Offering physical activities matching with the preferences of residents in long-term care facilities could increase compliance and contribute to client-centered care. A measure to investigate meaningful activities by using a photo-interview has been developed (“MIBBO”). In two pilot studies including 133 residents living on different wards in long-term care facilities, feasibility, most chosen activities, and consistency of preferences were investigated. It was possible to conduct the MIBBO on average in 30 min with the majority (86.4%) of residents. The most frequently chosen activities were: gymnastics and orchestra (each 28%), preparing a meal (31%), walking (outside, 33%), watering plants (38%), and feeding pets (40%). In a retest one week after the initial interview 69.4% agreement of chosen activities was seen. The MIBBO seems a promising measure to help health care professionals in identifying residents’ preferred activities. Future research should focus on the implementation of the tailored activity plan, incorporating it into the daily routine.
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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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Background: The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population. Methods: Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence. Results: The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and musclestrengthening activities, and (3) sedentary behaviour were formulated separately for adults and children. Conclusions: There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health.
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This paper reports on the first stage of a research project1) that aims to incorporate objective measures of physical activity into health and lifestyle surveys. Physical activity is typically measured with questionnaires that are known to have measurement issues, and specifically, overestimate the amount of physical activity of the population. In a lab setting, 40 participants wore four different sensors on five different body parts, while performing various activities (sitting, standing, stepping with two intensities, bicycling with two intensities, walking stairs and jumping). During the first four activities, energy expenditure was measured by monitoring heart rate and the gas volume of in‐ and expired O2 and CO2. Participants subsequently wore two sensor systems (the ActivPAL on the thigh and the UKK on the waist) for a week. They also kept a diary keeping track of their physical activities, work and travel hours. Machine learning algorithms were trained with different methods to determine which sensor and which method was best able to differentiate the various activities and the intensity with which they were performed. It was found that the ActivPAL had the highest overall accuracy, possibly because the data generated on the upper tigh seems to be best distinguishing between different types of activities and therefore led to the highest accuracy. Accuracy could be slightly increased by including measures of heartrate. For recognizing intensity, three different measures were compared: allocation of MET values to activities (used by ActivPAL), median absolute deviation, and heart rate. It turns out that each method has merits and disadvantages, but median absolute deviation seems to be the most promishing metric. The search for the best method of gauging intensity is still ongoing. Subsequently, the algorithms developed for the lab data were used to determine physical activity in the week people wore the devices during their everyday activities. It quickly turned out that the models are far from ready to be used on free living data. Two approaches are suggested to remedy this: additional research with meticulously labelled free living data, e.g., by combining a Time Use Survey with accelerometer measurements. The second is to focus on better determining intensity of movement, e.g., with the help of unsupervised pattern recognition techniques. Accuracy was but one of the requirements for choosing a sensor system for subsequent research and ultimate implementation of sensor measurement in health surveys. Sensor position on the body, wearability, costs, usability, flexibility of analysis, response, and adherence to protocol equally determine the choice for a sensor. Also from these additional points of view, the activPAL is our sensor of choice.
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Objective: To investigate the effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability. Methods: This controlled clinical trial included 71 children and adolescents from four schools for special education [mean age 13.7 (2.9) years, range 8–19, 55% boys]. Participants had various chronic health conditions including cerebral palsy (37%), other neuromuscular (44%), metabolic (8%), musculoskeletal (7%), and cardiovascular (4%) disorders. Before recruitment and based on the presence of school-based sports, schools were assigned as sport or control group. School-based sports were initiated and provided by motivated experienced physical educators. The sport group (n = 31) participated in a once-a-week school-based sports program for 6 months, which included team sports. The control group (n = 40) followed the regular curriculum. Anaerobic performance was assessed by the Muscle Power Sprint Test. Secondary outcome measures included aerobic performance, VO2 peak, strength, physical activity, blood pressure, arterial stiffness, body composition, and the metabolic profile. Results: A significant improvement of 16% in favor of the sport group was found for anaerobic performance (p = 0.003). In addition, the sport group lost 2.8% more fat mass compared to the control group (p = 0.007). No changes were found for aerobic performance, VO2 peak, physical activity, blood pressure, arterial stiffness, and the metabolic profile. Conclusion: Anaerobic performance and fat mass improved following a school-based sports program. These effects are promising for long-term fitness and health promotion, because sports sessions at school eliminate certain barriers for sports participation and adding a once-a-week sports session showed already positive effects for 6 months.
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Study selection: Randomized controlled trials published after 2007 with (former) healthcare patients ≥ 21 years of age were included if physical activity was measured objectively using a wearable monitor for both feedback and outcome assessment. The main goal of included studies was promoting physical activity. Any concurrent strategies were related only to promoting physical activity. Data extraction: Effect sizes were calculated using a fixed-effects model with standardized mean difference. Information on study characteristics and interventions strategies were extracted from study descriptions. Data synthesis: Fourteen studies met the inclusion criteria (total n = 1,902), and 2 studies were excluded from meta-analysis. The overall effect size was in favour of the intervention groups (0.34, 95% CI 0.23–0.44, p < 0.01). Study characteristics and intervention strategies varied widely. Conclusion: Healthcare interventions using feedback on objectively monitored physical activity have a moderately positive effect on levels of physical activity. Further research is needed to determine which strategies are most effective to promote physical activity in healthcare programmes. Lay Abstract Wearable technology is progressively applied in health care and rehabilitation to provide objective insight into physical activity levels. In addition, feedback on physical activity levels delivered by wearable monitors might be beneficial for optimizing their physical activity. A systematic review and meta-analysis was conducted to evaluate the effectiveness of interventions using feedback on objectively measured physical activity in patient populations. Fourteen studies including 1902 patients were analyzed. Overall, the physical activity levels of the intervention groups receiving objective feedback on physical activity improved, compared to the control groups receiving no objective feedback. Mostly, a variety of other strategies were applied in the interventions next to wearable technology. Together with wearable technology, behavioral change strategies, such as goal-setting and action planning seem to be an important ingredient to promote physical activity in health care and rehabilitation. LinkedIn: https://www.linkedin.com/in/hanneke-braakhuis-b9277947/ https://www.linkedin.com/in/moniqueberger/
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The (pre)school environment is an important setting to improve children’s health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children’s health in terms of physical activity, cognitive and social outcomes. In addition, we aimed to identify which playground characteristics are the strongest correlates of beneficial effects and for which subgroups of children effects are most distinct. In total, 13 experimental and 17 observational studies have been summarized of which 10 (77%) and 16 (94%) demonstrated moderate to high methodological quality, respectively. Nearly all experimental studies (n = 11) evaluated intervention effects on time spent in different levels of physical activity during recess. Research on the effects of (pre)school playgrounds on cognitive and social outcomes is scarce (n = 2). The experimental studies generated moderate evidence for an effect of the provision of play equipment, inconclusive evidence for an effect of the use of playground markings, allocating play space and for multi-component interventions, and no evidence for an effect of decreasing playground density, the promotion of physical activity by staff and increasing recess duration on children’s health. In line with this, observational studies showed positive associations between play equipment and children’s physical activity level. In contrast to experimental studies, significant associations were also found between children’s physical activity and a decreased playground density and increased recess duration. To confirm the findings of this review, researchers are advised to conduct more experimental studies with a randomized controlled design and to incorporate the assessment of implementation strategies and process evaluations to reveal which intervention strategies and playground characteristics are most effective. https://doi.org/10.1186/1479-5868-11-59 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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Background: Osteoarthritis (OA) is a chronic disease primarily affecting older adults, mainly impacting the hip and knee joints. The increasing prevalence of OA contributes to rising healthcare demands and costs. Current OA treatment guidelines emphasize the importance of self-management education and guidance, particularly in promoting physical activity and weight management. In addition, improving sleep is crucial for managing OA. Developing effective self-management interventions necessitates a comprehensive understanding of the factors that facilitate these behaviors. Especially for changing health behaviors, it is important to focus on psychosocial factors. Therefore, this systematic review aimed to identify the psychosocial factors associated with physical activity, weight management, and sleep in adults with hip and/or knee OA. Methods: Five databases (PubMed, Embase, CINAHL, PyschINFO, Web of Science) were searched for observational studies reporting statistics on the association between psychosocial determinants and physical activity, weight management, or sleep in people with OA. The methodological quality was assessed using the Quality Assessment Tool for Observational Studies of the National Heart, Lung, and Blood Institute. After screening 5,812 articles, 31 studies were included for analysis. Results: The results showed that intention, self-efficacy, and willpower beliefs were positively associated with physical activity. Kinesiophobia, pain catastrophizing and pain-related fear were negatively associated with physical activity. Depressive symptoms, negative affect, pain catastrophizing, and low willpower beliefs were associated with poor weight management. Anxiety, depression, pain anxiety, and post-traumatic stress disorder were related to poor sleep behavior. Conclusions This review enhances the understanding of the psychosocial factors underlying physical activity, weight management and sleep in OA. These insights are valuable for developing tailored behavior change interventions aimed at improving physical activity, weight management and sleep in patients with hip and/or knee OA.
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Background: The worldwide increase in the rates of childhood overweight and physical inactivity requires successful prevention and intervention programs for children. The aim of the Active Living project is to increase physical activity and decrease sedentary behavior of Dutch primary school children by developing and implementing tailored, multicomponent interventions at and around schools. Methods/design: In this project, school-centered interventions have been developed at 10 schools in the south of the Netherlands, using a combined top-down and bottom-up approach in which a research unit and a practice unit continuously interact. The interventions consist of a combination of physical and social interventions tailored to local needs of intervention schools. The process and short- and long-term effectiveness of the interventions will be evaluated using a quasi-experimental study design in which 10 intervention schools are matched with 10 control schools. Baseline and follow-up measurements (after 12 and 24 months) have been conducted in grades 6 and 7 and included accelerometry, GPS, and questionnaires. Primary outcome of the Active Living study is the change in physical activity levels, i.e. sedentary behavior (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and counts-per-minute (CPM). Multilevel regression analyses will be used to assess the effectiveness of isolated and combined physical and social interventions on children’s PA levels. Discussion: The current intervention study is unique in its combined approach of physical and social environmental PA interventions both at school(yard)s as well as in the local neighborhood around the schools. The strength of the study lies in the quasi-experimental design including objective measurement techniques, i.e. accelerometry and GPS, combined with more subjective techniques, i.e. questionnaires, implementation logbooks, and neighborhood observations. LinkedIn: https://www.linkedin.com/in/sanned/
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To assess the reporting quality of interventions aiming at promoting physical activity (PA) using a wearable activity tracker (WAT) in patients with infammatory arthritis (IA) or hip/knee osteoarthritis (OA). A systematic search was performed in eight databases including PubMed, Embase and Cochrane Library) for studies published between 2000 and 2022. Two reviewers independently selected studies and extracted data on study characteristics and the reporting of the PA intervention using a WAT using the Consensus on Exercise reporting Template (CERT) (12 items) and Consolidated Standards of Reporting Trials (CONSORT) E-Health checklist (16 items). The reporting quality of each study was expressed as a percentage of reported items of the total CERT and CONSORT E-Health (50% or less=poor; 51–79%=moderate; and 80–100%=good reporting quality). Sixteen studies were included; three involved patients with IA and 13 with OA. Reporting quality was poor in 6/16 studies and moderate in 10/16 studies, according to the CERT and poor in 8/16 and moderate in 8/16 studies following the CONSORT E-Health checklist. Poorly reported checklist items included: the description of decision rule(s) for determining progression and the starting level, the number of adverse events and how adherence or fdelity was assessed. In clinical trials on PA interventions using a WAT in patients with IA or OA, the reporting quality of delivery process is moderate to poor. The poor reporting quality of the progression and tailoring of the PA programs makes replication difcult. Improvements in reporting quality are necessary.
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