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The SOS-framework (Systems of Sedentary behaviours): an international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course

AbstractBackground: Ecological models are currently the most used approaches to classify and conceptualise determinantsof sedentary behaviour, but these approaches are limited in their ability to capture the complexity of and interplaybetween determinants. The aim of the project described here was to develop a transdisciplinary dynamic framework,grounded in a system-based approach, for research on determinants of sedentary behaviour across the life span andintervention and policy planning and evaluation.Methods: A comprehensive concept mapping approach was used to develop the Systems Of Sedentary behaviours(SOS) framework, involving four main phases: (1) preparation, (2) generation of statements, (3) structuring (sorting andranking), and (4) analysis and interpretation. The first two phases were undertaken between December 2013 andFebruary 2015 by the DEDIPAC KH team (DEterminants of DIet and Physical Activity Knowledge Hub). The lasttwo phases were completed during a two-day consensus meeting in June 2015.

Feasibility, reproducibility and validity of the 10 meter Shuttle Test in mild to moderately impaired people with stroke

Background There currently is no field test available for measuring maximal exercise capacity in people with stroke. Objective To determine the feasibility, reproducibility and validity of the Shuttle Test (ST) to measure exercise capacity in people with stroke. Design Longitudinal study design. Setting Rehabilitation department, day care centres from a nursing home and private practices specialized in neuro rehabilitation. Subjects People with subacute or chronic stroke. Interventions A standardized protocol was used to determine feasibility, reproducibility and validity of the 10-meter Shuttle Test (10mST). Main measures Number of shuttles completed, 1stVentilatory Threshold (1stVT). Results The associations of the number of shuttles completed and cardiopulmonary capacity as measured with a portable gas analyser were r > 0.7, confirming good convergent validity in subacute and chronic people with stroke. Criterion validity, however, indicates it is not a valid test for measuring maximal cardiopulmonary capacity (VO2max). Only 60% of participants were able to reach the 1stVT. Higher cardiopulmonary capacity and a higher total score of the lower extremity Motricity Index contributed significantly to a higher number of shuttles walked (p = 0.001). Conclusions The Shuttle Test may be a safe and useful exercise test for people after stroke, but may not be appropriate for use with people who walk slower than 2 km/h or 0.56 m/s.

Consensus statement on physical rehabilitation in children and adolescents with osteogenesis imperfecta

Surviving critical illness: what is next?

BACKGROUND: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness?METHODS: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record. A literature review determined five themes, forming the basis for Delphi round one, which was aimed at generating ideas. Statements were drafted and ranked on a 5-point Likert scale in two additional rounds with the objective to reach consensus. Results were expressed as median and semi-interquartile range, with the consensus threshold set at ≤0.5.RESULTS: Ten internationally established researchers and clinicians participated in this Delphi panel, with a response rate of 80 %, 100 %, and 100 % across three rounds. Consensus was reached on 88.5 % of the statements, resulting in a framework for PT after hospital discharge. Essential handover information should include information on 15 parameters. A core set of outcomes should test exercise capacity, skeletal muscle strength, function in activities of daily living, mobility, quality of life, and pain. PT interventions should include functional exercises, circuit and endurance training, strengthening exercises for limb and respiratory muscles, education on recovery, and a nutritional component. Screening tools to identify impairments in other health domains and referral to specialists are proposed.CONCLUSIONS: A consensus-based framework for optimal PT after hospital discharge is proposed. Future research should focus on feasibility testing of this framework, developing risk stratification tools and validating core outcome measures for ICU survivors.

International multi-stakeholder consensus statement on clinical trial integrity

Objective: To prepare a set of statements for randomised clinical trials (RCT) integrity through an international multi-stakeholder consensus. Methods: The consensus was developed via: multi-country multidisciplinary stakeholder group composition and engagement; evidence synthesis of 55 systematic reviews concerning RCT integrity; anonymised two-round modified Delphi survey with consensus threshold based on the average percentage of majority opinions; and, a final consensus development meeting. Prospective registrations: (https://osf.io/bhncy, https://osf.io/3ursn). Results: There were 30 stakeholders representing 15 countries from five continents including triallists, ethicists, methodologists, statisticians, consumer representatives, industry representatives, systematic reviewers, funding body panel members, regulatory experts, authors, journal editors, peer-reviewers and advisors for resolving integrity concerns. Delphi survey response rate was 86.7% (26/30 stakeholders). There were 111 statements (73 stakeholder-provided, 46 systematic review-generated, 8 supported by both) in the initial long list, with eight additional statements provided during the consensus rounds. Through consensus the final set consolidated 81 statements (49 stakeholder-provided, 41 systematic review-generated, 9 supported by both). The entire RCT life cycle was covered by the set of statements including general aspects (n = 6), design and approval (n = 11), conduct and monitoring (n = 19), reporting of protocols and findings (n = 20), post-publication concerns (n = 12), and future research and development (n = 13). Conclusion: Implementation of this multi-stakeholder consensus statement is expected to enhance RCT integrity.

A consensus-based framework for conducting and reporting osteoarthritis phenotype research

BACKGROUND: The concept of osteoarthritis (OA) heterogeneity is evolving and gaining renewed interest. According to this concept, distinct subtypes of OA need to be defined that will likely require recognition in research design and different approaches to clinical management. Although seemingly plausible, a wide range of views exist on how best to operationalize this concept. The current project aimed to provide consensus-based definitions and recommendations that together create a framework for conducting and reporting OA phenotype research.METHODS: A panel of 25 members with expertise in OA phenotype research was composed. First, panel members participated in an online Delphi exercise to provide a number of basic definitions and statements relating to OA phenotypes and OA phenotype research. Second, panel members provided input on a set of recommendations for reporting on OA phenotype studies.RESULTS: Four Delphi rounds were required to achieve sufficient agreement on 11 definitions and statements. OA phenotypes were defined as subtypes of OA that share distinct underlying pathobiological and pain mechanisms and their structural and functional consequences. Reporting recommendations pertaining to the study characteristics, study population, data collection, statistical analysis, and appraisal of OA phenotype studies were provided.CONCLUSIONS: This study provides a number of consensus-based definitions and recommendations relating to OA phenotypes. The resulting framework is intended to facilitate research on OA phenotypes and increase combined efforts to develop effective OA phenotype classification. Success in this endeavor will hopefully translate into more effective, differentiated OA management that will benefit a multitude of OA patients.