Efficacy of Early and Enhanced Respiratory Physiotherapy and Mobilization after On-Pump Cardiac Surgery: A Prospective Randomized Controlled Trial

Background: This randomized controlled trial aimed to investigate the influence of physical activity and respiratory physiotherapy on zero postoperative day on clinical, hemodynamic and respiratory parameters of patients undergoing cardiac surgeries under extracorporeal circulation. Methods: 78 patients undergoing coronary artery bypass graft (CABG) or/and valvular heart disease surgeries were randomly assigned into an early and enhanced physiotherapy care group (EEPC group; n = 39) and a conventional physiotherapy care group (CPC group; n = 39). Treatment protocol for the EEPC group included ≤3 Mets of physical activity and respiratory physiotherapy on zero post-operative day and an extra physiotherapy session during the first three post-operative days, whereas the CPC group was treated with usual physiotherapy care after the first post-operative day. The length of hospital and intensive care unit (ICU) stay were set as the primary study outcomes, while pre- and post-intervention measurements were also performed to assess the oxymetric and hemodynamic influence of early mobilization and physiotherapy. Results: Participants’ mean age was 51.9 ± 13.8 years. Of them 48 (61.5%) underwent CABG. Baseline and peri-procedural characteristics did not differ between the two groups. The total duration of hospital and ICU stay were significantly higher in the CPC group compared to the EEPC group (8.1 ± 0.4 days versus 8.9 ± 0.6 days and 25.4 ± 3 h versus 23.2 ± 0.6 h, p < 0.001, respectively). Statistically significant differences in pre-intervention oxygen saturation, and post-intervention PO2 and lactate levels were also observed between the two groups (p = 0.022, 0.027 and 0.001, respectively). Conclusion: In on-pump cardiac surgery, early and enhanced post-procedural physical activity (≤3 METS) can prevent a prolonged ICU stay and decrease the duration of hospitalization while ameliorating post-operative hemodynamic and oxymetric parameters.

Download Full-text

Efficacy of Early Respiratory Physiotherapy and Mobilization After on-pump Cardiac Surgery: a Prospective Randomized Controlled Trial

10.21203/rs.3.rs-1051420/v1 ◽

2021 ◽

Author(s):

Georgios Afxonidis ◽

Dimitrios V. Moysidis ◽

Andreas S. Papazoglou ◽

Christos Tsagkaris ◽

Anna Loudovikou ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Cardiac Surgery ◽

Controlled Trial ◽

Bypass Graft ◽

Primary Study ◽

Post Intervention ◽

Randomized Controlled ◽

Icu Stay ◽

Respiratory Physiotherapy

Abstract Objective: This randomized controlled trial aimed to investigate the influence of physical activity and respiratory physiotherapy on zero postoperative day on clinical, hemodynamic and respiratory parameters of patients undergoing cardiac surgeries under extracorporeal circulation.Methods: 78 patients undergoing coronary artery bypass graft (CABG) or/and valvular heart disease surgeries were randomly assigned into active physiotherapy group (APG; n=39) and conventional physiotherapy group (CPG; n=39). Treatment protocol for APG included ≤3 Mets of physical activity and respiratory physiotherapy on zero post-operative day and an extra physiotherapy session during the first three post-operative days, whereas CPG was treated with usual physiotherapy care after the first post-operative day. The length of hospital and intensive care unit (ICU) stay were set as the primary study outcomes, while pre- and post-intervention measurements were also performed to assess the oxymetric and hemodynamic influence of early mobilization and physiotherapy. Results: Participants’ mean age was 51.86 ±13.76 years. Of them 48 (61.5%) underwent CABG. Baseline and peri-procedural characteristics did not differ between the 2 groups. The total duration of hospital and ICU stay were significantly higher in the CPG compared to the APG (8.1±0.4 versus 10.2±0.6 days and 32.1±1.7 versus 23.2±0.6 hours, p<0.001, respectively). Statistically significant differences in pre-intervention oxygen saturation, and post-intervention PO2 and lactate levels were also observed between the 2 groups (p=0.022, 0.027 and 0.001, respectively). Conclusion: In on-pump cardiac surgery, early and active post-procedural physical activity (≤3 METS) can prevent prolonged ICU stay and decrease the duration of hospitalization whilst ameliorating post-operative hemodynamic and oxymetric parameters.

Download Full-text

Efficacy of task-specific circuit training on physical activity levels and mobility of stroke patients: A randomized controlled trial

Neurorehabilitation ◽

10.3233/nre-203207 ◽

2020 ◽

Vol 47 (4) ◽

pp. 451-462

Author(s):

Júlia Caetano Martins ◽

Sylvie Nadeau ◽

Larissa Tavares Aguiar ◽

Aline Alvim Scianni ◽

Luci Fuscaldi Teixeira-Salmela ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Post Intervention ◽

Randomized Controlled ◽

Secondary Outcomes ◽

Experimental Group

BACKGROUND: Impaired mobility is related to low physical activity (PA) levels observed after stroke. Therapeutic approaches, such as task-specific circuit training (TSCT), used to improve mobility in individuals with stroke, could also improve PA levels. OBJECTIVE: To investigate the efficacy of TSCT, focused on both upper (UL) and lower (LL) limbs, in improving PA levels and mobility (primary outcomes), as well as muscle strength, exercise capacity, and quality of life (secondary outcomes) in subjects with stroke. METHODS: A randomized controlled trial with 36 subjects with chronic stroke was conducted. Experimental group: TSCT, involving both UL and LL. Control group: global stretching, memory exercises, and education sessions. Both groups received 60 minute sessions/week over 12 weeks. Outcomes were measured at baseline, post-intervention and 16 week follow-up. RESULTS: No changes were found for primary and secondary outcomes (0.11≤p≤0.99), except for quality of life, which improved in the experimental group post-intervention and 16 week follow-up (p = 0.02). CONCLUSION: TSCT focused on both UL and LL was not effective on PA levels and mobility of individuals with chronic stroke, however, improvements in quality of life were observed. Since this is the first study to investigate this combined training aimed at improving PA levels, future studies are necessary to better understand the impact of this type of intervention.

Download Full-text

Pharmacist-led counselling intervention to improve antiretroviral drug adherence in Pakistan: a randomized controlled trial

BMC Infectious Diseases ◽

10.1186/s12879-020-05571-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zeenat Fatima Chatha ◽

Usman Rashid ◽

Sharon Olsen ◽

Fakhar ud Din ◽

Amjad Khan ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Intervention Group ◽

Care Group ◽

People Living With Hiv ◽

Post Intervention ◽

Randomized Controlled ◽

Cell Counts ◽

Cd4 Cell

Abstract Background Pakistan is facing a growing population of people living with human immunodeficiency (HIV). In this randomized controlled trial, we investigate if a pharmacist-led intervention can increase adherence to antiretroviral therapy (ART) for people living with HIV (PLWH). Methods Adults with HIV, who have been taking ART for more than 3 months were randomly assigned to receive either a pharmacist-led intervention or their usual care. Measures of adherence were collected at 1) baseline 2) just prior to delivery of intervention and 3) 8 weeks later. The primary outcomes were CD4 cell count and self-reported adherence measured with the AIDS Clinical Trial Group (ACTG) questionnaire. Results Post-intervention, the intervention group showed a statistically significant increase in CD4 cell counts as compared to the usual care group (p = 0.0054). In addition, adherence improved in the intervention group, with participants being 5.96 times more likely to report having not missed their medication for longer periods of time (p = 0.0086) while participants in the intervention group were 7.74 times more likely to report missing their ART less frequently (p < 0.0001). Conclusions The findings support the improvement in ART adherence and HIV management. Trial registration The trial is registered with Australian New Zealand Clinical Trials Registry (ACTRN12618001882213). Registered 20 November 2018.

Download Full-text

The Impact of Shorter, More Frequent Outdoor Play Periods on Preschoolers’ Physical Activity during Childcare: A Cluster Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214126 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4126 ◽

Cited By ~ 2

Author(s):

Molly Driediger ◽

Stephanie Truelove ◽

Andrew M. Johnson ◽

Leigh M. Vanderloo ◽

Brian W. Timmons ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Outdoor Play ◽

Cluster Randomized Controlled Trial ◽

Control Group ◽

Post Intervention ◽

Randomized Controlled ◽

Cluster Randomized ◽

The Impact

Children’s physical activity levels are higher at the start of outdoor playtime, which suggests that shorter, more frequent play periods might result in greater amounts of daily physical activity. In this extension of the Supporting Physical Activity in the Childcare Environment (SPACE) cluster randomized controlled trial, we explored the impact of four 30-min daily outdoor unstructured play periods on preschoolers’ moderate-to-vigorous-intensity physical activity (MVPA). Experimental childcare centres (n = 6) implemented four 30-min daily outdoor playtimes for 8 weeks, while control centres (n = 6) maintained their two 60-min outdoor sessions. Actical™ accelerometers were used to measure preschoolers’ physical activity pre- and post-intervention for 5 days during childcare hours. Linear mixed effects models were used to determine the impact of the intervention on preschoolers’ MVPA. Of the 185 preschoolers enrolled (54.20% female; mean age = 39.90 months, SD = 7.24), 127 (65 experimental and 62 control) were included in the analysis (30% and 9% loss to follow-up for experimental and control group preschoolers, respectively). No significant differences in MVPA were observed between groups over time (p = 0.36). Preschoolers’ MVPA did not improve after the introduction of shorter outdoor play periods. The loss of data due to wear time noncompliance and participant attrition may have influenced these findings. Trial registration: ISRCTN70604107 (October 8, 2014).

Download Full-text

Supporting behaviour change in sedentary adults via real-time multidimensional physical activity feedback: A mixed-methods randomized controlled trial (Preprint)

10.2196/preprints.26525 ◽

2020 ◽

Author(s):

Max James Western ◽

Martyn Standage ◽

Oliver James Peacock ◽

Thomas Edward Nightingale ◽

Dylan Thompson

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Mixed Methods ◽

Real Time ◽

Behaviour Change ◽

Controlled Trial ◽

Post Intervention ◽

Self Monitoring ◽

Randomized Controlled

BACKGROUND Increasing physical activity (PA) behaviour remains a public health priority and wearable technology is increasingly being used to support behaviour change efforts. Using wearables to capture and provide comprehensive, visually persuasive, multidimensional feedback with realtime support may be a promising way to increase PA in inactive individuals. OBJECTIVE To test whether a six-week self-monitoring intervention using composite web-based multidimensional PA feedback with real-time daily support increased PA in adults. METHODS A six-week, mixed-methods, two-armed pilot randomized controlled trial (RCT) with six-week follow-up was used, whereby fifty-one low to moderately active (physical activity Level (PAL)<2.0) adults (mean age = 51.3 years; %female = 55) were randomly assigned to receive the self-monitoring intervention (n=36) or waiting-list control (n=15). Assessment of PA across multiple health-harnessing PA dimensions (e.g. PAL, weekly moderate-to-vigorous intensity physical activity (MVPA), sedentary time, steps), psychosocial cognitions (e.g. behavioral regulation, barrier self-efficacy, habit strength) and health were made at pre-randomisation baseline, 6 and 12 weeks. An exploratory analysis of mean difference and confidence intervals was made using the ANCOVA model. After the 12-week assessment intervention participants were interviewed to explore their views on the programme. RESULTS There were no notable differences in any PA outcome immediately post-intervention, but at 12-weeks moderate-to-large effects were observed with a mean (95% CI) difference in PAL of 0.09 (0.02 – 0.15), effect size (Hedges’ g)=0.8; daily moderate-intensity PA of 24 minutes (0 – 45), g=0.6; weekly MVPA of 195 minutes (58 – 331), g=0.8; and steps of 1545 (581 – 2553), g=0.7. Descriptive analyses suggested the differences in PA at 12 weeks were more pronounced in females, and participants with lower baseline PA levels. Immediately post intervention there were favourable difference in autonomous motivation, controlled motivation, perceived competence for PA, and barrier self-efficacy, with the latter sustained at follow-up. Qualitative data implied that the intervention washighly informative for participants and that the realtime feedback element was particularly useful in providing tangible, daily, behavioural support. CONCLUSIONS Using wearable trackers to capture and present sophisticated multidimensional PA feedback combined with discrete realtime support may be a useful way to facilitate changes in behaviour. Further investigation into the ways to optimise the use of wearables in inactive participants and test the efficacy of this approach via a robust study design is warranted. CLINICALTRIAL www.clinicaltrials.gov REF: NCT02432924

Download Full-text