Physical inactivity has led to an increase in the prevalence of lifestyle-related chronic diseases on a global scale. There is a need for more awareness surrounding the preventive and curative role of a physically active lifestyle in healthcare. The prescription of physical activity in clinical care has been advocated worldwide through the ‘exercise is medicine’ (E=M) paradigm. However, E=M currently has no position in general routine hospital care, which is hypothesized to be due to attitudinal and practical barriers to implementation. This study aims to create an E=M tool to reduce practical barriers to enforcing E=M in hospital care. Firstly, this project will perform qualitative research to study the current implementation status of E=M in clinical care as well as its facilitators and barriers to implementation among clinicians and hospital managers. Secondly, an E=M tool towards application of active lifestyle interventions will be developed, based on a prediction model of individual determinants of physical activity behavior and local big data, which will result in a tailored advice for patients on motivation and physical activity. Thirdly, the feasibility of implementing the E=M-tool, as designed within this project, will be investigated with a process evaluation, conducting a pilot-study which will integrate the tool in routine care in at least four clinical departments in two Dutch hospitals. This project will give insight in the current implementation status of E=M and in factors that influence the actual E=M implementation. Secondly, an E=M tool will be designed providing a tailored E=M prescription for patients as part of clinical care. Thirdly, an implementation strategy will be developed for implementation of the E=M tool in clinical practice. This project envisages an extensive continuation of research on the implementation of E=M, supports the mutual decision making process of lifestyle referral of clinicians and will provide insights which can be used to assist in implementing physically active lifestyle prescription in the medical curriculum.
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Background: Despite the importance of sports injury prevention in youth, no broad scale approaches that work in real-life situations with significant positive effects exist. Main reasons for this are poor uptake and maintenance of current sports injury prevention exercises.Objective: In order to improve uptake of sports injury prevention routines, this project set out to: 1. identify the specifics of current injury prevention programs within 6 European countries, and 2: to establish wishes and needs regarding injury prevention of the end-users (sport coaches, physical educators and youth) within 6 European countries.Design: Semi-structured interviews and focus group sessions.Setting: Youth sports teams and physical education (PE) classes.Patients (or Participants): Interviews and focus group sessions were performed within 6 participating countries (Belgium, Denmark, Lithuania, Romania, The Netherlands, United Kingdom). National stakeholders were interviewed to identify injury prevention programs. The program owners of the identified programs were then individually interviewed. The focus group sessions were organized with youth basketball and soccer players and PE pupils. Separate focus group sessions were organized for basketball/soccer coaches and physical educators.Interventions (or Assessment of Risk Factors): This qualitative study provided input for the development of a freely available ICT based platform with video material of routines designed to prevent sports injuries in youth.Main Outcome Measurements: Overview of country specific results of interviews and focus groups.Results: This study will describe the current availability of national injury prevention programs within 6 European countries. The results of the focus group sessions will establish the differences in beliefs regarding injury prevention in 6 European countries regarding injury prevention.Conclusions: In the coming year, the Move Healthy project will use the qualitative results of this study to develop a freely available ICT based platform with video material of routines developed to prevent sports injuries in youth.
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To evaluate the 5-year course of physical work capacity of participants with early symptomatic osteoarthritis (OA) of the hip and/or the knee; to identify trajectories and explore the relationship between trajectories and covariates. Methods In a prospective cohort study, physical work capacity was measured at baseline, using a test protocol (functional capacity evaluation) consisting of work-related physical activities. Participants were invited to participate in 1, 2 and 5 year follow-up measurements. Multilevel analysis and latent classes analysis were performed, in models with test performances as dependent variables and age, sex, work status, self-reported function (Western Ontario McMasters Arthritis Scale-WOMAC), body mass index (BMI) and time as independent variables. Multiple imputation was used to control for the influence of missing data. Results At baseline and after 1, 2 and 5 years there were 96, 64, 61 and 35 participants. Mean (SD) age at baseline was 56 (4.9) years, 84% were females. There was no statistically significant change in test performances (lifting low and high, carrying, static overhead work, repetitive bending, repetitive rotations) between the 4 measurements. Male sex, younger age and better self-reported function were statistically significant (p < 0.05) determinants of higher performance on most of the tests; having a paid job, BMI and progression of time were not. Three trajectories were identified: 'weak giving way', 'stable and able', and 'strong with decline'. Discussion In subgroups of participants with early symptomatic OA, determined by age, sex and self-reported function, physical work capacity seems to be a stable characteristic over 5 years.
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