Patient‐related outcome measures in sport and exercise medicine

In 2014, The National Institute for Health and Care Excellence (NICE) called for the development of a system to collate local data on exercise referral schemes (ERS). This database would be used to facilitate continued evaluation of ERS. The use of health databases can spur scientific investigation and the generation of evidence regarding healthcare practice. NICE’s recommendation has not yet been met by public health bodies. Through collaboration between ukactive, ReferAll, a specialist in software solutions for exercise referral, and the National Centre for Sport and Exercise Medicine, which has its research hub at the Advanced Wellbeing Research Centre, in Sheffield, data has been collated from multiple UK-based ERS to generate one of the largest databases of its kind. This database moves the research community towards meeting NICEs recommendation. This paper describes the formation and open sharing of The National ReferAll Database, data-cleaning processes, and its structure, including outcome measures. Collating data from 123 ERSs on 39,283 individuals, a database has been created containing both scheme and referral level characteristics in addition to outcome measures over time. The National ReferAll Database is openly available for researchers to interrogate. The National ReferAll Database represents a potentially valuable resource for the wider research community, as well as policy makers and practitioners in this area, which will facilitate a better understanding of ERS and other physical-activity-related social prescribing pathways to help inform public health policy and practice.

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Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000888 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000888

Author(s):

Dane Vishnubala ◽

Katherine Rose Marino ◽

Margaret Kathryn Pratten ◽

Andy Pringle ◽

Steffan Arthur Griffin ◽

...

Keyword(s):

National Health Service ◽

Health Service ◽

National Health ◽

Thematic Analysis ◽

Heavy Exercise ◽

Structured Interviews ◽

Ultrasound Education ◽

Exercise Medicine ◽

Sport And Exercise ◽

Inductive Thematic Analysis

ObjectivesTo explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS.MethodsSemi-structured interviews were undertaken to collect data from identified ‘stakeholders’. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data.ResultsN=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality.ConclusionThe management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent ‘unique selling points’ of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.

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Defining standards in colorectal optimisation: a Delphi study protocol to achieve international consensus on key standards for colorectal surgery prehabilitation

BMJ Open ◽

10.1136/bmjopen-2020-047235 ◽

2021 ◽

Vol 11 (3) ◽

pp. e047235

Author(s):

Iona Pearson ◽

Sue Blackwell ◽

Rebecca Fish ◽

Sarah Daniels ◽

Malcolm West ◽

...

Keyword(s):

Systematic Review ◽

Colorectal Surgery ◽

Outcome Measures ◽

Delphi Study ◽

Public Involvement ◽

Healthcare Professionals ◽

Patient And Public Involvement ◽

International Consensus ◽

Elective Colorectal Surgery ◽

Patient Related Outcome

IntroductionPrehabilitation in colorectal surgery is evolving and may minimise postoperative morbidity and mortality. With many different healthcare professionals contributing to the prehabilitation literature, there is significant variation in reported primary endpoints that restricts comparison. In addition, there has been limited work on patient-related outcome measures suggesting that patients with colorectal cancer needs and issues are being overlooked. The Defining Standards in Colorectal Optimisation Study aims to achieve international consensus from all stakeholders on key standards to provide a framework for reporting future prehabilitation research.Methods and analysisA systematic review will identify key standards reported in trials of prehabilitation in colorectal surgery. Standards that are important to patients will be identified by a patient and public involvement (PPI) event. The longlist of standards generated from the systematic review and PPI event will be used to develop a three-round online Delphi process. This will engage all stakeholders (healthcare professionals and patients) both nationally and internationally. The results of the Delphi will be followed by a face-to-face interactive consensus meeting that will define the final standards for prehabilitation for elective colorectal surgery.Ethics and disseminationThe University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee has approved this protocol, which is registered as a study (200190120) with the Core Outcome Measures in Effectiveness Trials Initiative. Publication of the standards developed by all stakeholders will increase the potential for comparative research that advances understanding of the clinical application of prehabilitation.PROSPERO registration numberCRD42019120381.

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In a global pandemic, sport and exercise medicine can mean so much more

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103821 ◽

2021 ◽

Vol 55 (6) ◽

pp. 295-296

Author(s):

Jane S Thornton ◽

Karim M Khan

Keyword(s):

Exercise Medicine ◽

Global Pandemic ◽

Sport And Exercise

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Patient Related Outcome Measures (PROMs) in Morton’s Neuroma: Conservative vs. Surgical Management at One-Year Follow-Up

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00021 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0002

Author(s):

Alastair Faulkner ◽

Alistair Mayne ◽

Fraser Harrold

Keyword(s):

Outcome Measures ◽

Surgical Management ◽

Conservative Management ◽

Morton’S Neuroma ◽

Significant Difference ◽

Morton's Neuroma ◽

One Year ◽

Patient Related Outcome ◽

Eq Vas

Category: Midfoot/Forefoot Introduction/Purpose: Morton’s neuroma is a common condition affecting the foot and is associated with chronic pain and disability. Conservative management including a combination of orthotic input; injection or physiotherapy, and surgical excision are current treatment options. There is a paucity of literature regarding patient related outcome measures (PROMs) data in patients managed conservatively. We sought to compare conservative with surgical management of Morton’s neuroma using PROMs data in patients with follow-up to one year. Methods: Prospective data collection commenced from April 2016. Patients included had to have a confirmed Morton’s neuroma on ultrasound scan. Patient demographics including age, sex and BMI were collected. The primary outcome measures were the Manchester Foot Score for pain (MOX-FQ), EQ time trade off (TTO) and EQ visual analogue scale (VAS) taken pre-operatively; at 26-weeks and at 52-weeks post-operatively. Results: 194 patients were included overall: 79 patients were conservatively managed and 115 surgically managed. 19 patients were converted from conservative to surgical management. MOX-FQ pain scores: pre-op conservative 52.15, surgical 61.56 (p=0.009), 6-months conservative 25.1, surgical 25.39 (p=0.810), 12 months conservative 18.54, surgical 20.52 (p=0.482) EQ-TTO scores: pre-op conservative 0.47, surgical 0.51 (p=0.814), 6-months conservative 0.41, surgical 0.49 (p=0.261), 12 months conservative 0.26, surgical 0.37 (p=0.047) EQ-VAS scores: pre-op conservative 63.84, surgical 71.03 (p=0.172), 6-months conservative 46.10, surgical 52.51 (p=0.337), 12 months conservative 30.77, surgical 37.58 (p=0.227) Satisfaction at 12 months: conservative 17 (21.5%), surgical 32 (27.8%) p=0.327 Conclusion: This is one of the first studies investigating long-term PROMs specifically in conservative management for Morton’s neuroma patients. There was no significant difference in pain score and EQ-VAS between all conservative treatments and surgical management at 12 months There was no significant difference in satisfaction at 12 months between conservative and surgical groups.

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PRP use in sport and exercise medicine: be wary of science becoming the sham

British Journal of Sports Medicine ◽

10.1136/bjsports-2021-104822 ◽

2021 ◽

pp. bjsports-2021-104822

Author(s):

Jon Patricios ◽

Kimberly G Harmon ◽

Jonathan Drezner

Keyword(s):

Exercise Medicine ◽

Sport And Exercise

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So you want to be … a sport and exercise medicine physician

British Journal of Hospital Medicine ◽

10.12968/hmed.2009.70.sup11.45073 ◽

2009 ◽

Vol 70 (Sup11) ◽

pp. M176-M176

Author(s):

Eleanor Tillett ◽

Fares Haddad

Keyword(s):

Exercise Medicine ◽

Medicine Physician ◽

Sport And Exercise

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Special Issue “New Trends in Sport and Exercise Medicine”

Applied Sciences ◽

10.3390/app11188353 ◽

2021 ◽

Vol 11 (18) ◽

pp. 8353

Author(s):

Daniela Galli

Keyword(s):

Physical Activity ◽

Cardiovascular Diseases ◽

Regular Physical Activity ◽

Special Issue ◽

Exercise Medicine ◽

Sport And Exercise

The practice of regular physical activity has been proposed as a determinant in many disciplines, from wellness to physiotherapy; in fact, it reduces the risks of cardiovascular diseases and diabetes [...]

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