scholarly journals Walking Green: Developing an Evidence Base for Nature Prescriptions

Author(s):  
Elizabeth P.D. Koselka ◽  
Lucy C. Weidner ◽  
Arseniy Minasov ◽  
Marc G. Berman ◽  
William R. Leonard ◽  
...  

Although the health benefits of exercise and exposure to nature are well established, most evidence of their interaction comes from acute observations of single sessions of activity. However, documenting improved health outcomes requires ongoing interventions, measurement of multiple outcomes, and longitudinal analyses. We conducted a pilot study to guide the development of a protocol for future longitudinal studies that would assess multiple physiological and psychological outcomes. Herein, we report psychological outcomes measured from thirty-eight participants before and after three conditions: a 50 min walk on a forest path, a 50 min walk along a busy road, and a period of activities of daily living. Changes in positive and negative affect, anxiety, perceived stress, and working memory are reported. We benchmark these results to existing studies that used similar protocols and also identify elements of the protocol that might impair recruitment or retention of subjects in longer-term studies. Linear mixed-models regression revealed that walking improved psychological state when compared to activities of daily living, regardless of walk environment (p < 0.05). Comparison of mean differences showed that forest walks yielded the largest and most consistent improvements in psychological state. Thus, despite a protocol that required a 3.5 h time commitment per laboratory visit, the beneficial effects of walking and exposure to a forested environment were observed.

2013 ◽  
Vol 6 (2) ◽  
pp. 125-130
Author(s):  
Danelina E. Vacheva ◽  
Verjinia K. Simeonova ◽  
Boyko St. Stamenov

Summary Bulgaria ranks first in the world in incidence, morbidity and death associated with cerebrovascular disease. The aim of the study was to investigate, follow-up and register recovery of activities of daily living (using the toilet and maintaining personal hygiene) in patients with sequelae from cerebrovascular disease in a subacute stage, who underwent physiotherapy and rehabilitation. Sixty-one patients were included and followed up. They were given tailored physiotherapy and rehabilitation. This included kinesitherapy, occupational therapy and electrotherapy. All the patients filled in self-assessment questionnaires before and after the rehabilitation course. Major parameters were assessed, irrespective of the limb affected -dominant or non-dominant. Results were analyzed using the Wilcoxon rank test. At the end of the rehabilitation course, the Wilcoxon curves were driven to the right, confirming improvement concerning independence, irrespective of involvement of dominant or non-dominant limb.


2021 ◽  
Vol 13 ◽  
Author(s):  
Chunxiao Wu ◽  
Yingshan Xu ◽  
Hongji Guo ◽  
Chunzhi Tang ◽  
Dongfeng Chen ◽  
...  

Background/Objectives: Aerobic exercise and mind-body exercise, are vital for improving motor and non-motor functional performance of Parkinson’s disease (PD). However, evidence-based recommendations on which type of exercise is most suitable for each individual are still lacking. Therefore, we conduct a network meta-analysis to assess the relative efficacy of aerobic and mind-body exercise on motor function and non-motor symptoms in Parkinson’s disease and to determine which of these therapies are the most suitable.Design: A network meta-analysis and dose-response analysis.Setting and Participants: Medline, Embase (all via Ovid), and the Cochrane Central Register of Controlled Trials were comprehensively searched for related trials through April 2021.Measurements: Study quality was evaluated using the Cochrane Risk of Bias Tool. The effect sizes of continuous outcomes were calculated using mean differences (MDs) or standardized mean differences (SMDs). A network meta-analysis with a frequentist approach was conducted to estimate the efficacy and probability rankings of the therapies. The dose-response relationship was determined based on metaregression and SUCRA.Results: Fifty-two trials with 1971 patients evaluating six different therapies were identified. For the UPDRS-motor score and TUG score, yoga all ranked highest (SUCRA = 92.8%, 92.6%, respectively). The SUCRA indicated that walking may best improve the BBS score (SUCRA = 90.2%). Depression, cognitive and activities of daily living scores were significantly improved by yoga (SUCRA: 86.3, 95.1, and 79.5%, respectively). In the dose-response analysis, 60-min sessions, two times a week might be the most suitable dose of yoga for reducing the UPDRS-motor score of PD patients.Conclusion: Yoga and walking are important options for increasing functional mobility and balance function, and yoga might be particularly effective for decreasing depressive symptoms and cognitive impairment and improving activities of daily living in PD. The potential optimal dose of yoga for enhancing motor ability in PD patients is 60-min sessions, two times a week.Registration: PROSPERO CRD42021224823.


2016 ◽  
Vol 4 (2) ◽  
pp. 98-110 ◽  
Author(s):  
Magnus Sabel ◽  
Anette Sjölund ◽  
Jürgen Broeren ◽  
Daniel Arvidsson ◽  
Jean-Michel Saury ◽  
...  

Abstract Background. Physical activity can enhance cognitive functions in both animals and humans. We hypothesized that physically active video gaming could: i) improve cognitive functions and ii) improve the execution of activities of daily living among survivors of childhood brain tumors. Methods. Children 7 to 17 years old who completed treatment, including radiotherapy, for a brain tumor 1 to 5 years earlier were randomized to either intervention or waiting list. After 10 to 12 weeks the groups crossed over. The intervention consisted of active video gaming, using a motion-controlled video console (Nintendo Wii), for a minimum of 30 minutes a day, 5 days a week and weekly Internet-based coaching sessions. Evaluations before and after each period included tests of the execution of activities of daily living, using the Assessment of Motor and Process Skills (AMPS) and cognitive tests. Test scores before and after the intervention were compared. A parallel group comparison was performed as a sensitivity analysis. Results. All 13 children enrolled completed the program. Compared to baseline, the motor (P= .012) and process (P=.002) parts of AMPS improved significantly after active video gaming. In the parallel group analysis the improvement in the process part of AMPS remained statistically significant (P= .029), but not the change in AMPS motor score (P= .059). No significant change was found in cognitive tests although there were trends for improvement in sustained attention (P = .090) and selective attention (P = .078). Conclusion. In this pilot study, active video gaming used as a home-based intervention for childhood brain tumor survivors improved motor and process skills in activities of daily living.


2018 ◽  
Vol 76 (8) ◽  
pp. 512-516 ◽  
Author(s):  
Marcelo Piovezan ◽  
Hélio Amante Miot ◽  
Miriane Garuzi ◽  
Alessandro Ferrari Jacinto

ABSTRACT The Dementia Knowledge Assessment Tool Version Two (DKAT2) was developed to measure caregivers’ knowledge about the trajectory of dementia and assess changes in the knowledge before and after educational programs. The DKAT2 is a 21-item tool with questions about several aspects of dementia. The possible answers for each question are “yes”, “no” or “don't know”. The maximum score is 21. Objective: The aim of the study was to cross-culturally adapt the DKAT2 to Brazilian Portuguese. Methods: The essential steps to cross-culturally adapt were conducted and the final version administered to 30 caregivers of older people with dementia, sampled by convenience. Results: In the sample assessed, the mean age was 55.7 (± 12.5) years, 93.3% were female, 56.7% were sons/daughters and 23.3% were spouses of the older adults with dementia. The mean time caring for the elder was 4.7 (± 3.3) years and 70% of the caregivers had some level of burden. The mean age of the older people was 82.4 (± 6.7) years, 19 (63.3%) had a diagnosis of Alzheimer's disease, 100% were dependent for instrumental activities of daily living and 70% had some degree of dependence for basic activities of daily living. The mean score for the caregivers’ knowledge level was 15.0 (± 2.5) correct answers. Conclusions: The Brazilian Portuguese version was developed and the final version is suitable for use in Brazil.


2018 ◽  
Author(s):  
◽  
Russell Whittaker

Background: Cervicogenic headaches are usually chronic, debilitating and tend to be unresponsive to common headache medications. Manual therapy has been shown to be an effective form of management for cervicogenic headache. The Electromechanical Adjusting Instrument is a hand-held device offered as an alternative to manual therapy for musculoskeletal treatment. Aim: The aim of this study was to determine the effectiveness of the Electromechanical Adjusting Instrument compared to cervical spine manipulation in terms of subjective and objective measures in the treatment of cervicogenic headache. Methodology: This study was a randomised single-blinded clinical trial. There were 41 participants between the ages of 18 and 59 years who were randomly divided into two groups of 21 and 20 respectively by means of a randomisation table drawn up by the statistician. Participants in Group A received cervical spine manipulation while those in Group B received the Electromechanical Adjusting Instrument. Subjective headache intensity was determined using a Numerical Pain Rating Scale. The effect of neck pain on the participants’ activities of daily living before and after treatment was assessed using the Neck Disability Index. The effect of the headache on the participants’ activities of daily living before and after treatment was assessed using the Headache Disability Index. Objective cervical range of motion in all six planes of motion was assessed using a CROM goniometer. Participants in both groups received six interventions over a three-week period with a minimum interval of 48 hours between each intervention. The subjective and objectives assessments were taken at baseline, post-third and post-sixth interventions. The data was analysed using the IBM SPSS version 24.0. Repeated measures ANOVA was used to examine the effect on each outcome measure separately of time and treatment group interaction. Profile plots were generated to show the rates of changes in outcomes over time by the intervention group. A p value <0.05 was considered statistically significant. Results: For most of the outcomes, there was no clinical or statistical interaction present, i.e. the intervention effect was similar in both groups irrespective of the intervention. Conclusion: The trends in each of the outcomes suggest that the Electromechanical Adjusting Instrument is as effective as cervical spine manipulation for the treatment of cervicogenic headache


Author(s):  
Nádia Boldi Coutinho ◽  
Paulo Vinícius Braga Mendes ◽  
Mariana Midori Sime

Atualmente, dentre as diversas possibilidades para a reabilitação de pessoas com sequelas de Acidente Vascular Cerebral (AVC), os jogos de realidade virtual representam um recurso inovador no tratamento, com o incentivo do uso de funções motoras, através da experiência do indivíduo com o meio virtual, aumentando o engajamento, pelo caráter lúdico. O Nintendo Wii® é um equipamento muito utilizado terapeuticamente por apresentar uma gama variada de jogos, proporcionando diversos benefícios. Esta pesquisa objetivou verificar a influência do jogo de boxe do Nintendo Wii® no processo de reabilitação de um sujeito com sequelas de AVC. O indivíduo participou, duas vezes por semana, durante um mês, jogando partidas de boxe a partir de um protocolo estabelecido para este estudo. Foram aplicados instrumentos de avaliação (anamnese, Goniometria, Índice de Barthel, COPM, Escala de Ashworth, Escala de Lawton e Brody e questionário pré e pós sessão) a fim de avaliar aspectos do desempenho ocupacional antes e após a fase de jogos. Os dados foram analisados de forma descritiva e comparativa pré e pós-teste. Os resultados não apresentaram alterações significativas, sendo uma possível explicação o fato de o participante já apresentar importante independência em suas atividades da vida diária e atividades instrumentais da vida diária. No entanto, qualitativamente, relatou melhoras na movimentação no hemicorpo afetado e no desempenho das atividades em que apontava maiores dificuldades. Conclui-se que a reabilitação através do jogo de boxe do Nintendo Wii®, utilizado concomitante a outros tratamentos, pode contribuir na melhora na funcionalidade do indivíduo com sequelas de AVC.Palavras-chave: Terapia de Exposição à Realidade Virtual; Reabilitação; Acidente Vascular Cerebral Abstract: Currently, among the many possibilities for rehabilitation of people with stroke impairments, virtual reality games represent an innovative resource in the treatment, with the encouragement of the use of motor functions, through the individual's experience with the virtual environment, increasing the engagement, by the playful character. Nintendo Wii® is a device widely used therapeutically because it has a wide range of games, providing several benefits. This research aimed to verify the influence of the Nintendo Wii® boxing game on the rehabilitation process of a subject with stroke sequelae. The subject participated twice a week for a month, playing boxing matches following a protocol established for this study. Assessment instruments (anamnesis, Goniometry, Barthel Index, COPM, Ashworth Scale, Lawton and Brody Scale and pre and post session questionnaire) were applied to evaluate aspects of occupational performance before and after the games phase. Data were analyzed descriptively and comparatively before and after the test. The results did not present significant alterations, being a possible explanation the fact that the participant already presents important independence in their activities of daily living and instrumental activities of daily living. However, qualitatively, reported improvements in movement in the affected hemibody and in the performance of activities in which it pointed to greater difficulties. It is concluded that rehabilitation through Nintendo Wii® boxing game, used concomitantly with other treatments, can contribute to the improvement of the individual's functionality with stroke sequelae.Keywords: Virtual Reality Exposure Therapy; Rehabilitation; Stroke Resumen: Actualmente, entre las varias posibilidades de rehabilitación de personas com secuelas de accidente cerebrovascular (ACV), los juegos de realidad virtual representan un recurso innovador en el tratamiento, con el fomento del uso de funciones motoras, a través de la experiencia del individuo con la realidad virtual, aumentando los procesos de participación, por por su caracteristica lúdica. La Nintendo Wii® es el equipo ampliamente utilizado terapéuticamente porque tiene una amplia gama de juegos, proporcionando muchos beneficios. Esta investigación tuvo como objetivo verificar la influencia del juego de boxeo de la Nintendo Wii® en el proceso de rehabilitación de un sujeto con secuelas de ACV. El individuo participó dos veces por semana durante un mes, jugando partidos de boxeo siguiendo un protocolo establecido para este estudio. Se aplicaron herramientas de evaluación (anamnesis, goniometría, índice de Barthel, COPM, escala de Ashworth, escala de Lawton y Brody y cuestionario pre y post sesión) para evaluar aspectos del desempeño ocupacional antes y después de la fase de juegos. Los datos fueron analizados de forma descriptiva y comparativa pre y post-test. Los resultados no presentaron alteraciones significativas, siendo una posible explicación el hecho de que el participante ya tiene una independencia importante en sus actividades de la vida diaria y actividades instrumentales de la vida diaria. Sin embargo, cualitativamente, el informó mejoras en el movimiento en el hemi-cuerpo afectado y en el desempeño de actividades en las que señaló mayores dificultades. Se concluye que la rehabilitación a través del juego de boxeo Nintendo Wii®, usado concomitantemente con otros tratamientos, puede contribuir a la mejora de la funcionalidad del individuo con secuelas de ACV.Palabras-clave: Terapia de Exposición Mediante Realidad Virtual, Rehabilitación, Accidente Cerebrovascular


Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3263
Author(s):  
Jian Zhang ◽  
Ai Zhao ◽  
Wei Wu ◽  
Zhongxia Ren ◽  
Chenlu Yang ◽  
...  

Disability in activities of daily living (ADL) is common in elderly people. Dietary diversity is associated with several age-related diseases. The evidence on dietary diversity score (DDS) and ADL disability is limited. This study was based on the China Health and Nutrition Survey. Prospective data of 5004 participants were analyzed. ADL disability was defined as the inability to perform at least one of the five self-care tasks. Cox proportional regression models were conducted to estimate the association of cumulative average DDS with the risk of ADL disability. Logistic regression models were performed to estimate the odds ratios for the average DDS, the baseline DDS, and the recent DDS prior to the end of the survey in relation to ADL disability, respectively. The results indicate that higher average DDS was associated with a decreased risk of ADL disability (T3 vs. T1: hazard ratio 0.50; 95% confidence interval 0.39–0.66). The association was stronger among participants who did not had comorbidity at baseline than those who did (P-interaction 0.035). The average DDS is the most pronounced in estimating the association of DDS with ADL disability of the three approaches. In summary, higher DDS has beneficial effects on ADL disability, and long-term dietary exposure is more preferable in the investigation of DDS and ADL.


Author(s):  
Hayato Narao ◽  
Keisuke Hirota ◽  
Shunji Koya ◽  
Manabu Tomita ◽  
Yuta Manako ◽  
...  

Activities of daily living (ADL) are frequently impaired in patients with hepatocellular carcinoma (HCC). In this retrospective study, we aimed to investigate the effects of physical therapy on ADLs in patients with HCC during hospitalization for cancer treatment. Nineteen patients with HCC were enrolled. During hospitalization, patients performed a combination of resistance training, stretching, and aerobic exercise (20–60 min/day). ADLs were assessed using the functional independence measure (FIM). Changes in FIM were evaluated by before–after analysis. No significant difference was seen in Child–Pugh class before and after physical therapy. The bilateral knee extension strength and chair stand test were significantly increased after physical therapy compared with before physical therapy (p = 0.001 and p = 0.008, respectively). The total FIM score was significantly increased after physical therapy compared with that before physical therapy (p = 0.0156). Among the 18 indexes of FIM, the stairs index was significantly improved after physical therapy compared with that before physical therapy (5.9 vs. 6.4 points, p = 0.0241). We demonstrated that physical therapy improved muscle strength without worsening liver function. Furthermore, physical therapy improved FIM, especially in the stairs index, in patients with HCC. Thus, physical therapy may be beneficial in patients with HCC during cancer treatment.


1993 ◽  
Vol 5 (1) ◽  
pp. 67-77 ◽  
Author(s):  
Geri Adler ◽  
Linda Ott ◽  
Mary Jelinski ◽  
James Mortimer ◽  
Renee Christensen

Thirty-seven dementia patients and their caregivers were studied before and after a two-week in-hospital respite stay. Institutional respite care did not alter behavior problems in dementia patients, nor did changes in performance of activities of daily living (ADLs) by Alzheimer's disease (AD) patients exceed those expected from disease progression. Caregivers exhibited an improvement in burden and depression during the respite study, but levels returned to baseline following the patient's return home.


2003 ◽  
Vol 83 (10) ◽  
pp. 907-917 ◽  
Author(s):  
Joan P Scannell ◽  
Stuart M McGill

Abstract Background and Purpose. Physical therapists commonly attempt to reduce and prevent low back pain by “improving” individuals' lumbar posture. To investigate the physical therapy clinical practice of attempting to “improve” lumbar posture, measures of passive tissue stiffness and angular deformation during activities of daily living were used. Participants. The lumbar spine posture of 150 university students was measured as the inclinometer angle difference between L1 and S1. Eighteen female participants (6 with hypolordosis, 6 with hyperlordosis, and 6 controls without lumbar spine impairment) were recruited from this lumbar posture database. Hypolordosis and hyperlordosis were clinically classified by physical therapists. Methods. Lumbar passive tissue stiffness was measured during sitting, standing, and walking before and after a 12-week exercise program, and estimates of lumbar passive tissue strain were calculated from those measurements. Results. The neutral zone (NZ), a range of lumbar positions of low passive tissue stiffness, was identified. Prior to training, the subjects with hypolordosis had more passive tissue strain during sitting than the subjects with hyperlordosis, and the subjects with hyperlordosis stood in extension relative to their NZs while the control subjects and subjects with hypolordosis stood within their NZs. Before and after training, subjects in all 3 groups walked with lumbar spine positions within their NZs. After training, the lumbar posture of the subjects with hypolordosis and the subjects with hyperlordosis changed toward a “mean” (mid-range) lumbar posture. After the exercise program, subjects in all 3 groups stood and walked with their lumbar spines in positions within their NZs, and they sat with their lumbar spines flexed relative to their NZs. Discussion and Conclusion. Knowing that tissue failure can be related to passive tissue strain, the results of this study support the clinical practice of attempting to change individuals' posture-related lumbar spine positions during activities of daily living. Lumbar passive tissue strain, as estimated from the NZ and angular deformation during activities of daily living, can be decreased, but can also be increased, by an exercise program.


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