Access to exercise for people with visual impairments during the Coronavirus-19 pandemic

People with blindness and visual impairments have reduced access to exercise compared to the general population during typical societal functioning. The Coronavirus-19 pandemic completely disrupted daily life for most individuals worldwide, and in the United Kingdom, a stay-at-home order was enforced. One of the sole reasons an individual could leave their home was for the purpose of daily exercise. Here, we examined how the UK national lockdown impacted access to exercise for people with blindness and visual impairment. We used a mixed methods design, collecting quantitative data from two established measures (the Exercise Barriers and Benefits Scale and the International Physical Activity Questionnaire), and qualitative data from open-ended questions. We found that, during the initial stages of the lockdown, perceived barriers to exercise increased compared to pre-pandemic levels, driven by factors, such as the closure of exercise facilities and additional difficulties posed by social distancing. Interestingly, during the later stages of the UK Coronavirus-19 response, perceived barriers decreased to lower than pre-pandemic levels. Thematic analysis indicated that this may have been due to participants finding new online methods to exercise at home, in combination with the tentative reopening of facilities.

Exercise Training for Multiple Sclerosis: A Narrative Review of History, Benefits, Safety, Guidelines, and Promotion

Background: There have been significant advances in the medical treatment and management of multiple sclerosis pathogenesis, relapse and disease progression over the past 30 years. There have been advancements in the symptomatic treatment of multiple sclerosis, including management of secondary multiple sclerosis expressions such as walking, cognitive dysfunction, fatigue and depression. Scientific evidence and expert opinion suggest that exercise may be the single most effective non-pharmacological symptomatic treatment for multiple sclerosis. This article presents the historical context of exercise training within the multidisciplinary management of multiple sclerosis. We guide neurologists and healthcare providers on the recommended prescription of exercise and practical, theoretical methods to overcome barriers to exercise. Method: We undertook a critical search of the historical and current literature regarding exercise and multiple sclerosis from the viewpoint of exercise promotion by neurologists and the multidisciplinary care team. Results: We highlight the ever-strengthening body of research indicating that exercise is safe and effective for improving symptoms of multiple sclerosis. Further, exercise training may be necessary for reducing disease progression. Conclusion: We seek to encourage neurologists and specialists in multidisciplinary healthcare teams to prescribe and promote exercise at diagnosis and across all stages of the disease trajectory using prescriptive guidelines as part of comprehensive MS care. Available tools include clinical education to dispel any historical myths related to exercise in multiple sclerosis, clinical exercise guidelines and behaviour change theory to overcome patients barriers to exercise.

The movement-to-music (M2M) study: study protocol for a randomized controlled efficacy trial examining a rhythmic teleexercise intervention for people with physical disabilities

Background People with physical disabilities need exercise routines that are enjoyable, readily available in the home, adapted to their functional level, and eliminate common barriers to exercise participation related to transportation and time commitment. The purpose of the movement-to-music (M2M) study is to address these issues by establishing a remotely delivered, rhythmic exercise program for people with physical disabilities. Methods The study is a two-arm randomized controlled efficacy trial examining a 12-week remotely delivered M2M intervention (eM2M) in 108 people with physical disabilities. The primary outcomes are changes in cardiorespiratory fitness and muscle strength at post 12-week intervention. Discussion The eM2M study will enhance our understanding of an alternative intervention design and delivery mode that removes common barriers to exercise participation experienced by people with physical disabilities. The eM2M intervention may be an alternative option for people with physical disabilities to obtain regular exercise, especially during a pandemic when exercising in indoor facilities may be problematic. Trial registration ClinicalTrials.gov NCT03797378. Registered on January 9, 2019, with the trial name “Movement-to-Music: Lakeshore Examination of Activity, Disability, and Exercise Response Study (M2M LEADERS)”.

Staying Active While Staying Home: The Use of Physical Activity Technologies During Life Disruptions

One impact of the Covid-19 lockdowns was a restriction on people's ability to engage in physical activity in previously routine ways. This paper presents a two-stage mixed-method study exploring how people used technology to stay physically active during this period. We found that activity trackers reminded people to be active, while virtual coaching (i.e., video tutorials and online classes) helped them stay connected. The lockdown increased people's awareness of their activity levels and removed barriers to exercise, for example by giving them greater control over their time. However, it also created new challenges, with lack of time and space, injuries due to sudden changes in activity, and anxiety around lockdown, putting limits on physical activity. We highlight future directions that must be addressed to maximise the benefits of physical activity technologies for people trying to stay active during major life disruptions.

The complex relationship between physical activity and diabetes: an overview

Diabetes mellitus (DM) is a widespread condition, representing a challenging disease to manage. Exercise is being increasingly recommended as part of the therapeutic regimen for DM but the management of different forms of physical activity is difficult for individuals with diabetes, trainers, and physicians. Regular exercise can improve health and well-being, helping individuals to achieve their target lipid profile, body composition, cardio-respiratory fitness, and glycemic goals. People with diabetes tend to be as inactive as the general population, with a large percentage of individuals not achieving the minimum amount of recommended physical activity levels. Indeed, several barriers to exercise exist for persons with diabetes, including sports eligibility, multi-modality management of diabetic athletes, and inadequate knowledge about adequate type and intensity of exercise. The aim of the present review is to provide the current understanding of mechanisms, recommendations, and beneficial effects of different modalities of exercise for the treatment of DM.

Pickleball for Inactive Mid-Life and Older Adults in Rural Utah: A Feasibility Study

Many diseases, disabilities, and mental health conditions associated with aging can be delayed or prevented through regular exercise. Several barriers to exercise, many of which are exacerbated in rural communities, prevent mid-life and older adults from accessing its benefits. However, recently, a racquet sport named pickleball has become popular among older adults, and it appears to overcome some of these barriers. We conducted a feasibility study to evaluate the impact of a six-week pickleball intervention on measures of muscle function, cognitive function, perceived pain, and cardio-metabolic risk, as well as several psychosocial factors contributing to adherence in sedentary rural participants. Participants improved their vertical jump, cognitive performance, and reported a decrease in self-reported pain, suggesting improved physical and cognitive health across the sample. Participants also reported high levels of satisfaction and demonstrated good adherence over the duration of the study. Perhaps of greatest value was the overwhelmingly positive response from participants to the intervention and follow-up interviews reporting a desire to continue pickleball play beyond the study period. Overall, pickleball appears to be a promising intervention to, (1) elicit functional- and cognitive-related improvements, and (2) motivate mid-life and older adults to adhere to exercise sufficiently long to benefit their health.

Perfectionism, Motives, and Barriers to Exercise from a Person-Oriented Approach

Perfectionism is considered to be a significant personality factor within the sport and exercise field. However, very little is known about the reasons why individuals with different perfectionistic tendencies engage or not in physical activity. This study aims, from a person-oriented approach, to analyze if participation motives and barriers may differ among four perfectionistic profiles: Non-Perfectionists (low perfectionistic strivings, PS, and perfectionistic concerns, PC), Adaptive Perfectionists (high PS and low PC), Maladaptive Perfectionists (high PS and PC), and Moderate Perfectionists (moderate PS and PC). A sample composed of 597 (Mage = 22.08, SD = 3.33) undergraduates enrolled in a sport science degree from Ecuador participated in this study. Non-Perfectionists reported lower levels of motives, whereas Adaptive and Maladaptive Perfectionists reported higher scores on all participation motives. Significant and positive correlations were found between PS and both autonomous and controlled motives, whereas PC was positively correlated with controlled reasons and only significantly correlated with some autonomous reasons by the effect of PS. In terms of barriers, Maladaptive Perfectionists reported significantly higher scores on all barriers analyzed in comparison with the other three profiles, with moderate and large effect sizes. The results of the bivariate and partial correlations suggest that these inter-profile differences were explained by PC. Considering the results, it is advised to develop strategies to identify Maladaptive Perfectionists in order to increase their intrinsic reasons for practicing physical exercise, and to minimize their perceived barriers.

Exercise Barriers and Facilitators for Breast Cancer Patients After Surgery: A Qualitative Content Analysis

PURPOSE: This study aimed to understand the barriers to exercise and facilitators of exercise for up to 4 weeks following breast cancer surgery.METHODS: A descriptive qualitative research method was used in this study. Twelve patients were recruited through purposive sampling immediately after breast cancer surgery.RESULTS: Physical aspects (pain at the surgery site, reduction in the range of motion, and decrease in fitness), environmental aspects (difficulty in movement due to drain, lack of information on exercise), and psychological aspects (concerns about side effects, fear of pain, and fear of injury during exercise) were identified as barriers to exercise. Expectation of positive effects (recovery from surgery, prevention of lymphedema, usefulness for future radiation therapy, prevention of cancer recurrence, and health management) of exercise and social support (hospital education, support from medical staff, and exercise information received via mass media) were identified as facilitators of exercise.CONCLUSIONS: We recognized different barriers to exercise and facilitators of exercise among patients who recently underwent breast cancer surgery. Future exercise intervention studies should consider minimizing such barriers and maximizing the facilitators identified in our study.

Home-based exercise program for older adults with Motoric Cognitive Risk syndrome: feasibility study

Aim: We developed a home-based goal-directed exercise program with telephonic coaching to overcome barriers to exercise participation in cognitively impaired older adults. Methods: Six patients with Motoric Cognitive Risk syndrome at high risk for dementia were enrolled, three assigned to goal-directed exercises and three to stretching exercises. All participants underwent an in-person training session followed by a session at home with a telephonic coach. Sessions were supervised by a physiatrist, and exercise programs were personalized. Results: In-person training and remote telephonic coaching support promoted adherence. There were no adverse effects and interventions were rated highly. Participant and logistical barriers were identified that can inform design of home-based clinical trials. Conclusion: Home-based exercises are safe and feasible in older adults with Motoric Cognitive Risk.