scholarly journals Integrating Motivational Interviewing into Clinical Care to Increase Physical Activity Levels in Women with Gestational Diabetes

2020 ◽  
Author(s):  
Ralph Smith ◽  
Ashley Ridout ◽  
Angus Livingstone ◽  
N. Wango ◽  
Yvonne Kenworthy ◽  
...  

Abstract Background: Regular physical activity (PA) improves glycaemic control in women diagnosed with Gestational Diabetes (GDM). However, PA advice competes with other components of care, with many women forgoing the benefits of regular PA. Motivational interviewing (MI) is an effective technique for increasing individual PA levels. A clinical pathway was developed integrating MI on PA into the routine care. This report evaluates the impact of MIs on self-reported PA levels.Methods: Women attending a single centre NHS GDM clinic were invited to engage in an individual PA-focused MI session, delivered by a trained midwife. This included goal setting and activity planning. All women had a confirmed diagnosis of GDM based on a 75g oral glucose tolerance test using the International association of diabetes and pregnancy study group diagnostic thresholds. A modified version of the exercise vital sign was used to evaluate self-reported aerobic PA levels at baseline and two-week telephone follow-up. PA levels were coded into three categories: i) red (<30mins moderate intensity PA (MIPA)/week), ii) amber (30-150mins MIPA/week) and iii) green (150mins MIPA/week). Women with contraindications to PA were excluded. The main outcome was the difference PA levels from baseline to two weeks. The Pearson’s Chi-squared test was used to evaluate statistical difference in self-reported PA levels from baseline to follow-up.Results: Complete follow-up data was obtained from 62 women. Mean gestation was 27+5/40 weeks (9-36+4/40), mean age 31.7y (21-43y) and mean BMI 29.9kg/m2 (18.3-48.2 kg/m2). At baseline, 19 (30.6%) were coded red (<30mins MIPA/week); 26 (41.9%) amber (30-150mins MIPA/week); and 17 (27.4%) green (150mins MIPA/week). Self-reported physical activity levels of these women at two-week follow-up revealed only 3 (4.8%) women coded red, 24 (38.7%) amber and 35 (56.5%) green. This demonstrates a significant association for increased PA levels after MI at two-week follow-up (p=0.0001).Conclusion: This new clinical pathway provides encouraging results, showing that self-reported PA increased significantly at two-week follow-up. Further work is now required to examine the impact on glycaemic control, maternal and fetal outcomes, and maintenance of PA levels. This model of care should be integrated into other high-risk patient groups.

2021 ◽  
Vol 29 (10) ◽  
pp. 550-556
Author(s):  
Ralph Smith ◽  
Ashley Ridout ◽  
Angus Livingstone ◽  
Nicola Wango ◽  
Yvonne Kenworthy ◽  
...  

Regular physical activity improves glycaemic control in pregnant women with gestational diabetes. Motivational interviewing is an effective technique for increasing activity levels. This report evaluates a clinical pathway developed to integrate physical activity motivational interviewing into routine gestational diabetes care. Women attending a single-centre NHS clinic were invited to engage in a physical activity-focused motivational interview. The aerobic physical activity levels of 62 women were evaluated at baseline and at a 2-week telephone follow up, coded into three categories by minutes of moderate intensity physical activity per week: red (<30 minutes), amber (30–149 minutes) and green (≥150 minutes). At baseline, 30.6% of participants were coded red, 41.9% amber and 27.4% green. At follow up, 4.8% women coded red, 38.7% amber and 56.5% green, demonstrating a significant association for increased activity levels after motivational interviewing (P<0.001). This clinical pathway provides encouraging results that physical activity increased significantly in the short term.


2021 ◽  
pp. 1-8
Author(s):  
Maggie Han ◽  
Priscila Preciado ◽  
Ohnmar Thwin ◽  
Xia Tao ◽  
Leticia M. Tapia-Silva ◽  
...  

<b><i>Background/Objectives:</i></b> On March 22, 2020, a statewide stay-at-home order for nonessential tasks was implemented in New York State. We aimed to determine the impact of the lockdown on physical activity levels (PAL) in hemodialysis patients. <b><i>Methods:</i></b> Starting in May 2018, we are conducting an observational study with a 1-year follow-up on PAL in patients from 4 hemodialysis clinics in New York City. Patients active in the study as of March 22, 2020, were included. PAL was defined by steps taken per day measured by a wrist-based monitoring device (Fitbit Charge 2). Average steps/day were calculated for January 1 to February 13, 2020, and then weekly from February 14 to June 30. <b><i>Results:</i></b> 42 patients were included. Their mean age was 55 years, 79% were males, and 69% were African Americans. Between January 1 and February 13, 2020, patients took on average 5,963 (95% CI 4,909–7,017) steps/day. In the week prior to the mandated lockdown, when a national emergency was declared, and in the week of the shutdown, the average number of daily steps had decreased by 868 steps/day (95% CI 213–1,722) and 1,222 steps/day (95% CI 668–2300), respectively. Six patients were diagnosed with COVID-19 during the study period. Five of them exhibited significantly higher PAL in the 2 weeks prior to showing COVID-19 symptoms compared to COVID-19 negative patients. <b><i>Conclusion:</i></b> Lockdown measures were associated with a significant decrease in PAL in hemodialysis patients. Patients who contracted COVID-19 had higher PAL during the incubation period. Methods to increase PAL while allowing for social distancing should be explored and implemented.


Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1865 ◽  
Author(s):  
Linda A. Gallo ◽  
Tania F. Gallo ◽  
Sophia L. Young ◽  
Karen M. Moritz ◽  
Lisa K. Akison

The coronavirus disease 2019 (COVID-19) pandemic resulted in physical isolation measures in many parts of the world. In Australia, nationwide restrictions included staying at home, unless seeking medical care, providing care, purchasing food, undertaking exercise, or attending work in an essential service. All undergraduate university classes transitioned to online, mostly home-based learning. We, therefore, examined the effect of isolation measures during the early phase of the COVID-19 pandemic in Australia (March/April) on diet (24-h recall) and physical activity (Active Australia Survey) patterns in third-year biomedical students. Findings were compared with students enrolled in the same course in the previous two years. In females, but not males, energy intake was ~20% greater during the pandemic, and snacking frequency and energy density of consumed snacks also increased compared with 2018 and 2019. Physical activity was impacted for both sexes during the pandemic with ~30% fewer students achieving “sufficient” levels of activity, defined by at least 150 min over at least five sessions, compared with the previous two years. In a follow-up study six to eight weeks later (14–18% response rate), during gradual easing of nationwide restrictions albeit continued gym closures and online learning, higher energy intake in females and reduced physical activity levels in both sexes persisted. These data demonstrate the health impacts of isolation measures, with the potential to affect long-term diet and activity behaviours.


Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 877
Author(s):  
Damir Sekulic ◽  
Daria Ostojic ◽  
Andrew Decelis ◽  
‪José Castro-Piñero ◽  
Tatjana Jezdimirovic ◽  
...  

Scholastic factors (academic achievement) are hypothesized to be important determinants of health-related behaviors in adolescents, but there is a lack of knowledge on their influence on physical activity levels (PAL), especially considering the COVID-19 pandemic and the imposed lockdown. This study aimed to investigate the associations between scholastic factors and PAL before and during the pandemic lockdown. The participants were adolescents form Bosnia and Herzegovina (n = 525, 46% females), who were observed prospectively at the baseline (before the pandemic lockdown) and during the lockdown in 2020 (follow-up). The scholastic factors (grade point average, behavioral grade, school absences, unexcused absences) were evidenced at the baseline (predictors). The outcome (PAL) was evaluated using the Physical Activity Questionnaire for Adolescents at the baseline and the follow-up. Gender, age, parental/familial conflict, and sport participation were observed as confounders. No significant influence of the predictors on PAL were evidenced at the baseline or at the follow-up. The scholastic variables were significantly associated with the changes of PAL which occurred due to pandemic lockdown, with a lower risk for negative changes in PAL among adolescents who were better in school (OR = 0.56, 95%CI: 0.34–0.81, and OR = 0.66, 95%CI: 0.34–0.97, for the grade point average and behavioral grade, respectively). Students who do well in school are probably more aware of the health benefits of proper PAL, and therefore are devoted to the maintenance of their PAL even during the home-confinement of lockdown. Public health authorities should focus more on helping adolescents to understand the importance and benefits of proper PAL throughout the school system.


2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
J. Slaght ◽  
M. Sénéchal ◽  
T. J. Hrubeniuk ◽  
A. Mayo ◽  
D. R. Bouchard

Background. Most adults choose walking as a leisure activity. However, many do not reach the international physical activity guidelines for adults, which recommend moderate intensity aerobic activity for at least 150 minutes/week in bouts of 10 minutes. Purpose. This systematic review provides an update on the walking cadence required to reach moderate intensity in adults and older adults, identifies variables associated with reaching moderate intensity, and evaluates how walking cadence intensity should be measured, but the main purpose is to report the interventions that have been attempted to prescribe walking cadence to increase time spent at moderate intensity or other outcomes for adults and older adults. Methods. SportDISCUS, Scopus, and PubMed databases were searched. We identified 3,917 articles and 31 were retained for this systematic review. Only articles written in English were included. Results. In general, 100 steps/minute is prescribed for adults to achieve moderate intensity, but older adults may require a higher cadence. Currently, few studies have explored using walking cadence prescription as an intervention to increase physical activity levels. Conclusion. Prescribing walking cadence as a way to increase physical activity levels has potential as a practical and useful strategy, but more evidence is required to assess its ability to increase physical activity levels at moderate intensity.


2018 ◽  
Vol 33 (3) ◽  
pp. 741-746 ◽  
Author(s):  
Aline Mendes Gerage ◽  
Raphael Mendes Ritti-Dias ◽  
P Babu Balagopal ◽  
Raquel Dilguerian de Oliveira Conceição ◽  
Daniel Umpierre ◽  
...  

2020 ◽  
Author(s):  
Anne Reimers ◽  
Verena Heidenreich ◽  
Hans-Joachim Bittermann ◽  
Guido Knapp ◽  
Carl-Detlev Reimers

Abstract Background: Main symptoms of the restless legs syndrome (RLS) are sleep onset insomnia and difficulty to maintain sleep. Previous studies showed that regular physical activity can reduce the risk of developing RLS. However, the relationships of physical activity on sleep quality parameters in subjects suffering from RLS have not been investigated by applying accelerometry. Thus, the present study investigates the impact of physical activity during the day (7-12 h, 12-18 h, 18-23 h) on sleep quality in subject suffering from idiopathic RLS as well as their intensity and extent of physical activity by applying a real-time approach.Methods: In a sample of 47 participants suffering from idiopathic RLS, physical activity and sleep quality were captured over one week by using accelerometers. For data analysis physical activity levels and step counts during three periods of a day (morning, afternoon, evening) were correlated with sleep quality parameters of the following night.Results: In this observational study, significant correlations of physical activity with the sleep parameters were rarely confirmed (exception: negative correlation of steps in the morning with periodic leg movements in sleep and negative correlation of physical activity in the evening and total sleep period). However, the physical activity levels of the participants were unexpectedly high compared to population-level data and variance in physical activity was low. The average activity was 13,817 (SD=4,086) steps and 347 (SD=117) minutes of moderate physical activity per day in females and 10,636 (SD=3,748) steps and 269 (SD=69) minutes of moderate physical activity in males, respectively. However, the participants conducted no vigorous physical activity.Conclusions: To investigate the effects of daily physical activity and RLS symptoms interventional studies with different intensities of physical activities at different points of time during the day are needed.


2021 ◽  
Author(s):  
Alexandre-Charles Gauthier ◽  
Marie-Eve Mathieu

Introduction Taste is a key sensory modulator of eating behaviour and thus energy intake. The effects of acute exercise has recently been confirmed especially regarding sweet and salty tastes. Physical activity is a safe and effective countermeasure to certain types of chemosensory losses, especially in older populations. Knowing that taste can be impaired with increased adiposity, it is unknown if the adoption of an active lifestyle on a regular basis can mitigate such impairments. Methods Data were extracted from NHANES 2013-2014 database. Perception of salt and bitter tastes for Tongue Tip Test and Whole Mouth Test, physical activity levels over an 8-9-day period and adiposity were analyzed. Moderation analyses were used to study the impact of adiposity on taste perceptions, with physical activity level as the moderator. Results The 197 participants (130 males) included in this project had a mean+/-standard deviation age of 49.1+/-5.2 years, a mean body fat percentage of 31.7+/-7.6% and mean daily physical activity levels of 11 084+/-3531 Monitor-Independent Movement Summary unit (MIMS). The positive association between adiposity and both bitter Tongue Tip Test and overall result (salt+bitter) of Tongue Tip Test were moderated by the adoption of an active lifestyle, with better taste scores observed in individuals achieving higher physical activity levels. When moderation analysis were stratified by gender, the effect of physical activity was no longer significant. Perspectives This study is the first to evaluate the influence of an active lifestyle on the preservation of some taste perceptions across a wide range of adiposity levels. While differences in taste can be observed regarding body fat percentage, physical activity moderates that relation only when men and women are analysed together.


2020 ◽  
Vol 15 (8) ◽  
pp. 1-12
Author(s):  
Chelsea E Moore ◽  
Costas Tsakirides ◽  
Zoe Rutherford ◽  
Michelle G Swainson ◽  
Karen M Birch ◽  
...  

Background/aims The primary aim of this study was to evaluate the effectiveness of two 30-minute dietary education sessions, within cardiac rehabilitation, as a means to optimise nutrient and energy intakes. A secondary aim was to evaluate patients' habitual physical activity levels. Methods Thirty patients (males: n=24, 61.8±11.2 years; females: n=6, 66.7±8.5 years) attended a 6-week early outpatient cardiac rehabilitation programme in the UK and received two 30-minute dietary education sessions emphasising Mediterranean diet principles. Energy intakes and nutrient intakes were measured through completion of 3-day food diaries in weeks one and six (before and after the dietary education sessions) to assess the impact of these sessions on nutrient intakes. At the same time-points, a sub-group (n=13) of patients had their physical activity levels assessed via accelerometery to assess the impact of the cardiac rehabilitation programme on physical activity. Results Estimated energy requirements at week one (1988±366 kcal d−1) were not matched by actual energy intakes (1785±561 kcal d−1) (P=0.047, d=−0.36). Energy intakes reduced to 1655±470 kcal d−1 at week six (P=0.66, d=−0.33) whereas estimated energy requirements increased as a function of increased activity (cardiac rehabilitation sessions). Nutrient intakes remained suboptimal, while no significant increases were observed in healthy fats and fibre, which are core elements of a Mediterranean diet. Statistically significant increases were not observed in physical activity; however, patients decreased sedentary time by 11±12% in week six compared with week one (P=0.009; d=−0.54). Conclusions The present study findings suggest that two 30-minute dietary education sessions did not positively influence energy intakes and nutrient intakes, while habitual physical activity levels were not significantly increased as a result of the cardiac rehabilitation programme. Future research should explore means of optimising nutrition and habitual physical activity within UK cardiac rehabilitation.


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