scholarly journals Pilot Studies to Evaluate Feasibility of a Physical Activity Intervention for Persons With Depression

2020 ◽  
Vol 42 (6) ◽  
pp. 443-451
Author(s):  
Kendall J. Sharp ◽  
Charles C. South ◽  
Cherise Chin Fatt ◽  
Madhukar H. Trivedi ◽  
Chad D. Rethorst

Exercise reduces depressive symptoms and improves physical health in persons with depression. However, the interventions implemented in research studies require significant resources, limiting adoption into clinical practice and suggesting the need for more efficient interventions. In two nonrandomized pilot studies, the authors evaluated the feasibility of a multicomponent intervention (group educational sessions, Fitbit, and access to exercise facility) in adult persons with depression and breast cancer survivors with depression. The participants in both pilot studies completed 12 weeks of group educational sessions to increase physical activity levels, were provided with self-monitoring devices, and were provided access to on-site exercise facilities. Depressive symptoms significantly decreased postintervention, and over 90% of the participants reported that they had benefited from the intervention. These results indicate that implementing a multicomponent intervention is feasible and may reduce depressive symptoms and improve other psychosocial outcomes.

2019 ◽  
Author(s):  
Kendall Sharp ◽  
Charles South ◽  
Cherise Chin Fatt ◽  
Madhukar Trivedi ◽  
Chad Rethorst

Depressive disorders are associated with high disease burden and high rates of medical comorbidities. Exercise interventions have been shown to reduce depressive symptoms and help improve physical health outcomes in persons with depression. However, the interventions used in studies demonstrating exercise as an efficacious treatment for depression are unlikely to be adopted into clinical practice due to the significant resources (personnel, facilities, equipment) required to deliver these interventions. This suggests the need for more efficient interventions for increasing physical activity in persons with depression. Two pilot studies were conducted to determine the feasibility of a multi-component physical activity intervention in persons with depression. Components of the intervention included group educational sessions about increasing physical activity, a Fitbit, and access to on-site exer-cise facility. The results from these pilot studies show significant decreases in depressive symptoms post intervention (PA: t(13)= 3.51, p = .004; BC: t(13) = 3.05, p = .009). 100% of participants in the PA pilot and 85.7% of participants in the BC pilot responded that they benefited overall from the study. These results indicate that implementing a multi-component physical activity intervention is feasible and can reduce depressive symptoms and other psychosocial outcomes. Limitations and future directions for physical activity interventions are discussed.


2021 ◽  
Vol 27 (1) ◽  
pp. 146045822098727
Author(s):  
Adrià Muntaner-Mas ◽  
Victor A Sanchez-Azanza ◽  
Francisco B Ortega ◽  
Josep Vidal-Conti ◽  
Pere Antoni Borràs ◽  
...  

Since the 2012 Lancet Series on physical activity, progress regarding this topic has been negligible at global level. Thus, improving physical activity levels in specific populations through new methodologies is positioned as a priority. The aim of this study was to determine the effects of a physical activity intervention on body fatness composition, and measured and self-reported physical fitness components based on the use of a smartphone app. The investigation included 100 Spanish university students, cluster-randomized into the smartphone app intervention group or a control group ( n = 35 and n = 31 respectively, after applying exclusion criteria). The physical activity intervention comprised a 9-week programme designed to promote a healthy physical activity pattern using a smartphone app. Specifically, an mHealth approach was taken containing five BCTs. The results showed that the intervention group improved their physical fitness ( F = 8.1, p = .006) and reported better general scores in self-reported physical fitness ( F = 7.4, p = .008) over time, in comparison to the control group. However, the intervention group did not show any changes to their fatness. Further research is needed to disentangle which BCTs are more effective to achieve physical health improvements when using physical activity apps.


2017 ◽  
Vol 19 (1) ◽  
pp. 134-144 ◽  
Author(s):  
Stacie Scruggs ◽  
Scherezade K. Mama ◽  
Cindy L. Carmack ◽  
Tommy Douglas ◽  
Pamela Diamond ◽  
...  

This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.


2020 ◽  
Author(s):  
Jenny Rossen ◽  
Maria Hagströmer ◽  
Agneta Yngve ◽  
Kerstin Brismar ◽  
Barbara Ainsworth ◽  
...  

Abstract Background Describing implementation features of an intervention is required to compare interventions and to inform policy and best practice. The aim of this study was to conduct a process evaluation of the first 12 months of the Sophia Step Study: a primary care based RCT evaluating a multicomponent (self-monitoring of daily steps plus counseling) and a single component (self-monitoring of steps only) physical activity intervention to standard care on cardiometabolic health. Methods The evaluation was guided by the Medical Research Council Guidance for complex interventions. To describe the implementation communication with the health professionals implementing the interventions, attendance records and tracking of days with self-monitored pedometer-determined steps were used. Change in physical activity behaviour was measured at baseline, 6 and 12 months as daily steps by accelerometry. Results From April 2013 to January 2018 188 participants were randomized. Response rate was 49% and drop out was 10%. The interventions were delivered as intended with minor deviation from the protocol and dose received was satisfying for both the multicomponent and single component group. The mean [95% Confidence Interval (CI)] change in daily steps from baseline to 6 months was 941(227, 1655) steps/day for the multicomponent intervention group, 990 (145, 1836) step/day for the single component group and -506 (-1118, 107) for the control group. The mean (95% CI) change in daily steps from baseline to 12 months was 31(-507, 570) steps/day for the multicomponent intervention group, 144 (-566, 853) step/day for the single component group and -890 (-1485, -294) for the control group. There was a large individual variation in daily steps at baseline as well as in step change in all three groups.Conclusions Applying self-monitoring of steps is a feasible method to implement as support for physical activity in the primary care setting both with and without counseling support. While physical activity levels increased after 6 months, maintenance of physical activity is a more realistic expectation in the long term. Physical activity behavior varies among individuals and support for physical activity should be tailored to the person. Trial registration ClinicalTrials.gov, NCT02374788. Registered 2 March 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02374788


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A150-A151
Author(s):  
Jamie Walker ◽  
Rebecca Campbell ◽  
Ivan Vargas

Abstract Introduction Insomnia and depression are highly comorbid and have been shown to be independently associated with lower levels of physical activity. It is not clear, however, if being less physically active is a risk factor for or consequence of depression and insomnia. The factors that explain the associations between insomnia, depression, and physical activity are likely complex and overlapping. For example, insomnia may predict inactivity by impacting one’s energy levels, leaving them too tired to exercise. Insomnia may also interfere with one’s motivation to exercise due to low mood, as insomnia is associated with the development of depressive symptoms. The purpose of the present study was to explore whether depression mediated the link between insomnia and low levels of physical activity. Methods A national online survey was conducted from April-June 2020. Participants completed surveys to assess demographics, mood, sleep, and physical activity. Depressive symptoms were estimated with the Center for Epidemiologic Studies Depression Scale (CES-D). Insomnia symptoms were estimated with the Insomnia Severity Index (ISI). Physical activity levels were estimated with the International Physical Activity Questionnaire (IPAQ). Analyses were conducted using multiple linear regression, with separate models for depression, insomnia, and the combination of the two, on levels of physical activity. Results 3,952 adults (Mage = 46.9 years) completed the survey. According to the unadjusted models, greater insomnia symptoms were associated with greater depressive symptoms (b = 0.4523, SE = 0.019593, p < .001), and lower levels of physical activity (b = -38.741, SE = 18.236, p = 0.0337). The relationship between insomnia and physical activity was no longer significant, however, when controlling for depression (b = -6.140, SE = 19.274, p = 0.75). According to the mediation analyses, there was an indirect effect of insomnia on physical activity that was explained by differences in depressive symptoms (Sobel Test = -4.895, SE = 6.518, p < .001). Conclusion Our findings support previous research indicating associations between symptoms of insomnia and depression and physical activity. Future research should examine if these same results hold using a longitudinal design. Support (if any) Vargas: K23HL141581


TH Open ◽  
2021 ◽  
Vol 05 (01) ◽  
pp. e14-e23
Author(s):  
Siv Kjølsrud Bøhn ◽  
Inger Thune ◽  
Vidar Gordon Flote ◽  
Hanne Frydenberg ◽  
Gro Falkenér Bertheussen ◽  
...  

Abstract Introduction Physical activity may reduce the development of breast cancer. Whereas hypercoagulability has been linked to adverse outcomes in breast cancer patients, the effects of physical activity on their hemostatic factors are unknown. The study aimed to assess whether long-term (1 year) physical activity can affect hemostatic factors in breast cancer patients. Methods Fifty-five women (35–75 years) with invasive breast cancer stage I/II were randomized to a physical activity intervention (n = 29) lasting 1 year or to a control group (n = 26), and analyzed as intention to treat. Fibrinogen, factor VII antigen, tissue factor pathway inhibitor, and von Willebrand factor (VWF) antigen as well as prothrombin fragment 1 + 2, the endogenous thrombin potential and D-dimer, were measured in plasma before intervention (baseline), and then after 6 and 12 months. Results Maximal oxygen uptake (measure of cardiorespiratory fitness) decreased the first 6 months among the controls, but remained stable in the intervention group. We found no significant differences between the two study groups regarding any of the hemostatic factors, except a significantly higher increase in factor VII antigen in the intervention group. The effect of the intervention on VWF was, however, significantly affected by menopausal stage, and a significant effect of the intervention was found on VWF among postmenopausal women, even after adjustment for dietary intake. Conclusion Long-term physical activity had no effect on the majority of the hemostatic factors measured, but led to increased plasma concentrations of factor VII antigen and prevented an increase in VWF concentration after breast cancer treatment in postmenopausal women. The clinical impact of these findings for risk of vascular thrombosis warrants further studies.


Author(s):  
Roxanne Gal ◽  
Evelyn M. Monninkhof ◽  
Carla H. van Gils ◽  
Rolf H. H. Groenwold ◽  
Sjoerd G. Elias ◽  
...  

Abstract Purpose The Trials within Cohorts (TwiCs) design aims to overcome problems faced in conventional RCTs. We evaluated the TwiCs design when estimating the effect of exercise on quality of life (QoL) and fatigue in inactive breast cancer survivors. Methods UMBRELLA Fit was conducted within the prospective UMBRELLA breast cancer cohort. Patients provided consent for future randomization at cohort entry. We randomized inactive patients 12–18 months after cohort enrollment. The intervention group (n = 130) was offered a 12-week supervised exercise intervention. The control group (n = 130) was not informed and received usual care. Six-month exercise effects on QoL and fatigue as measured in the cohort were analyzed with intention-to-treat (ITT), instrumental variable (IV), and propensity scores (PS) analyses. Results Fifty-two percent (n = 68) of inactive patients accepted the intervention. Physical activity increased in patients in the intervention group, but not in the control group. We found no benefit of exercise for dimensions of QoL (ITT difference global QoL: 0.8, 95% CI = − 2.2; 3.8) and fatigue, except for a small beneficial effect on physical fatigue (ITT difference: − 1.1, 95% CI = − 1.8; − 0.3; IV: − 1.9, 95% CI = − 3.3; − 0.5, PS: − 1.2, 95% CI = − 2.3; − 0.2). Conclusion TwiCs gave insight into exercise intervention acceptance: about half of inactive breast cancer survivors accepted the offer and increased physical activity levels. The offer resulted in no improvement on QoL, and a small beneficial effect on physical fatigue. Trial registration Netherlands Trial Register (NTR5482/NL.52062.041.15), date of registration: December 07, 2015.


2007 ◽  
Vol 1 (4) ◽  
pp. 326-334 ◽  
Author(s):  
Matthew J. Peterson ◽  
Richard Sloane ◽  
Harvey Jay Cohen ◽  
Gail M. Crowley ◽  
Carl F. Pieper ◽  
...  

This study sought to determine if telephone exercise counseling attenuates frailty in older, male veterans through increased levels of physical activity. Eighty-one elderly, male veterans (age = 78.4 ± 4.9 years) randomized to intervention ( n = 39) or combined control groups ( n = 42) completed baseline and 6-month follow-up measures of gait velocity, 6-min walk, chair stands, body mass index, and physical activity. Adapting the Fried frailty model, deficits in one or more of these outcomes indicated frailty. The intervention group had a 6-month decrease of 18% in the proportion of frail to not frail participants, whereas the control groups had no change in proportions (Fisher's p = .08). Frail participants had a mean 6-month decrease in physical activity levels of 124 kilocalories/week, whereas the not frail group increased by 619 kilocalories/week ( p = .07). There was a clinically meaningful change in frailty status with intensive, telephone exercise counseling. Improvement in frailty status was likely due to improvement in functional limitations.


Author(s):  
Laura E. Balis ◽  
Samantha M. Harden

Background: Interventions undergo adaptations when moving from efficacy to effectiveness trials. What happens beyond these initial steps—that is, when the “research” is over—is often unknown. The degree to which implementation quality remains high and impacts remain robust is underreported as these data are often less valued by community entities. Comprehensive and iterative evaluation is recommended to ensure robust outcomes over time. Methods: The reach, effectiveness, adoption, implementation, and maintenance framework was used within an assess, plan, do, evaluate, report process to determine the degree to which a statewide physical activity promotion program aligned with evidence-based core components, assess who was reached and impacts on physical activity behaviors, and make decisions for future iterations. Results: Walk Across Arkansas was adopted by a majority of delivery agents and was effective at increasing physical activity levels postprogram, but those effects were not maintained after 6 months. Future decisions included recruitment strategies to reach a more diverse population and a blueprint document to reduce program drift. Conclusions: This article details the process of “replanning” a community-based physical activity intervention to understand public health impact and make decisions for future iterations. Pragmatic reach, effectiveness, adoption, implementation, and maintenance questions were useful throughout the assess, plan, do, evaluate, report process.


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