A physical activity program is no more effective than standard care at maintaining upper limb activity in community-dwelling people with stroke: secondary outcomes from a randomized trial

Objective: To evaluate whether an 18-month, physical activity coaching program is more effective than standard care in terms of upper-limb activity. Design: A prospective, randomized controlled trial. Setting: Three municipalities in Norway. Population: A total of 380 persons with stroke. Intervention: The intervention group received follow-up visits and coaching on physical activity and exercise each month for 18 months after inclusion, by a physiotherapist. The control group received standard care. Main measures: The primary outcome, in this secondary analysis, was Motor Assessment Scale items 6, 7, and 8. Secondary outcomes were National Institute of Health Stroke Scale item 5, the Stroke Impact Scale domain 7, and the Modified Ashworth Scale in flexion/extension of the elbow. Results: In total, 380 persons with stroke were recruited, with mean (SD) age 72 (11) years, and baseline scores total National Institute of Health Stroke Scale was 1.4 (2.2)/1.6 (2.4) and Motor Assessment Scale items 6, 7 and 8 in the intervention/control group was 5.5 (1.2)/5.5 (1.2), 5.4 (1.4)/5.4 (1.3), and 3.6 (2)/3.5 (2), respectively. There was no significant difference between groups in terms of upper limb function in any of the Motor Assessment Scale items. In this population with minor stroke, upper-limb activity was good at three months post-stroke (74% of the maximum) and remained good 18 months later (77% of maximum). Conclusion: After intervention, there was no difference between the groups in terms of upper-limb activity.

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Effects of a home-based rehabilitation program in community-dwelling older people after discharge from hospital: A subgroup analysis of a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/02692155211001672 ◽

2021 ◽

pp. 026921552110016

Author(s):

Turunen Katri Maria ◽

Aaltonen-Määttä Laura ◽

Portegijs Erja ◽

Rantalainen Timo ◽

Keikkala Sirkka ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Physical Performance ◽

Standard Care ◽

Controlled Trial ◽

Rehabilitation Program ◽

Community Dwelling ◽

Control Group ◽

Randomized Controlled ◽

Community Mobility

Objective: To examine whether pre-admission community mobility explains the effects of a rehabilitation program on physical performance and activity in older adults recently discharged from hospital. Design: A secondary analysis of a randomized controlled trial. Setting: Home and community. Participants: Community-dwelling adults aged ⩾60 years recovering from a lower limb or back injury, surgery or other disorder who were randomized to a rehabilitation ( n = 59) or standard care control ( n = 58) group. They were further classified into subgroups that were not planned a priori: (1) mild, (2) moderate, or (3) severe pre-admission restrictions in community mobility. Interventions: The 6-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counselling, and standard care. Measurements: Physical performance was measured with the Short Physical Performance Battery and physical activity with accelerometers and self-reports. Data were analysed by generalized estimating equation models with the interactions of intervention, time, and subgroup. Results: Rehabilitation improved physical performance more in the intervention ( n = 30) than in the control group ( n = 28) among participants with moderate mobility restriction: score of the Short Physical Performance Battery was 4.4 ± 2.3 and 4.2 ± 2.2 at baseline, and 7.3 ± 2.6 and 5.8 ± 2.9 at 6 months in the intervention and control group, respectively (mean difference 1.6 points, 95% Confidence Interval 0.2 to 3.1). Rehabilitation did not increase accelerometer-based physical activity in the aforementioned subgroup and did not benefit those with either mild or severe mobility restrictions. Conclusions: Pre-admission mobility may determine the response to the largely counselling-based rehabilitation program.

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Effect of a Physical Activity Program on Serum Biochemical Parameters among the Elderly Women

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666190201113809 ◽

2019 ◽

Vol 14 (3) ◽

pp. 209-216 ◽

Cited By ~ 2

Author(s):

Seyedeh Ameneh Motalebi ◽

Jamileh Amirzadeh Iranagh ◽

Fatemeh Mohammadi

Keyword(s):

Physical Activity ◽

Biochemical Parameters ◽

Elderly Women ◽

Fasting Blood Glucose ◽

Density Lipoprotein ◽

The Elderly ◽

Community Dwelling ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Significant Difference

Background: The present study examined the efficacy of the walking program on biochemical parameters among the elderly women. Methods: A total of one hundred elderly women participated in this randomized clinical trial study. The intervention group attended a 24-week walking exercise meeting five times per week. The control group continued with their routine activities. The subjects were assessed in Fasting blood glucose (FBS) and lipid profile before and after 12 and 24 weeks of the program. Results: The mean age of the elderly participants in the study was 68.33 ± 4.55 years. The results of repeated measures ANOVA showed a significant difference between the intervention and the control group in FBS, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after completing the program (for all p < 0.001). Conclusion: The low-cost physical activity intervention could be effective for reducing chronic vascular disease risk factors among community-dwelling elderly women.

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Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126645 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6645

Author(s):

Giulia Foccardi ◽

Marco Vecchiato ◽

Daniel Neunhaeuserer ◽

Michele Mezzaro ◽

Giulia Quinto ◽

...

Keyword(s):

Physical Activity ◽

Cardiac Rehabilitation ◽

Exercise Testing ◽

Text Messages ◽

Control Group ◽

Stand Test ◽

Randomized Controlled ◽

Sit To Stand ◽

Significant Difference

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

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Effectiveness and cost-effectiveness of the PLAN-A intervention, a peer led physical activity program for adolescent girls: results of a cluster randomised controlled trial

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01133-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Russell Jago ◽

Byron Tibbitts ◽

Kathryn Willis ◽

Emily Sanderson ◽

Rebecca Kandiyali ◽

...

Keyword(s):

Physical Activity ◽

Cost Effectiveness ◽

Randomised Controlled Trial ◽

Primary Outcome ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Control Group ◽

Cluster Randomised ◽

Secondary Outcomes ◽

Randomised Controlled

Abstract Background Physical activity is associated with improved health. Girls are less active than boys. Pilot work showed that a peer-led physical activity intervention called PLAN-A was a promising method of increasing physical activity in secondary school age girls. This study examined the effectiveness and cost-effectiveness of the PLAN-A intervention. Methods We conducted a cluster randomised controlled trial with Year 9 (13–14 year old) girls recruited from 20 secondary schools. Schools were randomly assigned to the PLAN-A intervention or a non-intervention control group after baseline data collection. Girls nominated students to be peer leaders. The top 18 % of girls nominated by their peers in intervention schools received three days of training designed to prepare them to support physical activity. Data were collected at two time points, baseline (T0) and 5–6 months post-intervention (T1). Participants wore an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity (MVPA). Multivariable mixed effects linear regression was used to estimate differences in the primary outcome between the two arms on an Intention-to-Treat (ITT) basis. Resource use and quality of life were measured and a within trial economic evaluation from a public sector perspective was conducted. Results A total of 1558 girls were recruited to the study. At T0, girls in both arms engaged in an average of 51 min of MVPA per weekday. The adjusted mean difference in weekday MVPA at T1 was − 2.84 min per day (95 % CI = -5.94 to 0.25) indicating a slightly larger decline in weekday MVPA in the intervention group. Results were broadly consistent when repeated using a multiple imputation approach and for pre-specified secondary outcomes and sub-groups. The mean cost of the PLAN-A intervention was £2817 per school, equivalent to £31 per girl. Economic analyses indicated that PLAN-A did not lead to demonstrable cost-effectiveness in terms of cost per unit change in QALY. Conclusions This study has shown that the PLAN-A intervention did not result in higher levels of weekday MVPA or associated secondary outcomes among Year 9 girls. The PLAN-A intervention should not be disseminated as a public health strategy. Trial registration ISRCTN14539759–31 May, 2018.

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Parenting Stress and Need Assessment of Families with Disabled Children across Himachal Himalaya

International Journal of Social Science Research ◽

10.5296/ijssr.v3i2.7344 ◽

2015 ◽

Vol 3 (2) ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Randhir S. Ranta ◽

Vijay Kumar Sharma ◽

Pankaj Gupta

Keyword(s):

Parenting Stress ◽

Assessment Scale ◽

Control Group ◽

Disabled Children ◽

Normal Children ◽

Need Assessment ◽

Significant Difference ◽

Group A ◽

And Control ◽

Experimental Group

The study pertains to the parenting stress, which is believed to be the resultant of child disability and further assesses the needs of the families across selected pockets of Himachal Himalaya. Perceived Stress Questionnaire (PSQ) and Need Assessment Scale were used for the purpose. For assessing the stress level among the parents, PQS was administered among two hundred parents having disabled children, herein called experimental group and two hundred parents with normal children, herein called control group. A three point Need assessment scale was used to measure the needs of 200 families on five different parameters. The result of t-test shows the significant difference between experimental and control groups indicating that the parents of disabled children experience more stress than their control counterpart. The study indicates that people need proper guidance and information regarding a child’s disability, nutritional requirements of a child, vocational training and child management. There is a need for proper counselling for parents suffering from stress and creating consciousness among parents of children with disabilities and in the society.

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Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136682 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6682

Author(s):

Hilde Bremseth Bårdstu ◽

Vidar Andersen ◽

Marius Steiro Fimland ◽

Lene Aasdahl ◽

Hilde Lohne-Seiler ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Resistance Training ◽

Home Care ◽

Community Dwelling ◽

Activity Level ◽

Group Differences ◽

Control Group ◽

Cluster Randomized ◽

Community Dwelling Older Adults

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

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The Efficacy and Mechanism of Positive Psychological Intervention on Well-Being for Colostomy Patients: A Randomized Controlled Trial

10.21203/rs.3.rs-1137918/v1 ◽

2021 ◽

Author(s):

Yanfei Jin ◽

Yuqing Wang ◽

Hongwen Ma ◽

Xu Tian ◽

Wang Honghong

Keyword(s):

Life Satisfaction ◽

Psychological Distress ◽

Standard Care ◽

Psychological Capital ◽

Psychological Intervention ◽

Well Being ◽

Control Group ◽

Significant Difference ◽

Experimental Group ◽

Positive Psychological Intervention

Abstract Aims To evaluate the efficacy and mechanism of positive psychological intervention (PPI) on the psychological capital, psychological distress, and life satisfaction among colostomy patients. Methods Patients (n=120) with permanent stomas were recruited and randomly assigned into two groups. Patients in the experimental group (n=60) received standard care and PPI, whereas patients in the control group (n=60) only received standard care. The psychological capital, psychological distress, and life satisfaction were measured and compared between two groups before the intervention, the immediate post-intervention, and follow-up. Results All 120 patients completed the study. The hope, optimism, resilience, psychological distress, and life satisfaction score of the experimental group were significantly higher than those of the control group at T1 and T2 (P<0.05). Self-efficacy score of the experimental group had no significant difference at the two-time points after the intervention than the control group (P>0.05). Changes in hope and resilience which belong to psychological capital mediated the intervention’s efficacy on changes in PPI on life satisfaction (β = 0.265, P=0.005; β = 0.686, P=0.002). Conclusions PPI could effectively improve psychological capital, psychological distress, and life satisfaction among patients with stomas. Besides, our findings add novel support that increased hope and resilience are the active ingredients that promote intervention change.

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Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2017-019042 ◽

2018 ◽

Vol 8 (7) ◽

pp. e019042 ◽

Cited By ~ 11

Author(s):

Helene G van der Meer ◽

Hans Wouters ◽

Lisa G Pont ◽

Katja Taxis

Keyword(s):

Cognitive Function ◽

Side Effects ◽

Medication Review ◽

Community Dwelling ◽

Mortality Data ◽

Digit Symbol Substitution Test ◽

Significant Difference ◽

Secondary Outcomes ◽

Randomised Controlled

ObjectiveTo evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI).DesignRandomised controlled single blind trial.Setting15 community pharmacies in the Northern Netherlands.Participants157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1.InterventionA medication review by the community pharmacist in collaboration with the patient’s general practitioner and patient.Primary and secondary outcomes measuresThe primary outcome was the proportion of patients whose DBI decreased by at least 0.5. Secondary outcomes were the presence of anticholinergic/sedative side effects, falls, cognitive function, activities of daily living, quality of life, hospital admission and mortality. Data were collected at baseline and 3 months follow-up.ResultsMean participant age was 75.7 (SD, 6.9) years in the intervention arm and 76.6 (SD, 6.7) years in the control arm, the majority were female (respectively 69.3% and 72.0%). Logistic regression analysis showed no difference in the proportion of patients with a≥0.5 decrease in DBI between intervention arm (17.3%) and control arm (15.9%), (OR 1.04, CI 0.47 to 2.64, p=0.927). Intervention patients scored higher on the Digit Symbol Substitution Test, measure of cognitive function (OR 2.02, CI 1.11 to 3.67, p=0.021) and reported fewer sedative side effects (OR 0.61, CI 0.40 to 0.94, p=0.024) at follow-up. No significant difference was found for other secondary outcomes.ConclusionsPharmacist-led medication review as currently performed in the Netherlands was not effective in reducing the anticholinergic/sedative load, measured with the DBI, within the time frame of 3 months. Preventive strategies, signalling a rising load and taking action before chronic use of anticholinergic/sedative medication is established may be more successful.Trial registration numberNCT02317666.

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Impact of a residential program on the psychological needs, motivation and physical activity of obese adults: A controlled trial based on Self-Determination Theory

Movement & Sport Sciences - Science & Motricité ◽

10.1051/sm/2018013 ◽

2018 ◽

pp. 33-40

Author(s):

Julie Boiché ◽

Mathieu Gourlan ◽

Léna Rubin

Keyword(s):

Physical Activity ◽

Repeated Measures ◽

Standard Care ◽

Controlled Trial ◽

Self Determination Theory ◽

Psychological Needs ◽

Self Determination ◽

Control Group ◽

Obese Adults ◽

Perceived Relatedness

Purpose: This study aimed to examine the increased benefits of a Self Determination Theory (SDT)-based motivational component on psychological needs’ fulfillment, self-determined motivation and Physical Activity (PA) of obese patients taking part in a rehabilitation program. Methods: Fourty-nine obese adults (mean age = 52 years, mean BMI = 38.25 kg/m2) attended a 3-week residential intervention. Patients in the Motivation group (n = 24) received a standard care plus SDT-based intervention (i.e., improved supervised PA sessions + a 1-hour motivational session). Patients in the Control group (n = 25) only benefited from standard care. Psychological needs and motivation were measured at baseline, at the end of the program and one month after. PA was measured at baseline and one month after the end of the program. Repeated measures ANOVAs were performed to compare the evolution of the variables between groups. Results: The results indicated that participants from both groups displayed significant changes in their perceived autonomy, relatedness, intrinsic motivation and integrated regulation between the beginning and the end of the program. Next, participants from both groups showed a decrease in perceived relatedness between the end of the program and one month after. Last, the participants from the Motivation group reported greater increase of their PA scores between the beginning of the program and one month after as compared to those in the Control group. Conclusions: Obesity interventions should integrate motivational components in order to promote behavior maintenance after programs have ended.

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Physical exercise during pregnancy and its influence in the type of birth

Einstein (São Paulo) ◽

10.1590/s1679-45082012000400003 ◽

2012 ◽

Vol 10 (4) ◽

pp. 409-414 ◽

Cited By ~ 3

Author(s):

Lílian Cristina da Silveira ◽

Conceição Aparecida de Mattos Segre

Keyword(s):

Physical Activity ◽

Physical Exercise ◽

Basic Education ◽

Exercise Program ◽

Regular Physical Activity ◽

Control Group ◽

Significance Level ◽

Vaginal Deliveries ◽

Significant Difference ◽

Primiparous Women

OBJECTIVE: To verify if medium intensity exercise performed during pregnancy can influence in the type of delivery, and to observe compliance to an exercise program among primiparous women with different levels of schooling. METHODS: A study carried out at the Centro de Incentivo ao Aleitamento Materno, in São Sebastiao (SP), between April 7, 2008, and April 14, 2009. A prospective study involving 66 primiparous women who were divided into two groups: an Exercise Group, engaged in regular physical activity during pregnancy, and the Control Group, that did not participate in regular physical activity during the same period. Significance level in this project was 5% (p=0.05). RESULTS: The group that did engage in regular exercise had a higher rate of vaginal deliveries, with a statistically significance difference evaluated by the χ² test (p=0.031). The pregnant women with the highest level of schooling showed greater compliance with the exercise program, with a statistically significant difference (p=0.01736). CONCLUSION: Physical exercise in primiparous women increased the chances of vaginal deliveries, and there was greater compliance with the exercise program among those with a higher level of schooling when compared to those with a basic education.

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