ◽  
Physical Fitness ◽  
Exercise Program ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk ◽  
Rehabilitation Exercise

Background Exercise is predicted to have a positive effect among hepatocellular carcinoma (HCC) patients. However, these patients are hesitant to start and build up an exercise program for one major reason: the vague fear of developing hepatic decompensation, a potentially fatal condition that can lead to death. Integrating mobile health (mHealth) with individualized exercise programs could be a possible option for promoting physical capacity among HCC patients. Objective The aim of this study was to evaluate the efficacy and safety of rehabilitation exercises, which have been individually prescribed via an mHealth app, on physical fitness, body composition, biochemical profile, and quality of life among HCC patients. Methods A total of 37 HCC patients were enrolled in a 12-week course with an mHealth app program targeted to HCC patients. The wearable wristband device Neofit (Partron Co) was provided to participants, and recorded daily physical data, such as the number of steps, calorie expenditure, exercise time, and heart rate. Each participant was given an individualized rehabilitation exercise program that was prescribed and adjusted at the 6-week midintervention period based on the assessment results. At baseline, 6-week, and 12-week sessions, participants’ physical fitness levels (ie, 6-minute walk test, grip strength test, and 30-second chair stand test) were measured. Physical activity levels, as measured by the International Physical Activity Questionnaire-Short Form (IPAQ-SF); body composition (ie, body mass index, body fat percentage, and muscle mass); biochemical profiles; and quality of life, as measured by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30, were assessed at baseline and at the end point. At the 6-week midpoint, exercise intensity was individually adjusted. Results Of the 37 patients, 31 (84%) completed the 12-week intervention. Grip strength improved significantly after 12 weeks of the intervention. The 30-second chair stand test and the 6-minute walk test showed significant improvement from 0 to 6 weeks, from 0 to 12 weeks, and from 6 to 12 weeks. Muscle mass and the IPAQ-SF score increased significantly after 12 weeks of the intervention without biochemical deterioration. Conclusions Following 12 weeks of mHealth care, including an individually prescribed rehabilitation exercise program, we saw significant improvements in physical fitness, body composition, and physical activity without any complication or biochemical deterioration among compensated HCC patients who had completed therapy.

scholarly journals Exercise Management Using a Mobile App in Patients with Parkinsonism: A Prospective, Open-label, Single-arm, Pilot Study (Preprint)

2021 ◽  
Author(s):  
Aram Kim ◽  
Seo Jung Yun ◽  
Kwan Sik Sung ◽  
Yeonju Kim ◽  
Ju Young Jo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Pilot Study ◽  
Management Strategy ◽  
Exercise Program ◽  
Mobile App ◽  
Open Label ◽  
Home Based ◽  
Secondary Outcomes

BACKGROUND Although exercise has benefits for motor function and quality of life in patients with parkinsonism, these patients have many barriers to exercise participation. Recently, the use of mobile apps has been highlighted as a remotely supervised exercise management strategy. OBJECTIVE This study aimed to evaluate the effects of home-based exercise management with a customized mobile app on exercise amount, physical activity, and quality of life in patients with parkinsonism. METHODS This was a prospective, open-label, single-arm, pilot study. Participants were encouraged to engage in an 8-week home-based exercise program delivered through a customized app. The primary outcome was the exercise amount. The secondary outcomes were International Physical Activity Questionnaire (IPAQ), Parkinson’s Disease Questionnaire-39 (PDQ-39), and Geriatric Depression Scale (GDS). RESULTS A total of 21 participants completed the intervention and assessment (mean age: 72 years; women: 17/21, 81%; men: 4/21, 19%). The participants reported a significant increase in the total amount of exercise (baseline: 343.33±206.70 min/week; 8-week follow up: 693.10±373.45 min/week; P<.001) and in the amount of each exercise component including stretching, strengthening, balance and cooperation, and oral-motor and vocal exercise after 8 weeks. The analysis of secondary outcomes revealed significant improvements in the IPAQ (P=.006), PDQ-39 (P=.02), and GDS (P=.04) scores. The usability of the program with the mobile app was verified based on the positive responses such as “intention to use” and “role expectation for rehabilitation.” CONCLUSIONS Exercise management with a customized mobile app may have benefits for improving exercise adherence, physical activity, depression, and quality of life in patients with parkinsonism. This supervised home-based, technology-based, reinforcing, and multimodal exercise management strategy should be recommend to patients with parkinsonism. In addition, this program may be useful as an alternative exercise management strategy during the COVID-19 pandemic. Additional clinical trials are needed to evaluate the efficacy of this exercise program in a large population and to confirm its disease-modifying effects.

scholarly journals P1306EFFECT OF A SUPERVISED PERI- DIALYTIC EXERCISE PROGRAM ON SERUM ASYMMETRIC DIMETHYLARGININE IN MAINTENANCE HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yaser Ammar ◽  
Ahmad Awad
Keyword(s):  
Physical Activity ◽  
Physical Activity Level ◽  
Asymmetric Dimethylarginine ◽  
Exercise Program ◽  
Activity Level ◽  
Maintenance Hemodialysis ◽  
Vascular Events ◽  
Nitric Oxide Synthase Inhibitor ◽  
General Physical ◽  
Esrd Patients

Abstract Background and Aims End-stage renal disease (ESRD) patients treated with maintenance hemodialysis (MHD) have high cardiovascular disease morbidity and mortality. Accumulation of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, has been strongly implicated in endothelial dysfunction, premature atherosclerosis, vascular events and mortality. Regular physical exercise effectively decreased serum ADMA in several studies. This potential should be explored among MHD patients. Method Forty four middle-aged ESRD patients treated with thrice-weekly MHD for &gt;6 months completed a 6 months regimen of peri-dialytic lower limb exercise comprising pre-dialytic 10-12 stretching cycles and 20-30 minutes of intra-dialytic pedalling cycles. Plasma ADMA, CRP, other laboratory parameters and overall physical activity level were assessed initially and at the end of the study. Results S.ADMA increased from a median of 2375 to 3000 ng/mL (P=0.016). 31 patients sustained an increase in S.ADMA (ADMA_Inc), whereas 13 patients had a declining or stable S.ADMA (ADMA_Dec). Compared with ADMA_Inc, ADMA_Dec patients had significantly higher Kt/V (P=0.02), significantly higher grade of basal general physical activity level (P=0.017) and significantly less intra-dialytic hypotension episodes (IDHs) (P=0.019). The increase in S.ADMA and the post- study S.ADMA level had statistically significant positive correlations with number of IDHs (r=0.401,P=0.007 and r=0.305,P=0.044, respectively). Conclusion A 6 months program of combined aerobic and resistance peri-dialytic exercise failed to reduce S.ADMA in most MHD patients studied. A modest S.ADMA decline, however, occurred in patients with higher basal exercise level, higher Kt/V, and less IDHs. A potential benefit of peri-dialytic exercise in decreasing S.ADMA may be promoted by a multidisciplinary approach targeting increased physical activity, improved dialysis efficiency and prevention of IDHs.

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