Objectives: Promoting unstructured outside play is a promising vehicle to increase children’s physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child’s outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
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Consumer wearables health data may reflect the impact of pancreatic cancer and its treatment on cardiorespiratory fitness and the subsequent recovery after treatment. The patient is a 65-year-old male treated for borderline resectable pancreatic cancer. Treatment consisted of four courses of FOLFIRINOX neoadjuvant chemotherapy, a Whipple procedure with a right hemicolectomy and venous segment resection, and eight courses of adjuvant FOLFIRINOX chemotherapy. Physical activity and moderate to vigorous physical activity declined after the onset of symptoms, increased in the weeks before surgery, declined after surgery and then gradually recovered during and after adjuvant chemotherapy. Estimated VO 2max remained stable during neoadjuvant chemotherapy, sharply decreased after surgery and then gradually recovered. Heart rate at rest increased and heart rate variability decreased after the onset of symptoms reaching their highest and lowest values after surgery. Both gradually returned to baseline seven months after the last course of chemotherapy. The physical impact of pancreatic cancer and its treatment and recovery was in this case reflected on consumer wearable health data. Seven months after the last chemotherapy recovery was close to baseline values.
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Background: Esophageal cancer and curative treatment have a significant impact on the physical fitness of patients. Knowledge about the course of physical fitness during neoadjuvant therapy and esophagectomy is helpful to determine the needs for interventions during and after curative treatment. This study aims to review the current evidence on the impact of curative treatment on the physical fitness of patients with esophageal cancer. Methods: A systematic literature search of PubMed, Embase, Cinahl and the Cochrane Library was conducted up to March 29, 2021. We included observational studies investigating the change of physical fitness (including exercise capacity, muscle strength, physical activity and activities of daily living) from pre-to post-neoadjuvant therapy and/or from pre-to post-esophagectomy. Quality of the studies was assessed and a meta-analysis was performed using standardized mean differences. Results: Twenty-seven articles were included. After neoadjuvant therapy, physical fitness decreased significantly. In the first three months after surgery, physical fitness was also significantly decreased compared to preoperative values. Subgroup analysis showed a restore in exercise capacity three months after surgery in patients who followed an exercise program. Six months after surgery, there was limited evidence that exercise capacity restored to preoperative values. Conclusion: Curative treatment seems to result in a decrease of physical fitness in patients with esophageal cancer, up to three months postoperatively. Six months postoperatively, results were conflicting. In patients who followed a pre- or postoperative exercise program, the postoperative impact of curative treatment seems to be less.
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Background Physical activity after bariatric surgery is associated with sustained weight loss and improved quality of life. Some bariatric patients engage insufficiently in physical activity. The aim of this study was to examine whether and to what extent both physical activity and exercise cognitions have changed at one and two years post-surgery, and whether exercise cognitions predict physical activity. Methods Forty-two bariatric patients (38 women, 4 men; mean age 38 ± 8 years, mean body mass index prior to surgery 47 ± 6 kg/m²), filled out self-report instruments to examine physical activity and exercise cognitions pre- and post surgery. Results Moderate to large healthy changes in physical activity and exercise cognitions were observed after surgery. Perceiving less exercise benefits and having less confidence in exercising before surgery predicted less physical activity two years after surgery. High fear of injury one year after surgery predicted less physical activity two years after surgery. Conclusion After bariatric surgery, favorable changes in physical activity and exercise cognitions are observed. Our results suggest that targeting exercise cognitions before and after surgery might be relevant to improve physical activity.
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It has been suggested that physical education (PE) and active transport can make a meaningful contribution to children's physical activity (PA) levels. However, data on the contribution these activities to total PA is scarce, and PE's contribution to total physical activity energy expenditure (PAEE) has to our knowledge never been determined. This is probably explained by the methodological complexity of determining PAEE (Welk, 2002). In this paper, we present the first data of an ongoing study using combined heart rate monitoring and accelerometry, together with activity diaries. Over the six measurement days, PE contributed 5% to total PAEE, and 16% to school-related PAEE, whereas active transportation had a much larger contribution.
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Aware of the consequences of their inactive lifestyles, many people still struggle to integrate enough physical activity into their busy lives. Interventions that nudge to reinforce existing active behaviour seem therefore more likely to be effective than those adding an activity to daily routines. To encourage people to increase their physical activity level, we designed Discov, a network of physical waypoints triggering people to lengthen their walks. Placed in a public park, Discov encourages people to explore their surroundings in a fun and challenging way by creating an interactive walking experience. Adopting a Research-through-Design approach, we explore the potential of the design of accessible infrastructures and human-environment interactions to impact public health by nudging citizens into being more physically active. We discuss insights gathered through this process and report on first user tests of this interactive walking experience.
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Parental involvement is a crucial force in children’s development, learning and success at school and in life [1]. Participation, defined by the World Health Organization as ‘a person’s involvement in life situations’ [2] for children means involvement in everyday activities, such as recreational, leisure, school and household activities [3]. Several authors use the term social participation emphasising the importance of engagement in social situations [4, 5]. Children’s participation in daily life is vital for healthy development, social and physical competencies, social-emotional well-being, sense of meaning and purpose in life [6]. Through participation in different social contexts, children gather the knowledge and skills needed to interact, play, work, and live with other people [4, 7, 8]. Unfortunately, research shows that children with a physical disability are at risk of lower participation in everyday activities [9]; they participate less frequently in almost all activities compared with children without physical disabilities [10, 11], have fewer friends and often feel socially isolated [12-14]. Parents, in particular, positively influence the participation of their children with a physical disability at school, at home and in the community [15]. They undertake many actions to improve their child’s participation in daily life [15, 16]. However, little information is available about what parents of children with a physical disability do to enable their child’s participation, what they come across and what kind of needs they have. The overall aim of this thesis was to investigate parents’ actions, challenges, and needs while enhancing the participation of their school-aged child with a physical disability. In order to achieve this aim, two steps have been made. In the first step, the literature has been examined to explore the topic of this thesis (actions, challenges and needs) and to clarify definitions for the concepts of participation and social participation. Second, for the purposes of giving breadth and depth of understanding of the topic of this thesis a mixed methods approach using three different empirical research methods [17-19], was applied to gather information from parents regarding their actions, challenges and needs.
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Objective : The first aim of this study was to determine whether adolescents with asymptomatic Generalized Joint Hypermobility (GJH) have a lower level of physical functioning (physical activity level, muscle strength and performance) compared to non-hypermobile controls. Secondly, to evaluate whether the negative impact of perceived harmfulness on physical functioning was more pronounced in adolescents with asymptomatic GJH. Methods : Cross-sectional study. Sixty-two healthy adolescents (mean age 16.8, range 12-21) participated. Hypermobility (Beighton score), perceived harmfulness (PHODA-youth) and muscle strength (dynamometry), motor performance (Single-Leg-Hop-for-Distance) and physical activity level (PAL) (accelerometry) were measured. Hierarchical regression analyses were used to study differences in physical functioning and perceived harmfulness between asymptomatic GJH and non-hypermobile controls. Results : Asymptomatic GJH was associated with increased knee extensor muscle strength (peak torque/body weight; PT/BW), controlled for age and gender (dominant leg; ß = 0.29; p = .02). No other associations between asymptomatic GJH and muscle strength, motor performance and PAL were found. Perceived harmfulness was not more pronounced in adolescents with asymptomatic GJH. Conclusions : Adolescents with asymptomatic GJH had increased knee extensor muscle strength compared to non-hypermobile controls. No other differences in the level of physical functioning was found and the negative impact of perceived harmfulness was not more pronounced in adolescents with asymptomatic GJH.
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Introduction Physical activity levels of children with disabilities are low, as these children and their parents face a wide variety of both personal and environmental barriers. Behavior change techniques support pediatric physical therapists to address these barriers together with parents and children. We developed the What Moves You?! intervention Toolkit (WMY Toolkit) filled with behavioral change tools for use in pediatric physical therapy practice. Objective To evaluate the feasibility of using the WMY Toolkit in daily pediatric physical therapy practice. Methods We conducted a feasibility study with a qualitative approach using semi-structured interviews with pediatric physical therapists (n = 11). After one day of training, the pediatric physical therapists used the WMY Toolkit for a period of 9 weeks, when facilitating physical activity in children with disabilities. We analyzed the transcripts using an inductive thematic analysis followed by a deductive analysis using a feasibility framework. Results For acceptability, pediatric physical therapists found that the toolkit facilitated conversation about physical activity in a creative and playful manner. The working mechanisms identified were in line with the intended working mechanisms during development of the WMY Toolkit, such as focusing on problem solving, self-efficacy and independence. For demand, the pediatric physical therapists mentioned that they were able to use the WMY Toolkit in children with and without disabilities with a broad range of physical activity goals. For implementation, education is important as pediatric physical therapists expressed the need to have sufficient knowledge and to feel confident using the toolkit. For practicality, pediatric physical therapists were positive about the ease of which tools could be adapted for individual children. Some of the design and materials of the toolkit needed attention due to fragility and hygiene. Conclusion The WMY Toolkit is a promising and innovative way to integrate behavior change techniques into pediatric physical therapy practice.
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In recent years, the effects of the physical environment on the healing process and well-being have proved to be increasingly relevant for patients and their families (PF) as well as for healthcare staff. The discussions focus on traditional and institutionally designed healthcare facilities (HCF) relative to the actual well-being of patients as an indicator of their health and recovery. This review investigates and structures the scientific research on an evidence-based healthcare design for PF and staff outcomes. Evidence-based design has become the theoretical concept for what are called healing environments. The results show the effects on PF and staff from the perspective of various aspects and dimensions of the physical environmental factors of HFC. A total of 798 papers were identified that fitted the inclusion criteria for this study. Of these, 65 articles were selected for review: fewer than 50% of these papers were classified with a high level of evidence, and 86% were included in the group of PF outcomes. This study demonstrates that evidence of staff outcomes is scarce and insufficiently substantiated. With the development of a more customer-oriented management approach to HCF, the implications of this review are relevant to the design and construction of HCF. Some design features to consider in future design and construction of HCF are single-patient rooms, identical rooms, and lighting. For future research, the main challenge will be to explore and specify staff needs and to integrate those needs into the built environment of HCF.
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