Effectiveness of Physiotherapy in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were searched. Randomised controlled trials (RCTs) on the effectiveness of non-pharmacological interventions supervised by a physiotherapist were compared with usual care or home-based exercise programmes. Two investigators independently screened eligible studies. A total of 12 RCTs satisfied eligible criteria. The risk of bias ranged between medium and high. The meta-analysis results indicated that between supervised physiotherapy and usual care, the former was significantly associated with improvement in disease activity (standardised mean difference = −0.37, 95% CI, −0.64; −0.11; p < 0.001, I2 = 71.25%, n = 629), and functional capacity (standardised mean difference = −0.36, 95% CI, −0.61; −0.12, p < 0.05; n = 629). No statistically significant differences emerged when interventions were compared with home-based exercise programmes. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity, and pain in patients with ankylosing spondylitis. No significant improvements emerged when supervised physiotherapy and home-based exercise programmes were compared. Further investigation and RCTs with larger samples are needed.

Angle-angle diagrams in the assessment of locomotion in persons with multiple sclerosis: A preliminary study

Gait analysis is clinically relevant in persons with multiple sclerosis (PwMS) and consists of several joint angular displace-ment-time relationships and spatiotemporal parameters. However, it lacks representation by means of diagrams in which knee angle-hip angle and knee angle-ankle angle variations are plotted against each other at the same instants of time. Three-dimensional kinematic analysis was performed on 20 subjects (10 PwMS/10 healthy controls, HCs), and the knee-angle/hip-angle and knee-angle/ankle-angle diagrams of both lower limbs were determined in the sagittal plane while walking on a motorized treadmill. The area (a quantifier of conjoint range of motion) and the perimeter (a quantifier of coordina-tion) of angle-angle diagram loops were calculated. PwMS showed reduced knee-angle/ankle-angle loops compared to HCs (P<0.05, ES = 0.80), whereas the hip-angle/ankle-angle loops between the PwMS and HCs was not significant (P> 0.05). Similarly, the activation of leg muscles showed significant differences between PwMS and HCs (p ranged from 0.05-to 0.001; ES ranged from 1.30 to 1.89). The results indicate that the proposed knee-angle/hip-angle diagram is feasible and could be applied as a reliable tool in future studies aimed at assessing the acute and long-term effects of specific exercise programmes and/or pharmacological treatment in PwMS.

Safety of home-based exercise for people with intermittent claudication: A systematic review

Intermittent claudication (IC) is a classic symptom of peripheral artery disease, with first line treatment being supervised exercise therapy (SET). Despite this, SET is frequently underutilised, and adherence is often poor. An alternative option are home-based exercise programmes (HBEP). Although HBEPs are well tolerated, to the authors’ knowledge, no research has assessed their safety. The aim of this review was to assess the safety of HBEPs in people living with IC. We performed an electronic search of the MEDLINE, CINAHL, and Cochrane Library databases. The main parameter of interest was complication rate, calculated as the number of related adverse events per patient-hours. Subanalysis was undertaken to determine differences in safety for studies that did and did not include pre-exercise cardiac screening, and for studies with exercise at low, moderate, and high levels of claudication pain. Our search strategy identified 8693 results, of which 27 studies were included for full review. Studies included 1642 participants completing 147,810 patient-hours of home-based exercise. Four related adverse events were reported, three of which were cardiac in origin, giving an all-cause complication rate of one event per 36,953 patient-hours. Three of these events occurred following exercise to high levels of claudication pain, and one occurred with pain-free exercise. All four events occurred in studies without cardiac screening. Based on the low number of related adverse events, HBEPs appear to be a safe method of exercise prescription for people with IC. Our results strengthen the rationale for providing alternative exercise options for this population. PROSPERO Registration No.: CRD42021254581

'Critical Ingredients of Success': Exercise for Men : Exploring the Preferences and Experiences of Men Who have Had a Diagnosis of Cancer

<p>Evidence demonstrates the benefits of exercise for those with a cancer diagnosis and there is an increasing recognition of the need to tailor exercise opportunities for specific patient groups. However, little is known about the preferences and experiences of exercise in men who have had a diagnosis of cancer. In May 2011, the Waikato/Bay of Plenty division of the Cancer Society of New Zealand introduced a supervised, circuit-based group exercise programme specifically for men. Given this was the first known such programme in New Zealand, this study involved a process evaluation of the programme‘s development and implementation. The aims of the study were to explore the experiences of the men who participated, to investigate their preferences for exercise, and identify factors essential to the ongoing design and delivery of acceptable, accessible and appropriate exercise programmes for men. The 10 male participants and the physiotherapist who delivered the programme were interviewed about their experiences of the 6 week programme. The men were aged 62-80 years with a median age of 69, had diverse professional and personal backgrounds, varied types and stages of cancer and a wide range of physical fitness. The interview data were analysed using an inductive, thematic approach. The programme met the men's needs and each felt invigorated for attending. The men all wanted the programme to continue. Four major themes emerged: 1) the importance of a safe, inclusive programme, 2) camaraderie and the impact of competition and humour, 3) acceptability of the programme and its purpose, and 4) the overall value of the programme. This research builds on existing knowledge and contributes to a deeper understanding of the utility and feasibility of a group-based exercise programme for men, and the factors that need to be considered in designing further programmes. Practicalities, possibilities and implications for practice and future research are discussed. These include the use of simple transferable resources and the ease in which this flexible programme could be further developed and expanded, the value of a multidisciplinary approach, and the potential multiple benefits for men‘s health care.</p>

'Critical Ingredients of Success': Exercise for Men : Exploring the Preferences and Experiences of Men Who have Had a Diagnosis of Cancer

<p>Evidence demonstrates the benefits of exercise for those with a cancer diagnosis and there is an increasing recognition of the need to tailor exercise opportunities for specific patient groups. However, little is known about the preferences and experiences of exercise in men who have had a diagnosis of cancer. In May 2011, the Waikato/Bay of Plenty division of the Cancer Society of New Zealand introduced a supervised, circuit-based group exercise programme specifically for men. Given this was the first known such programme in New Zealand, this study involved a process evaluation of the programme‘s development and implementation. The aims of the study were to explore the experiences of the men who participated, to investigate their preferences for exercise, and identify factors essential to the ongoing design and delivery of acceptable, accessible and appropriate exercise programmes for men. The 10 male participants and the physiotherapist who delivered the programme were interviewed about their experiences of the 6 week programme. The men were aged 62-80 years with a median age of 69, had diverse professional and personal backgrounds, varied types and stages of cancer and a wide range of physical fitness. The interview data were analysed using an inductive, thematic approach. The programme met the men's needs and each felt invigorated for attending. The men all wanted the programme to continue. Four major themes emerged: 1) the importance of a safe, inclusive programme, 2) camaraderie and the impact of competition and humour, 3) acceptability of the programme and its purpose, and 4) the overall value of the programme. This research builds on existing knowledge and contributes to a deeper understanding of the utility and feasibility of a group-based exercise programme for men, and the factors that need to be considered in designing further programmes. Practicalities, possibilities and implications for practice and future research are discussed. These include the use of simple transferable resources and the ease in which this flexible programme could be further developed and expanded, the value of a multidisciplinary approach, and the potential multiple benefits for men‘s health care.</p>

Can We Go Online for Sports Injury Prevention? A Systematic Review of English-Language Websites with Exercise-Based Sports Injury Risk Reduction Programmes

Background Preventing sports injuries is at the forefront of sports medicine. Although effective preventive strategies in scientific literature exist, their implementation is lagging behind. The Internet could support the translation of knowledge from the literature to end-users, but the quality of the online resources would have to be assured. This online-based systematic review is to assess availability, readability, quality, and content of the websites presenting exercise-based sports injury risk reduction (prevention) programmes. Moreover, the quality of reporting and contents of the exercise programmes were assessed. Methods Google, Yahoo, and Bing were searched on 2 September 2018. We used ‘sports injury prevention program*’ and ‘sports injury prevention warm-up’ as search phrases. The owners/authors of the included websites were asked for further recommendations on online resources. Search updates were run in DuckDuckGo on 15 May 2020 and 22 August 2021. Eligible websites were active, in English, and contained instructions for the exercise/s aiming at sports injury prevention. Two reviewers independently screened the links and previews and performed an in-depth appraisal of included websites. The website quality was assessed using JAMA framework criteria and Health on the Net Foundation Code of Conduct (HONcode) certification. The readability of websites was assessed using the Flesch-Kincaid Reading Ease score. The reporting appraisal of exercise programmes was done using the modified Consensus on Exercise Reporting Template (CERT). Results Among 480 websites screened, 16 were eligible with an additional four recommended and nine found in search updates (29 in total). None of the websites was certified by HONcode. The overall quality of websites was low 2.1 ± 1.0/4, but overall readability was high 67 ± 17/100. The average quality of reporting of exercise programmes was low 5.79 ± 3.1/12. Websites with community input had the lowest readability, but the highest quality, and vice versa websites run by businesses had the highest readability, but the lowest quality. Eight websites presented programmes tested for effectiveness. Conclusions Overall, the quality of the websites was low, but their readability was high. Improvements required are relatively easy to implement (i.e. including the date when the website was updated, applying for HONcode certification) and extremely important (e.g. providing resources on which the website’s content is based). There are some sports injury risk reduction programmes reported with high quality and effectiveness-tested available online for team sports, but none for individual sports. Trial Registration This review has been registered in the PROSPERO (CRD42019107104).

Physical activities for older adults: Are local co-operations of sports clubs and care partners an option to increase access?

Group-based physical activity brings high and long-term added value for the participants. Especially for older adults in need of care, this development is dependent on interdisciplinary thinking and the networking of local structures. Studies underline the consideration of the communication and access options that are needed to be able to promote the target group’s health through exercise programmes. Sports clubs are repeatedly mentioned as competent partners in health promotion, but in municipal practice—possibly due to very different basic structures to the system of care—they receive less attention. The project Moving Nursing Homes and Care Providers (2019–2022) is coordinated by the State Sports Federation of North Rhine-Westphalia, Germany. Local sports clubs cooperate with providers of outpatient and inpatient care to start new sports programs for older adults in need of care. As part of the scientific evaluation, the perspectives involved are equally considered and their motives and needs are analysed. For this paper, four conducted qualitative interviews with representatives of sports clubs were analysed with the focus on opportunities and barriers for local partnerships between sports clubs and care. Results show structural and personal parameters that have to be looked at from the beginning. Local networks are essential for sports clubs to get in contact with potential partners and to reflect initiated processes. Although aspects of (financial) organisation is an often named topic, sports clubs have the opinion that they have the social responsibility to influence developments in their neighbourhood for all generations positively.

Older Women’s Experiences of a Community-Led Walking Programme Using Activity Trackers

Promoting physical activity amongst older adults represents a major public health goal and community-led exercise programmes present benefits in promoting active lifestyles. Commercial activity trackers potentially encourage positive behaviour change with respect to physical exercise. This qualitative study investigated the experiences and attitudes of older adults following a 6-week community-led walking programme utilising activity trackers. Eleven community-dwelling older women aged 60+ completed individual phone interviews following their involvement in the programme. The programme, codesigned with a group of senior citizens, equipped participants with wrist-worn activity trackers and included biweekly check-in sessions with a researcher to monitor progress and support motivation. Interviews explored participants’ experiences of the programme and of using activity trackers for the purpose of becoming more active. A thematic analysis produced three main themes: ‘programme as a source of motivation’, ‘user experiences with the technology’ and ‘views on social dimension of the programme’. Overall, participants highlighted the self-monitoring function of activity trackers as most beneficial for their exercise levels. This study provides insights into the personal and social factors perceived by older adults in relation to being part of a community-led programme using activity trackers. It highlights the role of the programme and trackers in maintaining motivation to stay active.