scholarly journals Efficacy of an Internet-Based Program to Promote Physical Activity and Exercise after Inpatient Rehabilitation in Persons with Multiple Sclerosis: A Randomized, Single-Blind, Controlled Study

2020 ◽  
Vol 17 (12) ◽  
pp. 4544 ◽  
Author(s):  
Peter Flachenecker ◽  
Anna Karoline Bures ◽  
Angeli Gawlik ◽  
Ann-Christin Weiland ◽  
Sarah Kuld ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Multiple Sclerosis ◽  
Inpatient Rehabilitation ◽  
Physical Activity Promotion ◽  
Controlled Study ◽  
Activity Promotion ◽  
Physical Activity And Exercise ◽  
Exercise Promotion

Background: Multimodal rehabilitation improves fatigue and mobility in persons with multiple sclerosis (PwMS). Effects are transient and may be conserved by internet-based physical activity promotion programs. Objective: Evaluate the effects of internet-based physical activity and exercise promotion on fatigue, quality of life, and gait in PwMS after inpatient rehabilitation. Methods: PwMS (Expanded Disability Status Scale (EDSS) ≤ 6.0, fatigue: Würzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS) ≥ 32) were randomized into an intervention group (IG) or a control group (CG). After rehabilitation, IG received 3 months of internet-based physical activity promotion, while CG received no intervention. Primary outcome: self-reported fatigue (WEIMuS). Secondary outcomes: quality of life (Multiple Sclerosis Impact Scale 29, MSIS-29), gait (2min/10m walking test, Tinetti score). Measurements: beginning (T0) and end (T1) of inpatient rehabilitation, 3 (T2) and 6 (T3) months afterwards. Results: 64 of 84 PwMS were analyzed (IG: 34, CG: 30). After rehabilitation, fatigue decreased in both groups. At T2 and T3, fatigue increased again in CG but was improved in IG (p < 0.001). MSIS-29 improved in both groups at T1 but remained improved at T2 and T3 only in IG. Gait improvements were more pronounced in IG at T2. Conclusions: The study provides Class II evidence that the effects of rehabilitation on fatigue, quality of life, and gait can be maintained for 3–6 months with an internet-based physical activity and exercise promotion program.

scholarly journals Determinants of Physical Activity Practices in Metropolitan Context: The Case of Lisbon Metropolitan Area, Portugal

2021 ◽  
Vol 13 (18) ◽  
pp. 10104
Author(s):  
Ana Louro ◽  
Pedro Franco ◽  
Eduarda Marques da Costa
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Metropolitan Area ◽  
Physical Activity Promotion ◽  
Well Being ◽  
Urban Context ◽  
Daily Lives ◽  
Activity Promotion ◽  
Family Perceptions

Physical activity is an important health determinant for people’s quality of life and well-being. This study intends to (1) identify how the practice of physical activity fits into families’ daily lives; and (2) verify to what extent the practice of physical activity is influenced by the urban model, family composition, and family perceptions. A survey was applied to 410 families (corresponding to 1006 individuals) in Lisbon Metropolitan Area (LMA), Portugal, focusing on different physical activities—gym, swimming, walking/trekking/hiking, and cycling. Results are based on descriptive and bivariate data analysis and show the existence of asymmetries in the practice of physical activity in LMA. The urban context impacts the choice and frequency of physical activity practices. The typology of family and age proved to be more differentiating factors than income, being reinforced by daily lives (e.g., daily movements, transport modes, etc.). Positive self-perceptions of quality of life and health levels are also conducive to more active practices, contrary to negative perceptions of the neighborhood that are related to practices in peripheral destinations. Conclusions highlight the need for differentiated measures of physical activity promotion according to the territories and communities’ characteristics in a multilevel approach.

scholarly journals A Physical Activity Intervention Feasibility Study for Kidney Inpatients: A Basic Research Protocol

2021 ◽  
Vol 8 ◽  
pp. 205435812098705
Author(s):  
Kathryn Wytsma-Fisher ◽  
Stefan Mustata ◽  
Theresa Cowan ◽  
Manuel Ester ◽  
S. Nicole Culos-Reed
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Physical Function ◽  
Kidney Failure ◽  
Standard Care ◽  
Physical Activity Intervention ◽  
Clinical Care ◽  
Activity Promotion ◽  
Cardiovascular Morbidity And Mortality

Background: Low physical activity levels and poor physical functioning are strongly associated with poor clinical outcomes and mortality in adult kidney failure patients, regardless of treatment modality. Compared with the general population, individuals with chronic kidney disease are physically inactive, have reduced physical abilities and difficulties performing routine daily tasks, lower health-related quality of life, and higher cardiovascular morbidity and mortality. In addition, frail kidney failure patients have higher hospitalization and mortality rates as compared with other kidney failure patients. Evidence suggests that assessment and recommendations for physical activity should be part of standard care for kidney failure patients. Structured exercise can improve physical function and quality of life in frail older adults and may be used specifically for management of frailty in kidney failure. However, research is needed to determine best practices for implementation of physical function measurements and physical activity promotion in standard kidney failure care. Objective: The proposed Move More study will assess the feasibility of a physical activity intervention offered to the kidney failure inpatients in Calgary, Alberta. Specifically, this study is designed to examine the effects of an early physical activity/mobility intervention led by a kinesiologist, and supported by the clinical care team including physiotherapists (PT) and nurse clinicians. Methods: The Move More study is a single-arm pilot intervention examining feasibility and optimal improvement in real-world conditions. Kidney failure inpatients at the Foothills Medical Centre will be recruited to participate. Patients will receive an individualized in-hospital physical activity/mobility intervention. Frailty and physical function will be assessed at baseline and postintervention prior to hospital discharge. The goal is to recruit 24 to 36 patients. Conclusions: Evidence needed to support the inclusion of mobility and physical activity as part of standard care will be gathered, with knowledge gained used to help direct future physical activity programming for kidney failure inpatients.

scholarly journals 178Depression but not physical activity mediates the fatigue-mental quality of life relationship in multiple sclerosis

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Alexander Fidao ◽  
Alysha De Livera ◽  
Tracey Weiland ◽  
George Jelinek ◽  
Sandra Neate ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Multiple Sclerosis ◽  
Indirect Effect ◽  
Mediation Effect ◽  
Study Cohort ◽  
Wide Range ◽  
Clinically Significant

Abstract Background Fatigue is among the most prevalent symptoms of multiple sclerosis (MS), and significantly detrimental to mental quality of life. We examined the role of depression and physical activity as mediators in the fatigue-QoL relationship in MS. Methods Using an international study cohort measuring a wide range of lifestyle and clinical factors, determinants of fatigue (Fatigue Severity Scale) and mental quality of life (MSQoL-54; QoL) were assessed in 2,104 participants using log-binomial and linear regression, respectively. Structural equation modelling (SEM) was used to assess the mediating role of depression and physical activity between fatigue and mental QoL. Results The median mental QoL score in the sample was 73.8/100. The mean fatigue score was 40.5/63, with 65.6% having clinically significant fatigue. In SEM analyses evaluating depression as a mediator of the fatigue-QoL relationship, mental QoL was 14.17-points lower in those with clinically significant fatigue, of which the indirect effect via depression accounted for over 30.8% (p &lt; 0.001). This mediation effect was most pronounced for the Role Limitations from Emotional Issues (44.9%, p &lt; 0.001) and Emotional Wellbeing (41.6%, p &lt; 0.001) subdomains. Evaluating physical activity as a mediator of the fatigue-QoL relationship, mental QoL was 11.03-points lower in those with clinically significant fatigue, of which the indirect effect via physical activity accounted for only 1.0% (p = 0.001). Conclusions This study provides evidence that depression accounts for a majority of the fatigue-mental QoL relationship, while physical activity only plays a small role. While replication and longitudinal studies are required for validation, our findings may inform the development of treatments for reducing the impacts of fatigue and improving QoL in people with MS. Key messages Fatigue’s negative impact on emotional quality of life in multiple sclerosis is not a function of reduced ambulation but instead its impact on depression. Reducing depression may thus markedly improve quality of life in this population.

scholarly journals Associations between Activity Pacing, Fatigue, and Physical Activity in Adults with Multiple Sclerosis: A Cross Sectional Study

2020 ◽  
Vol 5 (2) ◽  
pp. 43 ◽  
Author(s):  
Ulric S. Abonie ◽  
Femke Hoekstra ◽  
Bregje L. Seves ◽  
Lucas H. V. van der Woude ◽  
Rienk Dekker ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Multiple Sclerosis ◽  
Perceived Risk ◽  
Cross Sectional Study ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Fatigue is common in people with multiple sclerosis (MS). Activity pacing is a behavioral way to cope with fatigue and limited energy resources. However, little is known about how people with MS naturally pace activities to manage their fatigue and optimize daily activities. This study explored how activity pacing relates to fatigue and physical activity in people with MS. Participants were 80 individuals (60 females, 20 males) with a diagnosis of MS. The participants filled in questionnaires on their activity pacing, fatigue, physical activity, and health-related quality of life, 3–6 weeks before discharge from rehabilitation. The relationships between the variables were examined using hierarchical regression. After controlling for demographics, health-related quality of life, and perceived risk of overactivity, no associations were found between activity pacing and fatigue (β = 0.20; t = 1.43, p = 0.16) or between activity pacing and physical activity (β = −0.24; t = −1.61, p = 0.12). The lack of significant associations between activity pacing and fatigue or physical activity suggests that without interventions, there appears to be no clear strategy amongst people with MS to manage fatigue and improve physical activity. People with MS may benefit from interventions to manage fatigue and optimize engagement in physical activity.

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