Effects of a WeChat-based individualized post-discharge rehabilitation program on patients with lumbar fusion surgery

BACKGROUND: Exercise training after lumbar fusion surgery (LFS) is important for regaining the strength in the spinal muscles, pain management, and minimizing dysfunction. It may be prudent to evaluate technologies such as web-based chat and social media apps for increasing the efficacy of post-surgery interventions in LFS patients. OBJECTIVE: To explore the effectiveness of a WeChat-based individualized post-discharge rehabilitation program in patients with LFS. METHODS: Seventy-two eligible discharged LFS patients were enrolled from October 2018 to February 2019. The experimental group (36 cases) received a 10-week WeChat-based individualized rehabilitation program, while the control group (36 cases) received routine follow-up guidance. The outcomes were measured using the Exercise Compliance Questionnaire, Numerical Rating Scale, Oswestry Disability Index and Chinese version of the self-efficacy for exercise scale. RESULTS: The analysis using generalized estimation equations method shows significant differences in the interaction effect of group*time in exercise compliance (Wald c2= 7.459, P< 0.05), group effect in pain (Wald c2= 5.811, P< 0.05) and self-efficacy (Wald c2= 16.383, P< 0.05). However, there was no significant difference between the experimental and control groups in the group effect in dysfunction improvement (Wald c2= 2.289, P> 0.05). CONCLUSIONS: The WeChat-based rehabilitation intervention can improve exercise compliance and self-efficacy, and help achieve greater pain relief compared to the routine intervention. However, the WeChat-based intervention did not offer better improvement in the self-dysfunction in the post-discharge LFS patients.

The Effect of Exercise Compliance on Risk Reduction for Hamstring Strain Injury: A Systematic Review and Meta-Analyses

Eccentric strength training can reduce the risk of hamstring strain injury (HSI) occurrence; however, its implementation can be impacted by athlete compliance and prescription. The aim of this review was to investigate the effects of intervention compliance, consistency and modality, on the prevention of HSIs among athletes. A literature search was conducted. 868 studies were identified prior to the application of the exclusion criteria which resulted in 13 studies identified. Random effects models were used to produce log odds ratios and 95% confidence intervals. Very high (>75.1%), moderate-high (50.1–75%), low-moderate (25.1–50%) and very low (<25%) and <1-, 1.01–3.00-, >3.01-weeks/session were used as thresholds of compliance and consistency, respectively. Modality was also observed. A positive effect on HSI incidence -0.61 (−1.05 to −0.17), favoring the intervention treatments (Z = −2.70, p = 0.007). There were non-significant, large differences between compliance (p = 0.203, Z = −1.272) and consistency (p = 0.137, Z = −1.488), with increased compliance and consistency showing greater effectiveness. A significant difference between intervention modalities was observed (p < 0.001, Z = −4.136), with eccentric interventions being superiorly effective. Compliance of >50.1% and consistent application with <3 weeks/session having positive effects on HSI incidence. Training interventions that can achieve high levels of compliance, and can be consistently performed, should be the objective of future practice.

Perception attitude and exercise compliance among menopausal females

Background: Menopause is perhaps the most striking event occurring during the middle age in women and represents the end of woman's reproductive life. With the general increase in life expectancy, many women are likely to live for more than 20 years after menopause, spending about one quarter of their lives or more in a state of oestrogen deficiency. Owing to lack of oestrogen woman may experience decrease physical and mental wellbeing that’s why postmenopausal woman can be considered a risk population. There is a lack of data to find the compliance and attitude towards exercise among menopausal females in India.Methods: A questionnaire-based survey was conducted among sample size of 150 menopausal females. Self-made questionnaire was the outcome measure.Results: 21% consider menopause is associated with changes in the body.1 % perceived all the symptoms to be associated with menopause.30% perceived that none are associated with menopause. Perception was seen to be positive overall.36% of uneducated females do not consider exercise at all important.51% of educated females consider it important. Only 61% exercise on regular basis.Conclusions: Most females perceive menopause as a positive life event. Exercise was considered somewhat important by menopausal females; however exercise compliance was poor.

The Effect of Real-Time Video-Based Engagement and Feedback during Pedaling on Cadence Control and Exercise Motivation: A Proof-of-Concept Study

The use of video and music as an intrinsic, dissociative attentional stimulus during exercise is thought to distract from the physical discomfort of exercise, and contribute to improved exercise adherence; however, the effects of video-based feedback and engagement during pedaling on exercise performance and motivation are poorly understood. The aims of the present study were twofold. Firstly, to develop a novel video-based engagement regime for pedaling that links pedaling cadence with the play rate of a video, and secondly, to employ an instrumented pedaling device to assess the influence of the video engagement paradigm on cadence performance and exercise motivation. Eighteen healthy subjects participated in 15-min-duration pedaling sessions while targeting a specific low cadence (60 rotations per minute) and high cadence (100 rotations per minute), including pedaling with the provision of (i) target pedaling cadence information only, (ii) visual feedback on cadence control, including pedaling duration, pedaling cadence, and cadence deviation from target, and (iii) real-time engagement, which involved pedaling at the target speed to maintain the playback rate of a pre-recorded video. Cadence deviation from the target was evaluated, and self-reported exercise motivation examined with a post-exercise survey. Pedaling-cadence deviations significantly reduced with cadence feedback at both low and high cadence (p < 0.05). Participants reported enjoying feedback and video-based engagement during pedaling, with 83% of participants feeling that engagement motivated them to perform pedaling-based exercise. In conclusion, real-time cadence control feedback and video-based engagement during pedaling for healthy individuals may improve performance in targeted pedaling tasks. Through dissociation from the physical cues associated with exercise and fatigue, feedback and engagement may ultimately increase enjoyment and exercise compliance and adherence of pedaling-based exercise. The findings may be useful in prescription and maintenance of targeted pedaling exercises for stroke rehabilitation and exercise therapy.

AB0877-HPR EXERCISE COMPLIANCE AND DISEASE STATUS IN PATIENTS WITH RHEUMATIC DISEASES DURING COVID-19 PANDEMIC

Background:The COVID-19 pandemic affects the whole world in many ways. In an effort to slow down the infection, physical distancing and isolation policies have been implemented in Turkey, likewise the rest of the world. Thereby, rheumatic diseases require to obey the self-isolation recommendations strictly due to general vulnerability to infections in those patients. Due to the precautions taken for isolation, the physical inactivity level of the patients which would affect the disease activity has increased (1).Objectives:The primary purpose of this study was to assess the exercise compliance and clinical status of the patients with rheumatic diseases during the COVID-19 pandemic. The secondary aim of the study was to evaluate the physical activity level and quality of life of the patients during the pandemic.Methods:The research is a cross-sectional study. Seventy-nine patients with various rheumatic diseases were included in the study. Standard questions were used to evaluate the exercise habits, the level of pain and morning stiffness and severity of exacerbations. Pain and morning stiffness levels and attack severity were scored on a numerical rating scale (NRS) (0-10; with 0 indicating no pain/stiffness and 10 severe pain/stiffness). Attack duration was recorded in number of exacerbated days. Parameters were compared before and after the pandemic with Paired Samples T Test. The International Physical Activity Questionnaire-Short Form (IPAQ) and Nottingham Health Profile (NHP) Questionnaire were filled to assess the physical activity level and quality of life.Results:Twenty-eight percent of the patients were diagnosed with Familial Mediterranean Fever (FMF), 37% were Ankylosing Spondylitis (AS), 14% were Systemic Sclerosis (ScS) 14% were Systemic Lupus Erythematosus (SLE), 6% were Rheumatoid Arthritis, 1% were Primary Sjogren Syndrome (PSS). Less than half of the patients (46%) did continue exercising regularly during the pandemic and 30 (81%) of them performed only the exercises given by the therapist while 7 (9%) of them tried different exercise types from another source. The reason for discontinuation to exercising expressed by the incompliant patients were mostly “unwillingness” (17 of 37 patients). Pain, morning stiffness and number of attacks were better during the pandemic compared to before however, a statistically significant difference was found only for morning stiffness (p = .036). The results of IPAQ showed that the majority of the patients (n: 48) were physically inactive, while only 2 patients were active during the pandemic. The most deteriorated quality of life subcategory was energy level of the patients according to the NHP scores.Conclusion:This study results showed that patients with rheumatic diseases stayed physically inactive during the pandemic and the disease status has also been affected negatively. As the duration of the pandemic prolongs, levels of physical inactivity would increase and the progressive physical inactivity is expected to worsen patients’ symptoms more. However, as the pandemic appears to continue, face-to-face exercise therapy should still be avoided. For all those reasons above, alternative ways of therapy like tele-rehabilitation would come onto stage to cope with the increasing physical inactivity of the rheumatic patients.References:[1]Pinto AJ, Dunstan DW, Owen N, Bonfá E, Gualano B. Combating physical inactivity during the COVID-19 pandemic. Nature Reviews Rheumatology. 2020; 16(7):1-2.Disclosure of Interests:None declared

Relationship of diet and exercise compliance with blood sugar stability in diabetes mellitus type 2

Background: Diabetes mellitus (DM) is a health problem that has become a threat. Prevalence DM based on the symptoms increases with age. The prevalence of women tends to be higher than that of men. The purpose of this study was to look at the relationship between diet and exercise compliance with blood sugar stability.Methods: This type of research is a cross sectional study carried out in the Kuranji public health center in Padang city from March to April 2020 with the sample in this study all patients with type 2 diabetes mellitus who went to Kuranji health center and did not come again in the last 3 months totaling 30 people. with the sampling technique purposive sampling. Statistical test using chi-square.Results: The results of this study show that as many as (50%) of respondents obey the diet and (15%) of the respondents do not obey the diet. With the obtained value of p=0.021. while as many as (60%) of respondents obeyed sports and (40%) did not obey sports, with a value of p=0.018. Conclusions: There is a relationship between diet and exercise adherence to blood sugar stability in type 2 DM patients.

Effects of motivational interviewing with conventional physical therapy on rehabilitation of chronic musculoskeletal disorders: a quasi-experimental study

Objective: To compare effects of motivational interviewing with conventional physical therapy in rehabilitation of chronic musculoskeletal disorders versus conventional physical therapy alone. Methods: This quasi-experimental study was conducted at outpatient physical therapy clinics of Lahore from September 2017 to March 2018. Purposive sampling technique was used and participants with chronic musculoskeletal disorders were alternatively allocated to experimental group or control group. Motivational interviewing with conventional physical therapy was given in experimental group whereas control group received conventional physical therapy only. Pain intensity, functional status and exercise compliance were outcome measures. The effects of interventions were measured through visual analogue scale, patient specific functional scale and exercise compliance chart with follow-up of two weeks. Results: Results of independent sample t-test showed that pain score was significantly reduced by mean of 7.19 to 1.66 in experimental group compared to 6.83 to 2.39 in control group from 1st to 14th day (p=0.00). Functional status was significantly improved in experimental group by mean of 3.22 to 8.75 than in control group from 3.17 to 7.63 from 1st to 14th day (p=0.00). Exercise compliance was significant in experimental group with mean repetition of 12.89 and 13.93 whereas 9.48 and 10.33 in control group at 1st and 2nd week respectively (p=0.00). Within-group effects of pain intensity, functional status and exercise compliance were also significant using paired sample t-test (p=0.00). Conclusion: Integration of Motivational Interviewing with conventional physical therapy was found to decrease pain and functional limitations and improve exercise compliance. Continuous.....

Physician Monitoring of FitBit Use for Patient Health

Background Physical activity is a critical component of health. Objective We implemented a pilot project to determine feasibility of embedding activity tracker data within routine primary care visits among family medicine residency patients. This study also examined whether physician monitoring of and feedback concerning tracker improves exercise compliance and overall health. Methods Twenty-six participants received the FitBit Charge HR and were randomized into the self-monitoring (control) or intervention group for 12 weeks. The intervention group received weekly electronic health record (EHR) messages from their physician with feedback. The control group self-monitored activity. Results Data demonstrates patient interest in sharing exercise data with primary providers, patient-generated exercise data can be embedded within visits to personalize recommendations, and patient-physician data sharing is logistically feasible via the EHR. Conclusion Physicians can utilize activity trackers to potentially positively influence patients’ exercise. This research supports the shift toward personalized medicine by facilitating conversations and additional studies about fitness data.

Effectiveness of Scoliosis-Specific Exercise for Alleviating Adolescent Idiopathic Scoliosis: A Systematic Review

Background: Adolescent idiopathic scoliosis (AIS) is the most common pediatric spinal deformity with reported complications including pain, mental health concern and respiratory dysfunction. The Scoliosis-specific exercise (SSE) is prescribed throughout pubertal growth to slow progression although effects are unclear. This review aims to establish the effectiveness of SSE in alleviating AIS in terms of reducing Cobb angle, improving trunk asymmetry and quality of life (QoL). Additionally, it aims to define the effects of age, skeletal maturity, curve magnitude and exercise compliance on the outcomes of SSE. Methods: A systematic reviewed was conducted to net SSE articles. Searched databases included PubMed, MEDLINE, Cochrane Library, Scopus, CINAHL and Google scholar. The quality of study was critically appraised according to the PEDro scale. Results: A total of ten trials with an average PEDro score of 6.9/10 were examined in this study. Two randomized controlled trials (RCTs) and two clinical controlled trials suggested that SSE alone and with bracing or traditional exercise had clinical significance in reducing Cobb angle more than 5°. One RCT specifically implicated no comparable effects between bracing and SSE in prevention of curve progression for moderate scoliosis. Insufficient evidence demonstrated the positive effects of SSE in improving truck asymmetry (n=4) and QoL (n=3). Five studies evaluated the interaction effects of age (n=2), skeletal maturity (n=1) and curve magnitude (n=2) with SSE in reducing Cobb angle yet without drawing any firm conclusions. Conclusions: Insufficient evidence is available to prove that SSE with or without other conservative treatments can reduce Cobb angle, improve trunk balance and QoL. The interaction effects of age, skeletal maturity, curve magnitude, and exercise compliance with SSE in reducing Cobb angle are not proven. Future studies should investigate the relationship of influencing factors and SSE in treating AIS but not only testing its effectiveness.