Physical Activity and Health-Related Quality of Life of Patients on Hemodialysis with Comorbidities: A Cross-Sectional Study

Patients on hemodialysis with multiple comorbidities have limited physical activity, resulting in poor health, low activity participation, and low quality of life. Accordingly, the nursing care provided to such patients should include regular physical activity training programs. Therefore, this cross-sectional descriptive study investigated whether patients on hemodialysis with and without comorbidities have different levels of physical activity and health-related quality of life (HRQoL); the correlations among the comorbidities, physical activity, and HRQoL of the two cohorts were also assessed. The 36-Item Short-Form Health Survey version 2 and International Physical Activity Questionnaire were employed to collect data from 120 patients on hemodialysis. An independent samples t-test and univariate and multivariate linear regression analyses were conducted. The overall HRQoL of patients with comorbidities was lower than that of patients without comorbidities (p = 0.008). Compared with patients who participated in low-intensity physical activity, the overall HRQoL of patients who participated in moderate-intensity physical activity was higher (p < 0.001). The overall HRQoL of patients with comorbidities who participated in low-intensity physical activity was lower than that of those who participated in moderate-intensity physical activity (p < 0.001). Moderate-intensity physical activity was correlated with higher HRQoL for patients with comorbidities. This finding supports the implementation of effective physical activity intervention measures. Furthermore, it supports the promotion of patient self-management and the implementation of regular exercise programs and lifestyle changes, and patients on hemodialysis can benefit from the future management of physical activities.

Salat Dhuha Improves Haemodynamic: A Randomized Controlled Study

BACKGROUND: The prevalence of hypertension increases with age, more than 1 in every two elderly have hypertension, dominated by women. The primary prevention of hypertension is a worldwide public health concern. Salat Dhuha is a moderate-intensity physical activity. Salat with a two-movement cycle (rakaat) demonstrated improved hemodynamic in adults. AIM: Our study purpose was to asses the effects of 2 and 8 rakaats of Salat Dhuha in improving systolic and diastolic blood pressure and heart rate in healthy elderly women. METHODS: Elderly women in the Senior Care Residence (aged 60–74 years) participated in a 6-week controlled study. We completed a formal physical, clinical, and blood assessments before admission. Participants with a history of hypertension were excluded from the study. The participants were randomized into 2 groups, i.e., “8 rakaats group” (n = 13) and “2 rakaats group” (n = 13) of Salat Dhuha. Two participants dropped out from the present study. At baseline and at the end of 6 weeks study period, blood pressure and heart rate were recorded. All data obtained were statistically analyzed. RESULTS: Both groups demonstrated the benefits of Salat Dhuha in improving hemodynamic parameters (systolic and diastolic blood pressure and heart rate). However, the reduction of systolic blood pressure in the “2 rakaats group” (2.16 mmHg) was less than in the “8 rakaats group” (5.50 mmHg), the reduction of diastolic blood pressure in the “2 rakaats group” (0.75 mmHg) was less than the “8 rakaats group” (2.41 mmHg) and the reduction of heart rate in “2 rakaats group” (2.08 bpm) was less than the “8 rakaats group” (6.08 bpm). All differences were statistically significant (p < 0.05). CONCLUSION: This study demonstrated that the Salat Dhuha has a significant potential in improving hemodynamic parameters for elderly women which the more frequent rakaat will give more benefit than less frequent rakaat.

Obesity, Lifestyle Behaviors, and Dietary Habits of Saudi Adolescents Living in Riyadh (ATLS-2 Project): Revisited after a Ten-Year Period

Objective: Undesirable lifestyle behaviors are associated with many adverse health outcomes. This study revisited the lifestyle behaviors, dietary habits, and overweight/obesity status of Saudi adolescents from Riyadh during the year 2019/2020. We report on the rationale, design, and methodology of the current study and provide preliminary findings of the changes that occurred between the two cross-sectional studies within the span of a ten-year period. Methods: A comparison was made between two cross-sectional studies, one conducted in 2009/2010 and the other in 2019/2020, using the same design, methods, and instruments. A multistage stratified cluster random sampling technique was used to select adolescents attending public and private secondary schools. Measurements included demographics, weight, height, waist circumference, physical activity (using valid questionnaire and accelerometer), sedentary time, sleep duration, and dietary habits. Results: The total number of participants was 1262 adolescents, of which 52.4% were male, with a mean (SD) age of 16.4 ± 0.95 years. About 41% of paternal and 39.1% of maternal education levels were university degrees. Over 37% of the families earned more than SAR 20,000/month. Body mass index and waist circumference of males was larger than that of females and the overall prevalence of overweight/obesity was 40.5% with significance (p < 0.001) difference between males (47.3%) and females (32.8%). Between 2009/2010 and 2019/2020 datasets, there were significant changes in age (p < 0.001), waist circumference (p < 0.001), screen time (p < 0.001), moderate-intensity physical activity (p < 0.001), vigorous-intensity physical activity (p < 0.001), total physical activity (p < 0.001), and consumption of breakfast (p = 0.015) and fruits (p = 0.002). Conclusion: The most notable change between the two studies was a significant reduction in the prevalence of physical inactivity among Saudi adolescents, which was due to increased levels of moderate-intensity physical activity among Saudi females, as a result of recent positive sociopolitical changes occurring in the country over the past four years. The findings provided rich information that can be used to explore trends in overweight/obesity, lifestyle behaviors, and dietary habits among Saudi adolescents over the past ten-year period.

Motivational interviewing to increase physical activity in women with gestational diabetes

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.

Acceptability of a mobile-health intervention to increase physical activity among pregnant patients with overweight or obesity: A feasibility randomized controlled trial (Preprint)

BACKGROUND Pregnant patients with overweight or obesity are at high risk of perinatal complications. Excess gestational weight gain further exacerbates this risk. Mobile health (mHealth) lifestyle interventions that leverage technology to facilitate self-monitoring and provide just-in-time feedback may motivate behavior change to reduce excess gestational weight gain, reduce intervention costs, and increase scalability by improving access. OBJECTIVE To test the acceptability and feasibility of a pilot mHealth lifestyle intervention for pregnant patients with overweight or obesity to promote moderate-intensity physical activity, encourage guideline-concordant gestational weight gain, and inform the design of a larger pragmatic cluster randomized controlled trial. METHODS We conducted a mixed-methods acceptability and feasibility randomized controlled trial among pregnant patients with a pre-pregnancy body mass index 25.0-40.0 kg/m2. Patients with singletons at 8–15 weeks’ gestation, and aged 21 years or older with Wi-Fi access were randomly assigned (1:1) to receive usual prenatal care or an mHealth lifestyle intervention. Participants in the intervention arm received wireless scales, access to an intervention website, activity trackers to receive automated feedback on weight gain and activity goals, and a monthly call from a lifestyle coach. Surveys and focus groups with intervention participants assessed intervention satisfaction and ways to improve the intervention. Physical activity outcomes were assessed using the Pregnancy Physical Activity Questionnaire and gestational weight gain was assessed using electronic health record data in both arms. RESULTS Thirty-three patients were randomly assigned to the intervention arm and 35 patients to the usual care arm. 100% of participants in the intervention arm weighed themselves at least once a week compared with 20% of participants in the usual care arm. Participants in the intervention arm wore the activity tracker 6.4 days/week, weighed themselves 5.3 times/week, and 87.9% rated the program “good to excellent.” Focus groups found participants desired more support related to nutrition to help them manage gestational weight gain and would have preferred an app instead of a website. Participants in the intervention arm had a 23.46 MET-hours greater change in total physical activity per week (95% CI:1.13, 45.8) and a 247.2-minute greater change in moderate intensity physical activity per week (95% CI: 36.2, 530.6) in unadjusted models, but these effects were attenuated in adjusted models (change in total physical activity: 15.55 MET-hours per week; 95% CI: -6.32, 37.42; change in moderate intensity physical activity: 199.6 minutes per week; 95% CI: -43.7, 442.9). We found no difference in total gestational weight gain (mean difference: 1.14 kg; 95% CI: -0.71, 3.00) compared to usual care. CONCLUSIONS A pilot mHealth lifestyle intervention was feasible, highly acceptable, and promoted self-monitoring. Refined interventions are needed to effectively impact physical activity and gestational weight gain among pregnant patients with overweight or obesity. CLINICALTRIAL ClinicalTrials.gov NCT03936283

Wearables-based walking program in addition to usual physiotherapy care for the management of patients with low back pain at medium or high risk of chronicity: A pilot randomized controlled trial

Background Although chronic low back pain (LBP) is a leading cause of disability and accounts for large costs, none of the available conventional treatments are clearly more favourable in treating people at increased risk of chronicity. Objectives To examine the feasibility and initial efficacy of a wearables-based walking intervention in addition to usual physiotherapy care in people with LBP at risk of chronicity. Methods Twenty-six adult participants, diagnosed with non-specific LBP with medium or high risk of chronicity, were recruited from physiotherapy private practices. Participants were randomized into usual physiotherapy care (control, n = 14) and usual physiotherapy care plus a wearables-based walking intervention (experimental, n = 12). The intervention duration was 8 weeks. Feasibility outcomes included recruitment rate, adherence to the intervention, dropout rate, and serious adverse events reporting rate. Other outcomes included disability and pain (primary); and physical activity level, daily walking steps, depression, pain catastrophizing and fear of movement (secondary). The outcomes were assessed at baseline, post-intervention and 26 weeks post-randomization follow-up. Results Adherence of experimental participants with the prescribed walking program was moderate. Four participants dropped out during the intervention, and no serious adverse events were reported. Participants in the experimental group showed significant improvement in pain at 26 weeks (β = -0.38; 95% confidence interval (CI) -0.66, -0.10; P = .013), compared with the control group. No between-group differences were found for disability at any time point and pain immediately post-intervention. Experimental participants demonstrated post-intervention improvement in light-intensity (β = 156.71; 95% CI 86.79, 226.64; P < .001), moderate-intensity physical activity (β = 0.46; 95% CI 0.12, 0.80; P = .012), and daily walking steps (β = 7099.13; 95% CI 4522.93, 9675.32; P < .001). Experimental participants demonstrated post-intervention increase in pain catastrophizing (β = 0.52, 95% CI 0.18, 0.86; P = .006). No between-group differences were found for pain catastrophizing at 26 weeks and other secondary outcomes. Conclusion Usual physiotherapy care plus a wearables-based walking intervention program was safe and moderately feasible, and provided significant reduction in pain at 26 weeks as well as increasing the total volume of light- and moderate-intensity physical activity, and daily walking steps immediately post-intervention.

Moderate-Intensity Physical Activity, Music and Art Activities Preserved Cognitive Health in Older Adults: An Argument for Social Prescribing Solution

Introduction: Rates of dementia are projected to increase over the coming years as global populations age. Without a treatment to slow the progression of dementia, many health policies are focusing on preventing dementia by slowing the rate of cognitive decline with age. However, it is unclear which lifestyle changes in old age meaningfully reduce the rate of cognitive decline associated with aging.Objectives: Use existing, multi-year longitudinal health data to determine if engagement in a variety of different lifestyle activities can slow the rate of cognitive decline as older adults age.Method: Data from the English Longitudinal Study of Aging was analyzed using a quasi-experimental, efficient matched-pair design inspired by the clinical trial methodology. Changes in short-term memory scores were assessed over a multi-year interval for groups who undertook one of 11 different lifestyle activities, compared to control groups matched across confounding socioeconomic and lifestyle factors.Results: Two factors, moderate-intensity physical activity and learning activities, resulted in significant positive impact on cognitive function.Conclusion: Our analysis brings cognitive benefit arguments in favor of two lifestyle activities, moderate-intensity physical activity and learning activities, while rejecting other factors advanced by the literature such as vigorous-intensity physical activity. Those findings justify and encourage the development of new lifestyle health programs by health authorities and bring forward the new health system solution, social prescribing.

Yoga Module to Improve Health and Wellbeing During COVID 19 Pandemic

After the initial outbreak of coronavirus disease 2019 (COVID-19) in China, the disease spreads rapidly across the whole world. It is observed that there is a rampant rise in the rate of infection in spite of best possible precautionary measures taken into consideration against Corona. As there is no scientifically validated full proofed medicine against COVID-19 till date, the only possible way is prevention against this infection by improving self-immunity, mass immunisation and controlling non-communicable diseases, if suffered from. Another possible way from the prevention from this deadly virus is development of herd immunity, but the process takes time and can be fatal for people with higher age groups and with co-morbidities. Yoga, an Indian way of mind-body purification, has been reported to improve functionality of human physiological systems and to prevent diseases. It is also observed that yoga, being a low to moderate intensity physical activity, breathing maneuvers and meditation, can also be performed by any person irrespective of age, with maximum benefit and having less stress in the vital organs during the practice. Therefore, a yoga package for improving immunity and other physical and physiological capacities and mental function to prevent Corona like disease has been formulated on the basis of knowledge from traditional yogic literature and evidence from available research publications on yoga. The yoga package might be beneficial across all age groups for improving health and wellbeing in this pandemic situation.