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Ndene‐Bodilsen SS, Aadahl M, Thomsen TH, Wienecke T. A Home-Based Behaviour Change Intervention With Sedentary Behaviour and Physical Activity in People With Stroke and Diabetes-A Feasibility and Safety Study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2025; 30:e70048. [PMID: 40088479 PMCID: PMC11910200 DOI: 10.1002/pri.70048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 02/10/2025] [Accepted: 03/07/2025] [Indexed: 03/17/2025]
Abstract
BACKGROUND AND PURPOSE Stroke survivors with type 2 diabetes mellitus (DM) face heightened cardiovascular risks, which are exacerbated by sedentary behaviour (SB). Despite existing interventions, there remains a gap in the literature regarding effective strategies to reduce SB and increase physical activity (PA). The purpose of this study was to explore the feasibility and safety of the 12-week 'Everyday Life is Rehabilitation' (ELiR) intervention comprising recruitment, adherence, practicality, and implementation into everyday life. METHODS Single-group longitudinal intervention study with 1-week baseline, motivational interviews at weeks 1 and 6, and 12-week follow-up. Stroke survivors with DM (N = 14) were recruited from Neurovascular Center at Zealand University Hospital, Roskilde. The ELiR intervention is a theory-based intervention that focuses on healthcare professionals (HCP) consultations with stroke survivors with DM to address SB and PA. Primary outcomes were recruitment, adherence, completion of physical tests (accelerometer measurements), cognitive tests, and safety. Secondary outcomes were sedentary time and steps collected using an accelerometer and glycated haemoglobin (HbA1c) measurements. RESULTS 23 participants were recruited, of whom two were readmitted, one withdrew consent before the baseline test, and six were not discharged with a physiotherapy rehabilitation plan within 1-7 hospitalisation days. The remaining 14 were included and completed the study with a median modified Rankin scale (mRS) score of 1. The ELiR intervention revealed high adherence. Three participants experienced falls, and two were hospitalised. These incidents were not related to the intervention. Future adjustments include modified inclusion criteria, SMS-reminders, and point-of-care HbA1c measurements. DISCUSSION The ELiR intervention was feasible and safe. Falls and serious adverse events are in line with previously reported risks. Self-reported questionnaires and clinical tests had low and moderate adherence, whereas accelerometers had high adherence. However, the small sample size limits generalisability, and adjustments to the ELiR intervention are suggested to improve usability in physiotherapy practice before testing in RCT studies to confirm these findings.
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Affiliation(s)
- Stefan Sjørslev Ndene‐Bodilsen
- Department of NeurologyZealand University HospitalRoskildeDenmark
- Department of Physiotherapy and Occupational TherapyZealand University HospitalRoskildeDenmark
- Faculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark
| | - Mette Aadahl
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Centre for Clinical Research and PreventionBispebjerg and Frederiksberg HospitalFrederiksbergDenmark
| | | | - Troels Wienecke
- Department of NeurologyZealand University HospitalRoskildeDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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Kjeldsen LL, Læssøe U, Bendix JM, Maimburg RD. Maternal positions in childbirth - A cohort study of labouring women's movements and body positions the last 24 hours before birth. SEXUAL & REPRODUCTIVE HEALTHCARE 2025; 43:101059. [PMID: 39729687 DOI: 10.1016/j.srhc.2024.101059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 12/08/2024] [Accepted: 12/16/2024] [Indexed: 12/29/2024]
Abstract
INTRODUCTION Maternal position plays an essential role in achieving labour progress as it supports the physiological mechanisms of labour. Evidence supports that adopting upright positions may facilitate physiological childbirth. AIM To describe the use of various positionsamong nulliparous pregnant women in the last 24 h before birth and describe physical positions in relation to maternal and neonatal outcomes at time of birth. METHODS Cohort study of 105 nulliparous women with an uncomplicated singleton pregnancy. Body position was measured by two triaxial accelerometers (SENS motion®), and maternal and neonatal outcomes at time of birth were obtained from medical records. Positions were described for the total population and further stratified into two groups based on time spent in sacrum non-flexible (lying, sitting) and sacrum flexible (standing, walking) positions.Descriptive analyses of maternal position in relation to birth outcomes and comparisons between the two groups were made. RESULTS Lying down was the mostfrequent position adapted, with a median time of 659 (78;1208) minutes, equivalent to 11.0 hours. Women spent 1152 (687;1369) minutes in sacrum non-flexible positions, equivalent to 19.2 hours or 80 % of the last 24 hours before childbirth. More than 90 % gave birth in a sacrum non-flexible position. Women spending more time in sacrum non-flexible positions had more epidural analgesia than women spending more time in sacrum flexible positions (42.6 % and 21.3 %, p = 0.03). CONCLUSIONS Women spent 80% of their time in sacrum non-flexible positions during the last 24 hours before childbirth. At birth, more than 90% gave birth in sacrum non-flexible positions.
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Affiliation(s)
- Louise L Kjeldsen
- Department of Midwifery, University College of Northern Denmark, Selma Lagerløfsvej 2, 9220 Aalborg Ø, Denmark; Research Center of Health and Applied Science, University College of Northern Denmark, Selma Lagerløfsvej 2, 9220 Aalborg Ø, Denmark.
| | - Uffe Læssøe
- Department of Research and Development, University College of Northern Denmark, Selma Lagerløfsvej 2, 9220 Aalborg Ø, Denmark
| | - Jane Marie Bendix
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital North Zealand, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - Rikke D Maimburg
- Department of Midwifery, University College of Northern Denmark, Selma Lagerløfsvej 2, 9220 Aalborg Ø, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Department of Occupational Health, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
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Dantoft TM, Jørgensen SW, Wellnitz KB, Ørnbøl E, Gormsen L, Fink P, Linneberg A, Jørgensen NR, Petersen MW, Bjerregaard AA, Jørgensen T. Unfavourable glucose metabolism is associated with functional somatic disorders. A cross-sectional general population-based study: The DanFunD study. Psychoneuroendocrinology 2025; 172:107258. [PMID: 39673833 DOI: 10.1016/j.psyneuen.2024.107258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Revised: 12/09/2024] [Accepted: 12/10/2024] [Indexed: 12/16/2024]
Abstract
OBJECTIVES Several studies have observed associations between unfavorable levels of blood glucose metabolic markers (i.e., fasting glucose, fasting insulin, glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR)) and functional somatic disorder (FSD). However, such associations have not yet been systematically analyzed in a general population-based sample using various FSD delimitations simultaneously. The aim of this study was to assess whether an unfavorable glucose metabolism is associated with FSD. DESIGN Cross-sectional population-based study SETTING: Ten municipalities in the western part of greater Copenhagen area in Denmark PARTICIPANTS: A total of 8183 men and women aged 18-76 years were included. Various delimitations of FSD, i.e., chronic fatigue (CF), chronic widespread pain (CWP), irritable bowel (IB), and bodily distress syndrome (BDS), were measured using validated self-administrated questionnaires. In a stratified subsample, BDS was also assessed by diagnostic interviews. OUTCOME MEASURES Logistic regression models were estimated for each delimitation of FSD as outcome and fasting glucose, fasting insulin, HbA1c, and estimated insulin resistance. Results were adjusted for age, sex (model 1), lifestyle, and social factors (model 2) and presented as odds ratios (OR) with 95 % confidence intervals (CI). RESULTS When only adjusting for sex and age, positive associations were found between all FSD delimitations and glucose, insulin, and HbA1c, except for between IB and HbA1c. Positive associations were also found between all questionnaire-based BDS groups, and men with BDS confirmed by diagnostic interviews and elevated insulin resistance. After adjusting for lifestyle and social factors, associations remained significant between both CF and glucose and HbA1c and between multi-organ BDS and glucose and HbA1c. Further, CF, single-organ BDS, multi-organ BDS, and women with overall-BDS also remained associated with increased levels of insulin resistance. CONCLUSION FSD seems to be associated with especially an increase in plasma insulin levels and increased levels of insulin resistance. Elevated levels of blood glucose and HbA1c among all FSD groups could also completely be explained by unhealthy lifestyle. Prospective studies are needed for further clarification of the clinical relevance of this observation.
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Affiliation(s)
- Thomas Meinertz Dantoft
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
| | - Sine Wanda Jørgensen
- Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - Kaare Bro Wellnitz
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Eva Ørnbøl
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Lise Gormsen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Frederiksberg, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark; Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Marie Weinreich Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Anne Ahrendt Bjerregaard
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Torben Jørgensen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Frederiksberg, Denmark; Department of Public health, Faculty of Health and Medical Science, University of Copenhagen, Denmark
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Knak KL, Primdahl J, Kröber G, Fongen C, Graversgaard J, Bremander A. Development of a Physiotherapist-Coordinated Interdisciplinary Rehabilitation Intervention for People with Suspected Axial Spondyloarthritis: The SPINCODE Rehabilitation Intervention. J Clin Med 2024; 13:6830. [PMID: 39597975 PMCID: PMC11595147 DOI: 10.3390/jcm13226830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 11/04/2024] [Accepted: 11/05/2024] [Indexed: 11/29/2024] Open
Abstract
Background: People with early axial spondyloarthritis experience a diagnostic delay and a similar disease burden as people with axial spondyloarthritis at a later stage of the disease. In many European countries, patients with early axial spondyloarthritis do not have access to an interdisciplinary rehabilitation team. The objective of this study was to develop a new evidence-based physiotherapist-coordinated interdisciplinary rehabilitation intervention for individuals suspected of axial spondyloarthritis. This development of the rehabilitation intervention is part of the SPINCODE project which focusses on early diagnosis and treatment for people with axial spondyloarthritis. Methods: The development of the intervention encompasses: (i) identifying the evidence base and program theories; (ii) modeling and remodeling the intervention; and (iii) describing the developed intervention. Results: The six-month SPINCODE rehabilitation intervention is a physiotherapist-coordinated, interdisciplinary, outpatient rehabilitation intervention at a specialized rheumatology hospital. The intervention consists of: (i) individual physiotherapist-coordinated consultations with assessment, goal setting, tailored physical activity support, and the defined goals, and coordination across the interdisciplinary team at the hospital and across primary and secondary healthcare levels; (ii) group sessions, encompassing patient education and peer support; and (iii) optional individual support from the interdisciplinary team. Physiotherapists from private care working with the patient enrolled in the SPINCODE study are offered digital support from the hospital-based physiotherapists. Conclusions: The developed physiotherapist-led interdisciplinary SPINCODE rehabilitation intervention is ready for feasibility testing.
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Affiliation(s)
- Kirsten Lykke Knak
- The Danish Centre for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, 6400 Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Jette Primdahl
- The Danish Centre for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, 6400 Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
- Hospital Sønderjylland, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark
| | - Georg Kröber
- The Danish Centre for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, 6400 Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Camilla Fongen
- Center for Treatment of Rheumatic and Musculoskeletal Disease (REMEDY), Diakonhjemmet Hospital, 0319 Oslo, Norway
| | - John Graversgaard
- The Danish Centre for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, 6400 Sønderborg, Denmark
| | - Ann Bremander
- The Danish Centre for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, 6400 Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
- Department of Clinical Sciences, Rheumatology Section, Lund University, 22148 Lund, Sweden
- Spenshult Research and Development Centre, 30274 Halmstad, Sweden
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Willems A, Sura-de Jong M, Klaassens E, van den Bogert B, van Beek A, van Dijk G. Self-Initiated Dietary Adjustments Alter Microbiota Abundances: Implications for Perceived Health. Nutrients 2024; 16:3544. [PMID: 39458538 PMCID: PMC11510366 DOI: 10.3390/nu16203544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 10/01/2024] [Accepted: 10/10/2024] [Indexed: 10/28/2024] Open
Abstract
Background/Objectives: Personalized and self-initiated dietary adjustments have been shown to alleviate mental and somatic complaints. Here, we investigated the potential role of gut microbiome alterations underlying these effects. Methods: For this purpose, participants (n = 185) underwent a four-week self-initiated dietary intervention and filled out weekly questionnaires on their dietary intake, somatic and mental symptoms, and physical activity. Results: Overall, the participants lost weight, had alleviated mental and somatic complaints, reduced their total caloric and percentual carbohydrate intake, and ate less processed, party-type, and traditional Dutch food items, but ate more Pescatarian type food items, while keeping their fiber intake unaltered. Baseline and endpoint gut microbiota analyses using 16S rRNA gene sequencing revealed an overall increase in Gemmiger formicilis and reductions in Peptostreptococcaceae and Ruminococcus bromii over the four-week dietary intervention. While these bacterial alterations were considered to be beneficial for the host, they were not individually correlated with alterations in, or endpoint levels of, somatic and/or mental complaints. Instead, individual increases in Ruminococcus bicirculans (a well-known utilizer of plant cell wall polysaccharides) were strongly correlated with reductions in mental complaints, even though overall R. bicirculans remained unaltered over the course of the four-week self-initiated dierary intervention. Conclusions: Our results suggest that overall altered versus individually correlated microbiota abundances and their relations with host health characteristics over the course of a self-chosen dietary intervention may represent different levels of regulation, which remain to be further untangled.
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Affiliation(s)
- Anouk Willems
- Applied Research Centre Food & Dairy, Van Hall Larenstein University of Applied Sciences, 8934 CJ Leeuwarden, The Netherlands
- Groningen Institute for Evolutionary Life Sciences—Neurobiology, University of Groningen, 9474 AG Groningen, The Netherlands
| | - Martina Sura-de Jong
- Applied Research Centre Food & Dairy, Van Hall Larenstein University of Applied Sciences, 8934 CJ Leeuwarden, The Netherlands
| | - Eline Klaassens
- Product Development Department, BaseClear B.V., 2333 BE Leiden, The Netherlands
| | - Bartholomeus van den Bogert
- Product Development Department, BaseClear B.V., 2333 BE Leiden, The Netherlands
- MyMicroZoo, 2333 BE Leiden, The Netherlands
| | - André van Beek
- Department of Endocrinology, University Medical Center Groningen, Postbus 30001, 9700 RB Groningen, The Netherlands
| | - Gertjan van Dijk
- Groningen Institute for Evolutionary Life Sciences—Neurobiology, University of Groningen, 9474 AG Groningen, The Netherlands
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Šuc A, Einfalt L, Šarabon N, Kastelic K. Validity and reliability of self-reported methods for assessment of 24-h movement behaviours: a systematic review. Int J Behav Nutr Phys Act 2024; 21:83. [PMID: 39095778 PMCID: PMC11295502 DOI: 10.1186/s12966-024-01632-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Time spent in sleep, sedentary behaviour (SB), and physical activity are exhaustive and mutually exclusive parts of a 24-h day that need to be considered in a combination. The aim of this study was to identify validated self-reported tools for assessment of movement behaviours across the whole 24-h day, and to review their attributes and measurement properties. METHODS The databases PubMed, Scopus, and SPORTDiscus were searched until September 2023. Inclusion criteria were: (i) published in English language, (ii) per-reviewed paper, (iii) assessment of self-reported time spent in sleep, SB, and physical activity, (iv) evaluation of measurement properties of all estimates across the full 24-h day, and (v) inclusion of adolescents, adults, or older adults. The methodological quality of included studies was assessed using the Consensus-based Standards for the selection of health Measurement Instruments checklist. RESULTS Our search returned 2064 records. After studies selection, we included 16 articles that reported construct validity and/or test-retest reliability of 12 unique self-reported tools - eight questionnaires, three time-use recalls, and one time-use diary. Most tools enable assessment of time spent in sleep, and domain-specific SB and physical activity, and account that sum of behaviours should be 24 h. Validity (and reliability) correlation coefficients for sleep ranged between 0.22 and 0.69 (0.41 and 0.92), for SB between 0.06 and 0.57 (0.33 and 0.91), for light-intensity physical activity between 0.18 and 0.46 (0.55 and 0.94), and for moderate- to vigorous-intensity physical activity between 0.38 and 0.56 (0.59 and 0.94). The quality of included studies being mostly fair-to-good. CONCLUSIONS This review found that only a limited number of validated self-reported tools for assessment of 24-h movement behaviours are currently available. Validity and reliability of most tools are generally adequate to be used in epidemiological studies and population surveillance, while little is known about adequacy for individual level assessments and responsiveness to behavioural change. To further support research, policy, and practice, there is a need to develop new tools that resonate with the emerging 24-h movement paradigm and to evaluate measurement properties by using compositional data analysis. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022330868.
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Affiliation(s)
- Anja Šuc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Lea Einfalt
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- InnoRenew CoE, Izola, Slovenia
| | - Kaja Kastelic
- InnoRenew CoE, Izola, Slovenia.
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia.
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Knorr S, Aalders J, Overgaard M, Støvring H, Mathiesen ER, Damm P, Clausen TD, Bjerre-Christensen U, Andersen LLT, Vinter C, Kofoed-Enevoldsen A, Lauenborg J, Kampmann U, Fuglsang J, Ovesen PG, Christensen TT, Sørensen A, Ringholm L, Jensen DM. Danish Diabetes Birth Registry 2: a study protocol of a national prospective cohort study to monitor outcomes of pregnancies of women with pre-existing diabetes. BMJ Open 2024; 14:e082237. [PMID: 38670616 PMCID: PMC11057310 DOI: 10.1136/bmjopen-2023-082237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Despite technological developments and intensified care, pregnancies in women with pre-existing diabetes are still considered high-risk pregnancies. The rate of adverse outcomes in pregnancies affected by diabetes in Denmark is currently unknown, and there is a limited understanding of mechanisms contributing to this elevated risk. To address these gaps, the Danish Diabetes Birth Registry 2 (DDBR2) was established. The aims of this registry are to evaluate maternal and fetal-neonatal outcomes based on 5 years cohort data, and to identify pathophysiology and risk factors associated with short-term and long-term outcomes of pregnancies in women with pre-existing diabetes. METHODS AND ANALYSIS The DDBR2 registry is a nationwide 5-year prospective cohort with an inclusion period from February 2023 to February 2028 of pregnancies in women with all types of pre-existing diabetes and includes registry, clinical and questionnaire data and biological samples of mother-partner-child trios. Eligible families (parents age ≥18 years and sufficient proficiency in Danish or English) can participate by either (1) basic level data obtained from medical records (mother and child) and questionnaires (partner) or (2) basic level data and additional data which includes questionnaires (mother and partner) and blood samples (all). The primary maternal outcome is Hemoglobin A1c (HbA1c) levels at the end of pregnancy and the primary offspring endpoint is the birth weight SD score. The DDBR2 registry will be complemented by genetic, epigenetic and metabolomic data as well as a biobank for future research, and the cohort will be followed through data from national databases to illuminate possible mechanisms that link maternal diabetes and other parental factors to a possible increased risk of adverse long-term child outcomes. ETHICS AND DISSEMINATION Approval from the Ethical Committee is obtained (S-20220039). Findings will be sought published in international scientific journals and shared among the participating hospitals and policymakers. TRIAL REGISTRATION NUMBER NCT05678543.
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Affiliation(s)
- Sine Knorr
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jori Aalders
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Martin Overgaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Syddanmark, Denmark
| | - Henrik Støvring
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Damm
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Tine D Clausen
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Lise Lotte T Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Christina Vinter
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | | | - Jeannet Lauenborg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Ulla Kampmann
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Fuglsang
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus N, Denmark
| | - Per G Ovesen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus N, Denmark
| | - Trine T Christensen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Sørensen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lene Ringholm
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Bautmans I, Knoop V, Beyer I, Bruunsgaard H, Molbo D, Mortensen EL, Lund R. The relationship between self-perceived fatigue, muscle endurance, and circulating markers of inflammation in participants of the Copenhagen aging and Midlife Biobank (CAMB). Eur Rev Aging Phys Act 2024; 21:2. [PMID: 38297218 PMCID: PMC10829210 DOI: 10.1186/s11556-024-00336-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/14/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Fatigue, low muscle endurance, muscle weakness and low-grade inflammation are strongly related to frailty at higher age. When signs of self-perceived fatigue and low muscle endurance are interrelated with low-grade inflammation at midlife, they might be used as early markers for frailty. This study investigated whether the interrelationships among self-perceived fatigue, muscle endurance and inflammation can be observed at midlife. METHODS A total of 965 participants of the Copenhagen Aging and Midlife Biobank (aged 52 ± 4 years, 536 males, 426 females) were assessed for self-perceived fatigue (20-item multidimensional fatigue inventory), muscle endurance (grip work), circulating markers of inflammation (hsCRP, IL-6, IL-10, TNF-alpha and IFN-γ), daily physical activity (PAS-2), body composition (%body fat assessed by bio-impedance) and self-reported health status. Participants were categorised (correcting for age and gender) according to high fatigue and/or low muscle endurance, differences in inflammatory profile between fatigue categories were assessed by ANCOVA (corrected for PAS-2, %body fat and presence of inflammatory conditions). RESULTS Overall, muscle endurance, fatigue and inflammatory markers were significantly interrelated. Higher levels of hsCRP (p < 0.001), IL-6 (p < 0.001), IL-10 (p = 0.035) and TNF-alpha (p = 0.028) were observed in participants presenting both low muscle endurance and high fatigue. IFN-γ was highest in those with high fatigue but normal muscle endurance (p = 0.015). CONCLUSIONS Middle-aged participants with higher fatigue in combination with low muscle endurance show higher levels of inflammation, independently from physical activity, body fat and inflammatory pathology. The underlying mechanisms should be identified and future studies should also investigate whether these individuals show early signs of reduced physiological reserve capacity, which in later life come to full expression by means of frailty.
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Affiliation(s)
- Ivan Bautmans
- Gerontology department (GERO), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium.
- Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium.
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussel, B-1090, Belgium.
- SOMT University of Physiotherapy, Softwareweg 5, Amersfoort, 3821, The Netherlands.
| | - Veerle Knoop
- Gerontology department (GERO), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
- Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
- SOMT University of Physiotherapy, Softwareweg 5, Amersfoort, 3821, The Netherlands
| | - Ingo Beyer
- Gerontology department (GERO), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
- Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
| | - Helle Bruunsgaard
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Center for Inflammation and Metabolism, National University Hospital, Copenhagen, Denmark
| | - Drude Molbo
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Jørgensen T, Jacobsen RK, Sæbye D, Petersen MW, Fink P, Gormsen L, Linneberg A, Bjerregaard AA, Schovsbo SU, Benros ME, Eplov LF, Jørgensen NR, Dantoft TM. Lipid metabolism and functional somatic disorders in the general population. The DanFunD study. PLoS One 2024; 19:e0296799. [PMID: 38277392 PMCID: PMC10817187 DOI: 10.1371/journal.pone.0296799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 12/19/2023] [Indexed: 01/28/2024] Open
Abstract
OBJECTIVES Earlier studies on the association between plasma lipid profiles and functional somatic disorders (FSD) are mainly small case control studies hampered by selection bias and do not consider the great overlap between the various FSDs. The aim of the present study was to investigate the associations between various FSDs and plasma lipid profiles (total cholesterol, HDL cholesterol, non-HDL cholesterol and triglycerides) in a large, unselected population. DESIGN A cross-sectional general population-based study. SETTING The Danish Study of Functional Somatic Disorders (DanFunD) conducted in 2011-2015 in 10 municipalities in the western part of greater Copenhagen, Denmark. PARTICIPANTS A total of 8,608 men and women aged 18-76 years were included in the analyses. Various delimitations of FSD such as chronic fatigue, chronic widespread pain, irritable bowel, and bodily distress syndrome were measured using validated self-administrated questionnaires. Lipid parameters were measured from fasting plasma samples using colorimetric slide methods with Vitros 4600/5600 Ortho Clinical Diagnostics. OUTCOME MEASURES Logistic regression analyses were used to calculate possible associations between plasma lipids and the various delimitations of FSD. Associations are presented by OR (95% CI) and shown in boxplots. RESULTS We found a positive association between bodily distress syndrome and triglycerides and non-HDL cholesterol and a negative association with HDL-cholesterol, but no consistent association with total cholesterol. A similar pattern was observed for persons with chronic fatigue, and to some degree for persons with chronic widespread pain, whereas persons with irritable bowel did not show a clear association with the lipid profiles. CONCLUSION This is the first major study on plasma lipid profiles and FSD indicating an association between some delimitations of FSD and an unfavorable lipid profile. Due to the cross-sectional design, it cannot be determined whether the findings are consequences or determinants of FSD. Further studies-preferable prospective studies-are needed.
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Affiliation(s)
- Torben Jørgensen
- Centre for Clinical Research and Prevention, Capital Region and University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Kart Jacobsen
- Centre for Clinical Research and Prevention, Capital Region and University of Copenhagen, Copenhagen, Denmark
| | - Ditte Sæbye
- Centre for Clinical Research and Prevention, Capital Region and University of Copenhagen, Copenhagen, Denmark
| | - Marie Weinreich Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lise Gormsen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Allan Linneberg
- Centre for Clinical Research and Prevention, Capital Region and University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Anne Ahrendt Bjerregaard
- Centre for Clinical Research and Prevention, Capital Region and University of Copenhagen, Copenhagen, Denmark
| | - Signe Ulfbeck Schovsbo
- Centre for Clinical Research and Prevention, Capital Region and University of Copenhagen, Copenhagen, Denmark
| | - Michael Eriksen Benros
- Copenhagen Research Center for Mental Health–CORE, Mental Health Centre Copenhagen, Copenhagen, Capital Region, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health–CORE, Mental Health Centre Copenhagen, Copenhagen, Capital Region, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Meinertz Dantoft
- Centre for Clinical Research and Prevention, Capital Region and University of Copenhagen, Copenhagen, Denmark
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10
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Wang H, He X, Tang Y, Tang J, Yang J. Unveiling the links between physical activity, self-identity, social anxiety, and emotional eating among overweight and obese young adults. Front Psychol 2024; 14:1255548. [PMID: 38259565 PMCID: PMC10800689 DOI: 10.3389/fpsyg.2023.1255548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Emotional eating not only contributes to physical obesity but also leads to the experience of guilt and shame, exacerbating emotional problems. Increasing physical activity, adopting a balanced diet, and seeking psychological support help improve emotional eating issues in overweight or obese young adults, enhancing overall mental and physical well-being. Methods This study investigates the correlation between physical activity, self-identity, social anxiety, and emotional eating among 373 overweight and obese college students aged 18-26 in central China. By utilizing AMOS v.26, a structural equation model was constructed to examine the hypotheses. Results The findings reveal that physical activity significantly influences self-identity and social anxiety, which, in turn, significantly impact emotional eating. Moreover, self-identity and social anxiety serve as mediators in the relationship between physical activity and emotional eating. These results emphasize the role of physical activity in mitigating emotional eating among young individuals struggling with overweight and obesity. Discussion Consequently, the government and relevant agencies are urged to address the issue of obesity among young adults and provide support for their engagement in physical activity.
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Affiliation(s)
- Huilin Wang
- School of Business, Hunan University of Science and Technology, Xiangtan, China
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Xianyi He
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Yiwei Tang
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Jiaxin Tang
- School of Business, Hunan University of Science and Technology, Xiangtan, China
| | - Jingyu Yang
- Department of Medical Bioinformatics, University of Göttingen, Göttingen, Germany
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11
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Pedersen MM, Carstensen TBW, Ørnbøl E, Fink P, Jørgensen T, Dantoft TM, Frostholm L. Translation and examination of construct validity of the Danish version of the Tampa Scale for Kinesiophobia. Scand J Pain 2024; 24:sjpain-2024-0022. [PMID: 39099219 DOI: 10.1515/sjpain-2024-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/26/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES This study investigates the construct validity of the Danish Tampa Scale for Kinesiophobia (TSK). METHODS The English 17-item scale was translated into Danish adhering to WHO's guidelines. The construct validity of the TSK was examined in a random general population sample of 4,884 18- to 72-year olds with pain within the past 4 weeks. Examination of construct validity adhered to the COSMIN checklist. Structural validity was examined by splitting the sample and conducting exploratory factor analysis on one half and confirmatory factor analysis on the other half. Convergent validity was examined through associations with self-report measures and objective physical performance tests. Reference scores for the TSK were calculated. RESULTS After translation, all respondents felt confident that they understood the meaning of the items. All but one found the questionnaire acceptable. The exploratory factor analysis suggested that a 1-factor 13-item version without 4 reversed items resulted in the most consistent fit across subgroups of gender, age, and severe pain report. Five different models of the TSK were tested in the confirmatory factor analysis. While none were excellent fits, both one- and two-factor models of the TSK-13 and TSK-11 were acceptable. Two-factor models marginally outperformed one-factor models on goodness of fit. There was no association between TSK scores and muscular fitness or self-reported physical activity. Cardiorespiratory fitness, self-perceived physical fitness, and self-efficacy had weak correlations with TSK scores. Scores showed modest associations with self-report measures of anxiety, illness worry, pain interference, and daily limitations. CONCLUSIONS Based on an overall consideration of results, we recommend using the TSK-13 as a one-dimensional construct for both research and clinical purposes pending further examinations of the TSK in clinical samples. TSK scores from the present study can serve as a standard of reference for levels of Kinesiophobia in the general population.
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Affiliation(s)
- Majbritt Mostrup Pedersen
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
| | - Tina Birgitte Wisbech Carstensen
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Eva Ørnbøl
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Per Fink
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Torben Jørgensen
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thomas Meinertz Dantoft
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
| | - Lisbeth Frostholm
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
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12
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Chen S, Jing L, Li C, Wang H. Exploring the Nexus between Moderate-to-Vigorous Physical Activity, Self-Disclosure, Social Anxiety, and Adolescent Social Avoidance: Insights from a Cross-Sectional Study in Central China. CHILDREN (BASEL, SWITZERLAND) 2023; 11:56. [PMID: 38255369 PMCID: PMC10814873 DOI: 10.3390/children11010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024]
Abstract
Objectives: Psychological issues among adolescents represent a prevalent challenge in today's society. The purpose of this study is to explore the associations among moderate-to-vigorous physical activity, self-disclosure, social anxiety, and social avoidance in adolescents. Methods: This study collected cross-sectional data from 427 students in eight provincial key junior and senior high schools in the central China region of three provinces using snowball sampling and convenience sampling from July to August 2023. A structural equation model was employed to investigate the relationship between moderate-to-vigorous physical activity and social avoidance among adolescents. Results: The findings indicate that moderate-to-vigorous physical activity is negatively correlated with social anxiety (standardized coefficient = -0.219, p < 0.001) and positively correlated with self-disclosure (standardized coefficient = 0.454, p < 0.001). Social anxiety is negatively correlated with self-disclosure (standardized coefficient = -0.220, p < 0.001). Social avoidance is positively correlated with social anxiety (standardized coefficient = 0.461, p < 0.001) and negatively correlated with self-disclosure (standardized coefficient = -0.331, p < 0.001). Conclusions: The chain-mediated dual-path model between moderate-to-vigorous physical activity and social avoidance is facilitated by social anxiety and self-disclosure. In other words, adolescents who engage in more moderate to high-intensity physical activities exhibit lower levels of social anxiety, and those who have a stronger inclination for self-disclosure tend to demonstrate lower levels of social avoidance. In light of these findings, it is recommended that the government, society, schools, and families collaborate synergistically to promote the holistic well-being of adolescents and advance the development of a healthier China.
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Affiliation(s)
- Shuyin Chen
- School of Physical Education, Hunan University of Science and Technology, Xiangtan 411201, China
| | - Longjun Jing
- School of Physical Education, Hunan University of Science and Technology, Xiangtan 411201, China
- China Athletics College, Beijing Sport University, Beijing 100061, China
| | - Chuchu Li
- Moray House School of Education and Sport, The University of Edinburgh, Edinburgh EH8 8AQ, UK
| | - Huilin Wang
- Moray House School of Education and Sport, The University of Edinburgh, Edinburgh EH8 8AQ, UK
- School of Business, Hunan University of Science and Technology, Xiangtan 411201, China
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13
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Vivekanantha P, de Sa D, Halai M, Daniels T, Del Balso C, Pinsker E, Shah A. Kinesiophobia contributes to worse functional and patient-reported outcome measures in Achilles tendinopathy: a systematic review. Knee Surg Sports Traumatol Arthrosc 2023; 31:5199-5206. [PMID: 37553554 DOI: 10.1007/s00167-023-07537-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE To assess the effect of kinesiophobia or fear of reinjury on patient-reported outcome measures and physical performance measures in patients with chronic Achilles tendinopathy (AT). METHODS Three databases were systematically screened for studies from inception to May 22nd, 2023 for literature investigating the impact of kinesiophobia on PROMs or physical performance metrics in AT. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, pain, level of activity, self-reported injury severity, quality of life, single-leg hop performance, and heel-raise performance were recorded. Data was presented primarily in a narrative summary fashion. The MINORS score was used for all studies to perform a quality assessment of included studies. RESULTS Six studies comprising 705 patients were included in this review. Variations of the Tampa Scale of Kinesiophobia (TSK-11 or TSK-17) were used in all studies. TSK scores were strongly correlated with the Pain Catastrophizing Score (PCS) and Visual Analogue Scale (VAS) scores and were correlated with decreased Victorian Institute of Sports Assessment Achilles (VISA-A) and Foot and Ankle Outcome Scores Quality of Life (FAOS-QoL) subscale scores. Kinesiophobia was associated with heel raise completion with conflicting evidence on correlations with hop test performance. CONCLUSION Increased kinesiophobia scores (> 35 points), measured by TSK are associated with worse PROMs, including increased pain, decreased quality of life, increased self-reported severity, and is also associated with poorer physical performance measures in patients with AT. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Prushoth Vivekanantha
- Michael DeGroote School of Medicine, McMaster University Medical Centre, 1200 Main Street West, 4E14, Hamilton, ON, L8N 3Z5, Canada.
| | - Darren de Sa
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Mansur Halai
- Division of Orthopaedic Surgery, Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Timothy Daniels
- Division of Orthopaedic Surgery, Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Christopher Del Balso
- Division of Orthopaedic Surgery, Department of Surgery, London Health Sciences Centre, London, ON, Canada
| | - Ellie Pinsker
- Division of Orthopaedic Surgery, Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Ajay Shah
- Division of Orthopaedic Surgery, Postgraduate Medical Education, University of Toronto, Toronto, ON, Canada
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14
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Wang H, Liu Y, Zhang S, Xu Z, Yang J. Investigating Links between Moderate-to-Vigorous Physical Activity and Self-Rated Health Status in Adolescents: The Mediating Roles of Emotional Intelligence and Psychosocial Stress. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1106. [PMID: 37508604 PMCID: PMC10378217 DOI: 10.3390/children10071106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023]
Abstract
Adolescence represents a crucial phase, characterized by rapid physical and mental development and numerous challenges. Physical activity plays a vital role in the mental well-being of adolescents; however, due to the prevailing educational philosophy prioritizing academic performance, adolescent participation in physical activities has yet to reach its full potential. Thus, this study aims to investigate the effects of moderate-to-vigorous physical activity on adolescents' emotional intelligence, psychosocial stress, and self-rated health status. To achieve this objective, a cluster sampling method was employed to collect data from 600 adolescents in 10 schools across five municipal districts of Changsha, China. A total of 426 valid questionnaires were returned and analyzed. Utilizing AMOS v.23, a structural equation model was constructed to validate the hypotheses. The findings reveal that moderate-to-vigorous physical activity significantly impacts adolescents' emotional intelligence and self-rated health status. Conversely, it exerts a significant negative influence on their psychosocial stress. Moreover, emotional intelligence and psychosocial stress mediate the relationship between moderate-to-vigorous physical activity and self-rated health status. In light of these results, education departments, schools, and families must embrace a paradigm shift in educational philosophies and provide robust support for adolescents to engage in moderate-to-vigorous physical activities.
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Affiliation(s)
- Huilin Wang
- School of Business, Hunan University of Science and Technology, Xiangtan 411201, China
| | - Yang Liu
- School of Business, Hunan University of Science and Technology, Xiangtan 411201, China
| | - Songbiao Zhang
- School of Business, Hunan University of Science and Technology, Xiangtan 411201, China
| | - Ziqing Xu
- International College, National Institute of Development Administration, Bangkok 10240, Thailand
| | - Jingyu Yang
- Department of Medical Bioinformatics, University of Göttingen, 37077 Göttingen, Germany
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15
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Liu Y, Jing L, Liu Y, Wang H, Yuan T, Yang J. Active for Life after Cancer: Association of Physical Activity with Cancer Patients' Interpersonal Competence, Quality of Life, and Survival Beliefs. Behav Sci (Basel) 2023; 13:449. [PMID: 37366701 DOI: 10.3390/bs13060449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
This study aimed to examine the relationship between physical activity and cancer patients' survival beliefs and constructed a mediation model involving the mediating effects of interpersonal competence and quality of life. We conducted 252 questionnaire surveys on multiple chat groups for cancer patients using the WeChat software, and assessed physical activity, survival beliefs, interpersonal competence, and quality of life using standard scales. Data were analyzed using SPSS and AMOS. There were positive correlations between physical activity and quality of life (β = 0.393, p < 0.001), physical activity and interpersonal competence (β = 0.385, p < 0.001), interpersonal competence and quality of life (β = 0.455, p < 0.001), and quality of life and survival beliefs (β = 0.478, p < 0.001). In addition, a significant mediating effect between physical activity and survival beliefs was observed between interpersonal competence and quality of life (standardized indirect effect = 0.384, p < 0.001). The study revealed that effective physical activity led to higher interpersonal competence, more excellent quality of life, and improved survival beliefs in cancer patients, and that the association of physical activity with improved survival beliefs was fully mediated through interpersonal competence and quality of life. The findings suggest that the relevant government should increase policy support and publicity to improve cancer patients' participation in physical activity.
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Affiliation(s)
- Ying Liu
- School of Physical Education, Hunan University of Science and Technology, Xiangtan 411201, China
- China Institute of Sports Science, Beijing 100061, China
| | - Longjun Jing
- School of Physical Education, Hunan University of Science and Technology, Xiangtan 411201, China
- China Athletics College, Beijing Sport University, Beijing 100061, China
| | - Yang Liu
- School of Business, Hunan University of Science and Technology, Xiangtan 411201, China
| | - Huilin Wang
- School of Business, Hunan University of Science and Technology, Xiangtan 411201, China
| | - Tinggang Yuan
- China Institute of Sports Science, Beijing 100061, China
| | - Jingyu Yang
- Department of Medical Bioinformatics, University of Göttingen, 37077 Göttingen, Germany
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16
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Keep Moving to Retain the Healthy Self: The Influence of Physical Exercise in Health Anxiety among Chinese Menopausal Women. Behav Sci (Basel) 2023; 13:bs13020140. [PMID: 36829369 PMCID: PMC9952320 DOI: 10.3390/bs13020140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
Menopause is a period of high incidence of chronic diseases. Women experience various physical and psychological discomforts during menopause, and hormonal changes exacerbate mood swings in menopausal women and also cause them to begin to experience excessive worry and anxiety about their health problems. This study was a cross-sectional survey investigating the relationship between physical activity and women's health anxiety. Using cluster sampling, a valid sample of 455 females aged 45-50 was collected from 78 communities in five municipal districts in Changsha, China, and AMOS v.23 was adopted to construct a structural equation model to verify the hypotheses. The results indicate that interpersonal competence and emotional intelligence are negatively associated with health anxiety. Furthermore, interpersonal competence and emotional intelligence mediate the relationship between physical exercise and health anxiety, which means that menopausal women with more physical exercise, higher interpersonal competence, and higher emotional intelligence reported lower health anxiety. Finally, to alleviate menopausal women's health anxiety and reduce their risk of chronic diseases, the government, community, and family should create conditions and opportunities for women to participate in group physical activities.
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17
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Krawcyk RS, Vinther A, Petersen NC, Faber J, Iversen HK, Christensen T, Klausen TW, Kruuse C. High-intensity training in patients with lacunar stroke: A one-year follow-up. J Stroke Cerebrovasc Dis 2023; 32:106973. [PMID: 36623990 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106973] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/06/2022] [Accepted: 12/26/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Physical inactivity is a major risk factor for stroke. It is a challenge for patients to initiate and adhere to regular exercise post-stroke. Early initiation of home-based high-intensity interval training (HIIT) may engage patients in physical activity, improve cardiorespiratory fitness, and reduce risk of recurrent stroke. MATERIALS AND METHODS Post-intervention follow-up of patients with lacunar stroke, randomized to three-months HIIT including weekly motivational calls, or usual care. At follow-up (six- and 12-months post-stroke), we investigated changes in cardiorespiratory fitness, physical activity, fatigue, depression, mental well-being, stress, cognition, cardiovascular function, and recurrent stroke. RESULTS We included 71 patients of whom 59 patients (mean age: 63.9 ± 8.8 years) completed six- and 12-month follow-up. No change was detected in cardiorespiratory fitness between groups from baseline to 12-months follow-up. At six months, vigorous-intensity activity (median hours/week [interquartile range]) was maintained in the intervention group (baseline, 0[0;2]; post-intervention, 2[0;3]; six-month, 2[0;4]) and increased in the usual care group (baseline, 0[0;1]; post-intervention, 1[0;2]; six-month, 1[0;3]), with no difference between groups. Vigorous-intensity activity declined to baseline levels at 12-months in both groups. Secondary outcomes improved from baseline to 12-months with no significant differences between groups. Similar rate of recurrent stroke (n=3) occurred in each group with a three-month delay in the intervention group. CONCLUSIONS Early initiated HIIT did not increase long-term cardiorespiratory fitness, but increased time spent doing vigorous-intensity activities post-stroke. Decline to baseline activity level at 12 months warrants identification of motivators to initiate and sustain physical activity post-stroke.
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Affiliation(s)
- Rikke Steen Krawcyk
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Department of Neurology, Neurovascular Research Unit, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Hospital Secretariat and Communications, Research, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | | | - Jens Faber
- Department of Internal Medicine, Division of Endocrinology, Copenhagen University Hospital - Herlev and Gentofte, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Helle K Iversen
- Department of Neurology, Stroke Center Rigshospitalet, Copenhagen University hospital - Rigshospitalet, Copenhagen, Denmark and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Christensen
- Department of Neurology, Copenhagen University hospital - North Zealand, Copenhagen, Denmark and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Christina Kruuse
- Department of Neurology, Neurovascular Research Unit, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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18
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Wang H, Xu Z, Yang J, Huang D. Promoting Physical Activity among Working Women: The Influence of Perceived Policy Effectiveness and Health Awareness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1021. [PMID: 36673777 PMCID: PMC9859384 DOI: 10.3390/ijerph20021021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
In recent years, patients with chronic diseases have shown a younger trend due to physical inactivity and irregular lifestyles. Accordingly, the Chinese government has implemented the "National Fitness Program", which aims to enhance people's health by popularizing exercise and a healthy lifestyle. However, women are less physically active than men, and how to appeal to women to devote themselves to fitness activities has become a social concern. Based on the expanded theory of planned behavior (TPB), this study explores the impact of the perceived policy effectiveness and health awareness on physical activity among working women. This study adopted a repeated cross-sectional study method, and each respondent was asked to complete a two-stage survey. The structural model of the extended TPB was tested using sample data from 376 working women in Changsha, China. The results show that perceived policy effectiveness and health awareness positively affect actual behavioral control and implementation intention. Among them, perceived policy effectiveness has the most significant impact on implementation intention, followed by health awareness. Furthermore, actual behavioral control and implementation intention mediate the relationship between perceived policy effectiveness/health awareness and physical activity. The findings suggest that to promote physical activity among working women, the Chinese government should deepen the implementation of the "National Fitness Program" and raise the public's health awareness.
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Affiliation(s)
- Huilin Wang
- School of Business, Hunan University of Science and Technology, Xiangtan 411201, China
- Faculty of Economics, Chulalongkorn University, Bangkok 10330, Thailand
| | - Ziqing Xu
- International College, National Institute of Development Administration, Bangkok 10240, Thailand
| | - Jingyu Yang
- Department of Medical Bioinformatics, University of Göttingen, 37077 Göttingen, Germany
| | - Dan Huang
- School of Physical Education, Hunan University of Science and Technology, Xiangtan 411201, China
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19
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Wu R, Jing L, Liu Y, Wang H, Yang J. Effects of physical activity on regulatory emotional self-efficacy, resilience, and emotional intelligence of nurses during the COVID-19 pandemic. Front Psychol 2022; 13:1059786. [PMID: 36571052 PMCID: PMC9780437 DOI: 10.3389/fpsyg.2022.1059786] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
The normalization of epidemic prevention and control has exacerbated nurses' physical and mental stresses. The important role of physical activity in relieving nurses' physical and mental stresses has received extensive attention from researchers in recent years. The purpose of this study was to investigate the influence of physical activity on the regulatory emotional self-efficacy, resilience, and emotional intelligence of nurses and explain their interactions. The present study adopted the cluster sampling method. From April to May 2022, a total of 500 nurses in six municipal hospitals in Changsha City were selected. Finally, 402 valid data samples were obtained. Afterward, AMOS 23.0 (by maximum likelihood estimation) was used to process the collected data and analyze the proposed hypotheses by using 5,000 bootstrap samples to test the mediating effects of the structural equation model. The results demonstrated that there are positive correlations between physical activity and resilience (standardized coefficients = 0.232, p < 0.001), resilience and regulatory emotional self-efficacy (standardized coefficients = 0.449, p < 0.001), and emotional intelligence and regulatory emotional self-efficacy (standardized coefficients = 0.330, p < 0.001). The positive influence of physical activity on emotional regulation self-efficacy is completely mediated by emotional intelligence and resilience (standardized indirect effect = 0.237, p < 0.01), and this explanatory power is far higher than any previous study (R 2 = 0.49). The positive emotions generated by an individual's physical activity have an important explanatory role for individuals who want to establish more emotional regulation self-efficacy, emotional intelligence, and psychological resilience.
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Affiliation(s)
- Ruoshan Wu
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
| | - Longjun Jing
- School of Physical Education, Hunan University of Science and Technology, Xiangtan, China
- China Athletics College, Beijing Sport University, Beijing, China
| | - Yang Liu
- School of Business, Hunan University of Science and Technology, Xiangtan, China
| | - Huilin Wang
- School of Business, Hunan University of Science and Technology, Xiangtan, China
- Faculty of Economics, Chulalongkorn University, Bangkok, Thailand
| | - Jingyu Yang
- Department of Medical Bioinformatics, University of Göttingen, Göttingen, Germany
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20
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Willems AE, Sura-de Jong M, van Beek AP, van Dijk G. Self-initiated dietary changes reduce general somatic and mental symptoms in a relatively healthy Dutch population. Prev Med Rep 2022; 30:102004. [PMID: 36245808 PMCID: PMC9562416 DOI: 10.1016/j.pmedr.2022.102004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/16/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022] Open
Abstract
The risk for development of non-communicable diseases (NCDs) can be predicted by somatic or mental symptoms and dietary alterations aimed at improvement of those symptoms could potentially delay development of NCDs. The goal of this study was to identify whether self-initiated dietary changes could reduce mental and somatic symptoms in relatively healthy individuals. Participants (n = 494) recruited from the Dutch population filled out weekly questionnaires on dietary intake, somatic and mental symptoms and physical activity at baseline and during dieting for four weeks. There was a significant reduction in mental and somatic symptoms, body weight, and waist circumference at four weeks, whereas physical activity remained unchanged. Five dietary patterns were identified by principal component analysis labelled “Processed foods”, “Animal source foods”, “Wheel of Five”, “Traditional Dutch”, and “Party”. Reduction in mental symptoms was correlated to increased physical activity and increased intake of Wheel of Five foods. Reduction in somatic symptoms was correlated to body weight loss and less Processed foods, more Wheel of Five foods, and lower intake of fat and protein. Higher intake of protein and fat and lower intake of carbohydrates, however, were correlated to body weight loss. In conclusion this research showed that a self-initiated dietary change can lead to a significant reduction of mental and somatic symptoms.
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Affiliation(s)
- Anouk E.M. Willems
- Van Hall Larenstein University of Applied Sciences, Applied Research Centre Food & Dairy, Leeuwarden, The Netherlands
- Groningen Institute for Evolutionary Life Sciences (GELIFES) – Neurobiology, University of Groningen, Groningen, The Netherlands
| | - Martina Sura-de Jong
- Van Hall Larenstein University of Applied Sciences, Applied Research Centre Food & Dairy, Leeuwarden, The Netherlands
| | - André P. van Beek
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gertjan van Dijk
- Groningen Institute for Evolutionary Life Sciences (GELIFES) – Neurobiology, University of Groningen, Groningen, The Netherlands
- Corresponding author at: G. van Dijk, Nijenborg 7, 9747AG Groningen, The Netherlands.
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21
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Ujiie Y, Takahashi K. Association of personality with habituation of physical and non-physical activities among Japanese adults: Results from questionnaire research before COVID-19 pandemic. DIALOGUES IN HEALTH 2022; 1:100076. [PMID: 36785624 PMCID: PMC9670675 DOI: 10.1016/j.dialog.2022.100076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/02/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022]
Abstract
Background Physical activity has benefits for public health as it reduces the risk of non-communicable diseases and improves the quality of life. Previous studies have shown that health conditions, lifestyle, and socioeconomic status influence one's tendency to engage in physical activity. However, the influence of psychological traits on engagement in physical activity is not yet fully understood. In this study, we explored personality traits associated with the habituation of physical activity and compared them with personality traits associated with the habituation of non-physical activity. Methods We recruited 1600 Japanese adult volunteers and conducted an online survey just before the spread of COVID-19. We collected data for the prevalence of physical and non-physical activities, and various aspects of personality traits including the Big Five personality traits, sensitivity to behavioral activation, dark triad personality, levels of internal locus of control, and the degree of just-world belief. Findings The results demonstrated that high levels of extraversion, sensitivity to behavioral activation, and an internal locus of control had a positive influence on the habituation of physical activity. Moreover, our results were contradictory as they also showed that high levels of openness, sensitivity to behavioral activation, and just world belief related to the habituation of non-physical activity. Interpretation These results suggest that the personality traits that influenced the habituation of activities depend on the characteristics of the activity and reveal extraversion and internal locus of control as the personality traits specific to the habituation of physical activity. Fundings This study was supported by Senryakuteki-kenkyu from Chukyo University, a Grant-in-Aid for Early-Career Scientists (Grant No. 19 K20650 and 22 K13880), the Promotion of Joint International Research (Grant No. 20KK0054). This work was also supported by a Grant-in-Aid for Scientific Research on Innovative Areas "Construction of the Face-Body Studies in Transcultural Conditions" (Grant No. 17H06342).
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Affiliation(s)
- Yuta Ujiie
- Department of Psychology, College of Contemporary Psychology, Rikkyo University, 1-2-26 Kitano,Niiza-shi, Saitama Japan 352-8558, Japan
- Research Organization of Open Innovation and Collaboration, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki, Osaka 567-8570, Japan
| | - Kohske Takahashi
- Research Organization of Open Innovation and Collaboration, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki, Osaka 567-8570, Japan
- College of Comprehensive Psychology, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki, Osaka 567-8570, Japan
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22
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Kårhus LL, Møllehave LT, Osler M, Jørgensen T, Linneberg A. Population-based epidemiology: The Glostrup Population Studies 1964–2021. Scand J Public Health 2022; 50:1007-1011. [DOI: 10.1177/14034948221086387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Glostrup Population Studies are population-based cohorts undertaken in the south-western part of Greater Copenhagen since 1964. The participants were randomly selected from the adult general population. The first cohort was established to assess cardiovascular risk factors and, since, the objectives have been broadened to describe and analyse the health of the general population. The studies are health-examination studies with clinical and biochemical data in addition to data from self-administered questionnaires and, in some studies, interviews. Fasting blood and urine samples were collected and stored in our biobank for further studies. Several of the cohorts were performed according to standardized methods in international consortia, hence data have been pooled with other, both Danish and international, cohorts. To date more than 30,000 individuals, both men and women, aged 15–85 years, have participated in The Glostrup Population Studies and participants have been re-examined up to eight times. The data can be used for disease-specific epidemiology, social epidemiology, genetic epidemiology, ageing, lifestyle and health interventions nested within the cohorts. The Glostrup Population Studies represent a great resource; the possibility of merging the different cohorts enables large datasets, as well as trends over time. Furthermore, the long follow-up in both the national registers and with follow-up examinations is unique. The purpose of this commentary is to inform about The Glostrup Population Studies and to invite collaborations to continue utilizing this great resource to combat current and future challenges within health promotion and disease prevention.
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Affiliation(s)
- Line L. Kårhus
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Line T. Møllehave
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Torben Jørgensen
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Frederiksberg, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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23
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Muff Bech L, Poetzsch S, Andersen K, Nørgaard B. Onboarding in Health Care-Content Validity and Reliability of the Danish Onboarding Questionnaire (DOQ-34). THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 43:148-154. [PMID: 37638678 DOI: 10.1097/ceh.0000000000000448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
INTRODUCTION During recent years, health care organizations have paid increasing attention to onboarding because of recruitment challenges. Organizational initiatives are frequently monitored and evaluated using questionnaire data, and to produce high-quality data, reliable instruments are paramount. We aimed to investigate the content validity and reliability of the Danish Onboarding Questionnaire, including cognitive interviewing and test-retest analyses. METHOD We investigated content validity, including face validity and the content validity index, and reliability for the percentage of agreement. To analyze the cognitive interview data, thematic analysis was applied, followed by the question-and-answer model to categorize the problems revealed. To test reliability, the percentage of agreement was calculated with an accepted deviation of 1 on test-retest data. RESULTS Regarding the mental processes, multiple items were identified to be challenged regarding comprehension (clarification of concepts and understanding), judgment (ambiguity and relevance), and response (anonymity and personal information). The mental process retrieval was not represented. The subscale content validity index/Ave was found to be 0.935, representing a "good" level of content validity. With an accepted deviation of 1, the mean agreement was 97.7%. DISCUSSION Questionnaire items causing uncertainties or challenges are potential sources of deteriorated content validity and should be revised. We suggest that the Danish Onboarding Questionnaire-34 undergo an item reduction, which might increase its validity and reliability.
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Affiliation(s)
- Line Muff Bech
- Ms. Muff Bech, Poetzsch, and Andersen:Muff Bech and Poetzsch: Consultant, HR Department, Hospital of South West Jutland, Denmark. Hospital of South West Jutland, Denmark
- Dr. Nørgaard: Professor, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Simone Poetzsch
- Ms. Muff Bech, Poetzsch, and Andersen:Muff Bech and Poetzsch: Consultant, HR Department, Hospital of South West Jutland, Denmark. Hospital of South West Jutland, Denmark
- Dr. Nørgaard: Professor, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kamilla Andersen
- Ms. Muff Bech, Poetzsch, and Andersen:Muff Bech and Poetzsch: Consultant, HR Department, Hospital of South West Jutland, Denmark. Hospital of South West Jutland, Denmark
- Dr. Nørgaard: Professor, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Birgitte Nørgaard
- Ms. Muff Bech, Poetzsch, and Andersen:Muff Bech and Poetzsch: Consultant, HR Department, Hospital of South West Jutland, Denmark. Hospital of South West Jutland, Denmark
- Dr. Nørgaard: Professor, Department of Public Health, University of Southern Denmark, Odense, Denmark
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24
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Yang MX, Wang J, Zhang X, Luo ZR, Yu PM. Perioperative respiratory muscle training improves respiratory muscle strength and physical activity of patients receiving lung surgery: A meta-analysis. World J Clin Cases 2022; 10:4119-4130. [PMID: 35665118 PMCID: PMC9131220 DOI: 10.12998/wjcc.v10.i13.4119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/07/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The clinical role of perioperative respiratory muscle training (RMT), including inspiratory muscle training (IMT) and expiratory muscle training (EMT) in patients undergoing pulmonary surgery remains unclear up to now.
AIM To evaluate whether perioperative RMT is effective in improving postoperative outcomes such as the respiratory muscle strength and physical activity level of patients receiving lung surgery.
METHODS The PubMed, EMBASE (via OVID), Web of Science, Cochrane Library and Physiotherapy Evidence Database (PEDro) were systematically searched to obtain eligible randomized controlled trials (RCTs). Primary outcome was postoperative respiratory muscle strength expressed as the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Secondary outcomes were physical activity, exercise capacity, including the 6-min walking distance and peak oxygen consumption during the cardio-pulmonary exercise test, pulmonary function and the quality of life.
RESULTS Seven studies involving 240 participants were included in this systematic review and meta-analysis. Among them, four studies focused on IMT and the other three studies focused on RMT, one of which included IMT, EMT and also combined RMT (IMT-EMT-RMT). Three studies applied the intervention postoperative, one study preoperative and the other three studies included both pre- and postoperative training. For primary outcomes, the pooled results indicated that perioperative RMT improved the postoperative MIP (mean = 8.13 cmH2O, 95%CI: 1.31 to 14.95, P = 0.02) and tended to increase MEP (mean = 13.51 cmH2O, 95%CI: -4.47 to 31.48, P = 0.14). For secondary outcomes, perioperative RMT enhanced postoperative physical activity significantly (P = 0.006) and a trend of improved postoperative pulmonary function was observed.
CONCLUSION Perioperative RMT enhanced postoperative respiratory muscle strength and physical activity level of patients receiving lung surgery. However, RCTs with large samples are needed to evaluate effects of perioperative RMT on postoperative outcomes in patients undergoing lung surgery.
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Affiliation(s)
- Meng-Xuan Yang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jiao Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiu Zhang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ze-Ruxin Luo
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Peng-Ming Yu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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25
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Zhou W, Webster KE, Smith EL, Chen W, Veliz PT, Reddy RM, Larson JL. Physical activity in surgical lung cancer patients: a systematic review. Support Care Cancer 2022; 30:6473-6482. [PMID: 35384612 DOI: 10.1007/s00520-022-07018-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/25/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Perioperative exercise could improve health outcomes of surgical lung cancer patients, but less is known about their natural physical activity (PA) behavior before exercise interventions. This review aimed to synthesize evidence on PA, regarding the following: (1) proportion of patients meeting PA guidelines, (2) amount of PA, (3) PA trajectory following surgery, and (4) correlates of PA before or after surgery. METHODS We conducted a systematic review using PubMed, CINHAL, Scopus, and SPORTDiscus (July 2021). Observational or experimental studies that measure PA of lung cancer patients before/after surgery were included. We assessed methodological quality using the NIH Quality Assessment Tools and extracted data using a standardized form. RESULTS Seventeen studies (25 articles, N = 1737 participants) published between 2009 and 2021 were included. Fourteen studies had sample sizes less than 100. Thirteen studies were of fair quality and four studies were of good quality. Only 23-28% of patients met PA guideline (150 min/week moderate-vigorous PA) at 6 months-6 years after surgery. Patients took an average of 3822-10,603 daily steps before surgery and 3934-8863 steps at 1-3 months after surgery. Physical activity was lower at 1 day-3 months after surgery, compared with preoperative levels. Perioperative PA was positively associated with exercise capacity, quality of life and reduced postoperative complications. CONCLUSION This review suggests that PA is low among surgical lung cancer patients, and it may not recover within 3 months following surgery. Physical activity has the potential to improve postoperative outcomes. However, the existing evidence is weak, and future larger longitudinal studies are needed.
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Affiliation(s)
- Weijiao Zhou
- School of Nursing, University of Michigan, Ann Arbor, MI, USA.
| | | | - Ellen Lavoie Smith
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Philip T Veliz
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Rishindra M Reddy
- Department of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Janet L Larson
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
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26
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Thomsen JLS, Vinge L, Harbo T, Andersen H. A population-based follow-up study of maximal muscle strength and mobility in patients with myasthenia gravis. Neuromuscul Disord 2022; 32:305-312. [DOI: 10.1016/j.nmd.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 01/23/2022] [Accepted: 02/15/2022] [Indexed: 10/19/2022]
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27
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Eddelien HS, Butt JH, Amtoft AC, Nielsen NSK, Jensen ES, Danielsen IMK, Christensen T, Danielsen AK, Hornnes N, Kruuse C. Patient-reported factors associated with early arrival for stroke treatment. Brain Behav 2021; 11:e2225. [PMID: 34087953 PMCID: PMC8413799 DOI: 10.1002/brb3.2225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/29/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Timely evaluation and initiation of treatment is the key for improving stroke outcomes, although minimizing the time from symptom onset to the first contact with healthcare professionals remains a challenge. We aimed to identify patient-related factors associated with early hospital arrival. MATERIALS AND METHODS In this cross-sectional survey, we included patients with stroke or transient ischemic attack admitted directly to one of two noncomprehensive stroke units or transferred to the units from comprehensive stroke centers in the Capital Region of Denmark. Patient-reported factors associated with early hospital arrival were analyzed using multivariable logistic regression analysis adjusted for age, sex, education, living arrangement, brain location of the stroke, stroke severity, patient-perceived symptom severity, history of prior stroke, stroke risk factors, and knowledge of stroke symptoms. RESULTS In total, 479 patients with acute stroke were included (median age 74 (25th-75th percentile, 64-80), 40% women), of whom 46.4% arrived within 180 min of symptom onset. Factors associated with early hospital arrival were patients or bystanders choosing emergency medical service (EMS) for the first contact with a medical professional (adjusted odds ratio (OR), 3.41; 95% confidence interval, CI [1.57, 7.35]) or the patient's perceived symptom severity above the median score of 25 on a 100-point verbal scale (adjusted OR, 2.44; 95% CI [1.57, 3.82]). Living alone reduced the likelihood of early arrival (adjusted OR, 0.53; 95% CI [0.33, 0.86]). CONCLUSIONS Only when patients perceived symptoms as severe or when EMS was selected as the first contact, early arrival for stroke treatment was ensured.
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Affiliation(s)
- Heidi S Eddelien
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jawad H Butt
- Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - André C Amtoft
- Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nicholine S K Nielsen
- Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Emilie S Jensen
- Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ida M K Danielsen
- Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Christensen
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Nordsjaellands Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anne K Danielsen
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Gastroenterology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nete Hornnes
- Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Christina Kruuse
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Neurovascular Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
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28
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Orlando G, Reeves ND, Boulton AJM, Ireland A, Federici G, Federici A, Haxhi J, Pugliese G, Balducci S. Sedentary behaviour is an independent predictor of diabetic foot ulcer development: An 8-year prospective study. Diabetes Res Clin Pract 2021; 177:108877. [PMID: 34058300 DOI: 10.1016/j.diabres.2021.108877] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/12/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
AIMS To prospectively explore the association between sedentary time (SED-time) and the development of diabetic foot ulcer (DFU) in people with diabetic peripheral neuropathy (DPN). METHODS 175 DPN individuals who attended the annual evaluation for the SAMBA Study (2012-2019) were included. Main outcome measure was the first diagnosis of DFU. SED-time was measured by the PAS 2.1 questionnaire. Nerve function was evaluated by nerve conduction studies. Vascular function was assessed by Ankle-brachial index (ABI) and pedal pulses. Foot deformity and skin dryness were examined by visual inspection. RESULTS 62 participants (35.5%) developed a DFU during the study. SED-time was significantly higher in people who developed DFUs (12.8 ± 3.0 vs 9.4 ± 3.1 h/day). Logistic regression showed that among several nervous (motor amplitude, OR 0.33, 95% CI, 0.18-0.60; sensory amplitude, 0.85, 0.77-0.94) and vascular parameters (ABI, 0.23, 0.1-0.61; pedal pulses, 2.81, 0.12-0.63) and foot characteristics (deformity, 2.63, 1.30-5.32; skin dryness, 2.04, 0.95-4.37), SED-time was one of the strongest variables contributing to the development of DFUs (2.95, 1.45-6.44). CONCLUSIONS SED-time is an independent predictor of the risk of DFU in people with DPN. The monitoring of SED-time with strategies aimed at reducing it should be included in the standard care of diabetic patients.
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Affiliation(s)
- Giorgio Orlando
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK; Metabolic Fitness Association, Monterotondo, Rome, Italy.
| | - Neil D Reeves
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Andrew J M Boulton
- Department of Medicine, Manchester Royal Infirmary, Manchester, UK; Diabetes Research Institute, University of Miami, Miami, FL, USA
| | - Alex Ireland
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | | | | | - Jonida Haxhi
- Department of Clinical and Molecular Medicine, "La Sapienza" University, and Diabetes Unit, Sant' Andrea University Hospital, Rome, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, "La Sapienza" University, and Diabetes Unit, Sant' Andrea University Hospital, Rome, Italy
| | - Stefano Balducci
- Department of Clinical and Molecular Medicine, "La Sapienza" University, and Diabetes Unit, Sant' Andrea University Hospital, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy
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29
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Valles-Medina AM, Castillo-Anaya SI, Sevilla-Mena TL, Aadahl M. Validity of the Danish Physical Activity Scale, adapted to Spanish speaking population. Aten Primaria 2021; 53:101949. [PMID: 33744710 PMCID: PMC7985467 DOI: 10.1016/j.aprim.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/01/2020] [Accepted: 09/30/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ana M Valles-Medina
- Master in Public Health Graduate Program, Universidad Autonoma de Baja California, Tijuana, Mexico.
| | | | - Thelma L Sevilla-Mena
- Medicine and Psychology School, Universidad Autonoma de Baja California, Tijuana, Mexico
| | - Mette Aadahl
- University of Copenhagen, Faculty of Health and Medical Sciences, Institute of Public Health, Copenhagen, Denmark; Center for Clinical Research and Prevention, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
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30
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Aadahl M, Andreasen AH, Petersen CB, Gupta N, Holtermann A, Lau CJ. Should leisure-time sedentary behavior be replaced with sleep or physical activity for prevention of diabetes? Scand J Med Sci Sports 2021; 31:1105-1114. [PMID: 33462843 DOI: 10.1111/sms.13924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 12/25/2022]
Abstract
The aim was to examine the effects of replacing self-reported leisure-time sedentary behavior with sleep, light-to-moderate physical activity, or vigorous physical activity on incident diabetes among Danish adults using isotemporal substitution modeling. Participants ≥25 years from the Danish Capital Region Health Survey 2007 (N = 69 800, response rate 52.3%), 2010 (N = 95 150, response rate 52.3%), and 2013 (N = 95 150, response rate 43.5%) were included. Information on daily sleep duration, leisure-time sedentary behavior, and movement behaviors was collected by questionnaire. Information on incident diabetes was obtained from National registers. Analyses included Cox proportional hazards regression models and isotemporal substitution analyses, with time (in years) from baseline to incident diabetes or censoring December 31, 2017. Potential confounders, sex, age, BMI, ethnicity, education, smoking, inflammatory joint disease, perceived stress, physical and mental component scale and work status, were included. Out of N = 87 339 in the final study sample, n = 3007 had incident diabetes during a mean follow-up time of 7.4 years. Adults with incident diabetes included more men, higher mean age, and higher BMI, compared to respondents without incident diabetes. Theoretically substituting 30 minutes of leisure-time sedentary behavior with light-to-moderate PA (HR: 0.96; 95% CI: 0.94; 0.98) or with vigorous PA (HR: 0.82; 95% CI: 0.72; 0.94) decreased the risk of incident diabetes. We found no change in incident diabetes risk of substituting sedentary time with sleep (HR: 1.00; 95% CI: 0.97; 1.02). Substituting 30 minutes per day of leisure-time sedentary behavior with light-to-moderate or vigorous PA may significantly reduce the risk of incident diabetes among adults.
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Affiliation(s)
- Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne H Andreasen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Christina B Petersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Copenhagen, Denmark
| | - Cathrine J Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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Jespersen T, Møllehave LT, Thuesen BH, Skaaby T, Rossing P, Toft U, Jørgensen NR, Corfixen BL, Jakobsen J, Frimodt-Møller M, Linneberg A. Uncarboxylated matrix Gla-protein: A biomarker of vitamin K status and cardiovascular risk. Clin Biochem 2020; 83:49-56. [PMID: 32422228 DOI: 10.1016/j.clinbiochem.2020.05.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Dephosphorylated uncarboxylated matrix Gla-protein (dp-ucMGP) is a biomarker of functional vitamin K status. High plasma dp-ucMGP concentrations reflect a low vitamin K status and have been related to vascular calcification. Our aims were to assess plasma levels of dp-ucMGP and their association with cardiovascular risk in a general population. METHODS Plasma dp-ucMGP measurements were performed using the IDS-iSYS InaKtif MGP assay in 491 consecutive participants in a Danish general population study (229 males and 262 females, aged 19-71 years). Multivariable linear and logistic regressions were used to assess the association between dp-ucMGP levels and cardiovascular risk factors. RESULTS Mean ± standard deviation (SD) for dp-ucMGP was 465 ± 181 pmol/L, and upper 95th percentile was 690 pmol/L. In logistic regression analyses, an increase in dp-ucMGP category (<300, 300-399, 400-499, ≥500 pmol/L) was positively associated with obesity, odds ratio (OR) 2.27 (95% confidence interval (CI) 1.54-3.33), history of cardiovascular disease, OR 1.77 (CI 1.02-3.05), and above-median estimated pulse wave velocity (ePWV), OR 1.54 (CI 1.21-1.96), when adjusted for age, sex, and lifestyle factors. 1 SD increase in diastolic and systolic blood pressure (BP) corresponded to a 5.5% (CI 2.9-8.0%) and 4.7% (CI 2.1-7.4%) increase in dp-ucMGP, respectively, when adjusted for age and sex. CONCLUSION Plasma dp-ucMGP levels were positively associated with obesity, BP, ePWV, and history of cardiovascular disease. These findings support that dp-ucMGP is a biomarker of cardiovascular risk, and that vitamin K status could play a role in vascular calcification. The strong association with obesity deserves further attention.
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Affiliation(s)
- T Jespersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Capital Region, Denmark.
| | - L T Møllehave
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Capital Region, Denmark
| | - B H Thuesen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Capital Region, Denmark
| | - T Skaaby
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Capital Region, Denmark
| | - P Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - U Toft
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Capital Region, Denmark
| | - N R Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - B L Corfixen
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - J Jakobsen
- National Food Institute, Technical University of Denmark, Kgs. Lyngby 2800, Denmark
| | | | - A Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Capital Region, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Mose LS, Pedersen SS, Jensen RH, Gram B. Medication-overuse headache: The effect of a patient educational programme-A randomized controlled trial. Eur J Pain 2019; 24:435-447. [PMID: 31661579 DOI: 10.1002/ejp.1500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/16/2019] [Accepted: 10/20/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Little is known about the effects of non-pharmacological interventions among medication-overuse headache (MOH) patients, although non-pharmacological approaches combined with pharmacological treatment are recommended. The objective was to evaluate the effect of an educational programme as an add-on to standard treatment. METHODS Medication-overuse headache patients were randomized (1:1) in a single-centre setting to standard treatment with 12 weeks of education (I-group) versus standard treatment (C-group). The primary outcome was measurement of reduction in headache days/last month at 9 months' follow-up. Secondary outcomes were headache intensity, acute medication intake, bothersomeness, disability, physical activity and patient satisfaction. The between-group differences were analysed using a mixed-effects model for repeated measurements with a between group factor (I-group vs. C-group) and a time factor (baseline, 4 and 9 months). RESULTS Ninety-eight patients were randomized (I-group: n = 48, C-group: n = 50), with 40 and 39 patients completing the study, respectively. Intention-to-treat analyses showed that both groups experienced statistically significant reductions in headache days/last month (I-group: -4 ± 6 days (95% CI 2.47; 5.95), p < .001) versus C-group: -4 ± 9 days ([95% CI 1.53; 6.79], p = .003), but there were no significant differences between groups (mean ± SE):Δ: 0.7 days ([95% CI, -2.50; 3.93], p = .66). At follow-up, 85% from the I-group and 86% from C-group, no longer fulfilled the criteria for MOH. CONCLUSION The compliance rate was high, indicating that patients were motivated for receiving education, but we found no additional benefits of adding an educational programme to standard treatment. Future research focusing on the MOH complexity, group heterogeneity, duration and content of educational programmes is warranted. SIGNIFICANCE Randomized controlled trials (RCTs) of non-pharmacological intervention such as patient educational programmes are of great importance, as this approach is common in the clinical practice. Medication-overuse headache (MOH) is a heterogenetic patient group, which must be taken into account when conducting RCTs of non-pharmacological interventions. An educational programme based on Motivational Interviewing is well-tolerated among MOH patients, however, no superior effects were found from adding the educational programme to standard treatment versus standard treatment alone.
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Affiliation(s)
- Louise S Mose
- Department of Neurology, University Hospital of Southern Denmark, Esbjerg, Denmark.,Research Unit of Health Sciences, University Hospital of Southern Denmark, Esbjerg, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Rigmor H Jensen
- Department of Neurology, Danish Headache Centre, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Bibi Gram
- Research Unit of Health Sciences, University Hospital of Southern Denmark, Esbjerg, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Fjerbæk A, Søndergaard L, Andreasen J, Glavind K. Treatment of urinary incontinence in overweight women by a multidisciplinary lifestyle intervention. Arch Gynecol Obstet 2019; 301:525-532. [DOI: 10.1007/s00404-019-05371-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/30/2019] [Indexed: 11/24/2022]
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O'Hara C, Ojo B, Emerson SR, Simenson AJ, Peterson S, Perkins-Veazie P, Payton ME, Hermann J, Smith BJ, Lucas EA. Acute Freeze-Dried Mango Consumption With a High-Fat Meal has Minimal Effects on Postprandial Metabolism, Inflammation and Antioxidant Enzymes. Nutr Metab Insights 2019; 12:1178638819869946. [PMID: 31452602 PMCID: PMC6700848 DOI: 10.1177/1178638819869946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 12/23/2022] Open
Abstract
Objective Postprandial fluxes in oxidative stress, inflammation, glucose, and lipids, particularly after a high-fat meal (HFM), have been implicated in the development of cardiovascular disease (CVD). The aim of this study is to determine whether acute freeze-dried mango consumption modulates the postprandial response to an HFM. We hypothesized that the addition of mango, which is a rich source of many bioactive components, to an HFM would lower postprandial triglycerides, glucose, and inflammation, and increase antioxidant enzymes, compared to a standard HFM alone. Methods In a randomized cross-over study, 24 healthy adult males (18-25 years old) consumed a typical American breakfast (670 kcal; 58% fat) with or without the freeze-dried mango pulp (50 g). Lipids, glucose, antioxidant enzymes, and inflammatory markers were assessed at baseline/fasting and 1, 2, and 4 hours after the HFM. Results Addition of mango resulted in lower glucose (95.8 ± 4.4 mg/dL; P = .002) and higher high-density lipoprotein cholesterol (HDL-C; 58.4 ± 2.7 mg/dL; P = .01) 1 hour post-HFM compared to control (glucose: 104.8 ± 5.4 mg/dL; HDL-C: 55.2 ± 2.3 mg/dL), although no differences were observed in triglycerides (P = .88 for interaction). No significant meal × time interactions were detected in markers of inflammation (C-reactive protein, P = .17; interleukin-6, P = .30) or antioxidant enzymes (superoxide dismutase, P = .77; glutathione peroxidase, P = .36; catalase, P = .32) in the postprandial period. Conclusions When added to an HFM, acute mango consumption had modest beneficial effects on postprandial glucose and HDL-C responses, but did not alter triglyceride, inflammatory, or antioxidant enzymes.
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Affiliation(s)
- Crystal O'Hara
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Babajide Ojo
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Sam R Emerson
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Ashley J Simenson
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Sandra Peterson
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
| | | | - Mark E Payton
- Department of Statistics, Oklahoma State University, Stillwater, OK, USA
| | - Janice Hermann
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Brenda J Smith
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Edralin A Lucas
- Department of Nutritional Sciences, College of Human Sciences, Oklahoma State University, Stillwater, OK, USA
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Steen Krawcyk R, Vinther A, Petersen NC, Faber J, Iversen HK, Christensen T, Lambertsen KL, Rehman S, Klausen TW, Rostrup E, Kruuse C. Effect of Home-Based High-Intensity Interval Training in Patients With Lacunar Stroke: A Randomized Controlled Trial. Front Neurol 2019; 10:664. [PMID: 31316451 PMCID: PMC6611174 DOI: 10.3389/fneur.2019.00664] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/06/2019] [Indexed: 02/03/2023] Open
Abstract
Background: High-intensity interval training (HIIT) is superior to moderate-intensity continuous training in improving cardiorespiratory fitness in patients with cardiovascular disease, but is it safe, feasible and effective in patients with stroke? We investigated feasibility and effect of early, home-based HIIT in patients with lacunar stroke combined with usual care vs. usual care, only. Methods: Patients with minor stroke (severity: 55/58 point on the Scandinavian Stroke Scale) were randomized to HIIT or usual care in a randomized, controlled trial. We measured the following outcomes at baseline and post-intervention: cardiorespiratory fitness monitored as power output from the Graded Cycling Test with Talk Test (GCT-TT; primary outcome), physical activity, fatigue, depression, well-being, stress, cognition, endothelial function, blood pressure, body mass index, and biomarkers. Results: We included 71 patients (mean age 63.7 ± 9.2), 49 men, 31 in intervention group. Home-based HIIT was feasible with no reported adverse events in relation to the intervention. No significant change between the groups in GCT-TT power output was detected (p = 0.90). The change in time spent on vigorous-intensity activity was 2 h/week and 0.6 h/week, intervention and usual care, respectively (p = 0.045). There were no significant differences between groups in the remaining secondary outcomes. Conclusion: HIIT was feasible and safe in patients with lacunar stroke. Patients can engage early in home-based HIIT when involved in choosing exercise modality and guided by weekly motivational phone calls. Within 3 months, HIIT did, however, not yield effect on cardiorespiratory fitness. We await further evaluation of long-term effects of this intervention on continued regular physical exercise and cardiovascular event. Clinical Trial Registration: https://clinicaltrials.gov, identifier NCT02731235.
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Affiliation(s)
- Rikke Steen Krawcyk
- Department of Physiotherapy and Occupational Therapy, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,QD-Research Unit, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Jens Faber
- Division of Endocrinology, Department of Internal Medicine, Faculty of Health and Medical Sciences, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Helle K Iversen
- Department of Neurology, Stroke Center Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Christensen
- Department of Neurology, Nordsjællands Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,Department of Neurology, Odense University Hospital, Odense, Denmark.,BRIDGE-Brain Research Interdisciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Shazia Rehman
- Department of Radiology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Christina Kruuse
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
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Steen Krawcyk R, Vinther A, Petersen NC, Faber J, Rehman S, Iversen HK, Christensen T, Kruuse C. Self-Reported Physical Activity and Cardiovascular Disease Risk Factors in Patients with Lacunar Stroke. J Stroke Cerebrovasc Dis 2019; 28:2168-2176. [PMID: 31130306 DOI: 10.1016/j.jstrokecerebrovasdis.2019.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/03/2019] [Accepted: 04/25/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Physical inactivity is a major modifiable risk factor for stroke. The aim was to explore if stroke patients admitted with lacunar stroke adhere to the international recommendations on physical activity prestroke (≥150 minutes of moderate-intensity activity, or ≥75 minutes of vigorous-intensity activity, or an equivalent combination). Further, to assess association between prestroke physical activity and cardiovascular disease (CVD) risk factors. METHODS A cross-sectional study, including patients with lacunar stroke according to the Trial of Org 10172 in Acute Stroke Treatment criteria. Data collected included prestroke physical activity using the self-reported Physical Activity Scale. Cardiorespiratory fitness was estimated as the power output from the Graded Cycling Test with Talk Test and sociodemographic factors including age, sex, education, and CVD risk factors including pre-existing diabetes, history of hypertension, body mass index, and lipids were assessed. RESULTS We included 19 women and 52 men (mean age 64 years). Overall, 79% of the recruited patients adhered to the physical activity recommendations prestroke, but only 35% did vigorous-intensity activity. Prestroke physical activity was associated with a history of hypertension. CONCLUSIONS A high proportion of the lacunar stroke patients reported to adhere to the recommendations on physical activity prestroke; however, only one third engaged in vigorous-intensity activity. Studies are warranted to investigate if vigorous-intensity activity is effective as secondary prevention in patients with a lacunar stroke.
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Affiliation(s)
- Rikke Steen Krawcyk
- Department of Physiotherapy and Occupational Therapy, and Department of Neurology, Neurovascular Research Unit, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, QD-Research Unit, Herlev Gentofte Hospital, Copenhagen, Denmark
| | | | - Jens Faber
- Department of Internal Medicine, division of Endocrinology, Herlev Gentofte Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Shazia Rehman
- Department of Radiology, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Helle K Iversen
- Department of Neurology, Stroke Center Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Christensen
- Department of Neurology, Nordsjællands Hospital, Hillerød, University of Copenhagen, Denmark
| | - Christina Kruuse
- Department of Neurology, Neurovascular Research Unit, Herlev Gentofte Hospital, Copenhagen, Denmark.
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Home-based aerobic exercise in patients with lacunar stroke: Design of the HITPALS randomized controlled trial. Contemp Clin Trials Commun 2019; 14:100332. [PMID: 30815618 PMCID: PMC6378897 DOI: 10.1016/j.conctc.2019.100332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/05/2018] [Accepted: 01/31/2019] [Indexed: 01/22/2023] Open
Abstract
Background The effects of physical exercise in patients with lacunar stroke, seem promising in secondary prevention and only few studies have investigated the effect of high-intensity interval training in patients with lacunar stroke. This study will be investigating whether high-intensity interval training improves cardiovascular fitness as well as cognitive- and endothelial function and potentially attenuating the risk of recurrent stroke. Methods A randomized controlled trial evaluating 12 weeks of home-based, high-intensity interval training compared with usual care. The intervention group will be exercising 15 min a day, 5 days a week, for 12 weeks. Outcomes will be evaluated at baseline, three, six and twelve months post-stroke with ‘The Graded Cycling Test with Talk Test’ as the primary outcome registered as power output in Watts. Additionally, an annually register-based follow-up will be performed for 5 years from date of inclusion with a composite endpoint of cardiovascular disease or death. Secondary outcomes will be: physical activity, endothelial response, mental well-being, cognition, mood, fatigue, stress, and MRI scan. Discussion This study is going to show if early initiated home-based high-intensity interval training is feasible and effective in patients with lacunar stroke. A self-chosen aerobic exercise modality allows a realistic implementation of practice, together with greater chance of long-term adherence. A limitation of the study is that recruitment bias cannot be ruled out, as there may be a preferential enrolment of patients who are self-motivated to engage in exercise.
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Ruge M, Skaaby T, Andersson AM, Linneberg A. Cross-sectional analysis of sleep hours and quality with sex hormones in men. Endocr Connect 2019; 8:141-149. [PMID: 30668526 PMCID: PMC6376994 DOI: 10.1530/ec-18-0548] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/22/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Reduced total hours of sleep and low quality of sleep have been suggested to be associated with low levels of male hormones. Few studies have examined the association between excessive sleep and male reproductive hormones. OBJECTIVE To investigate the association of total hours of sleep and quality of sleep with serum levels of total, bioavailable and free testosterone (tT, bT and fT), sex hormone-binding globulin (SHBG) and dehydroepiandrosteron-sulfate (DHEAS). METHODS Serum levels of tT, SHBG and DHEAS were measured with immunoassays in a cross-sectional population-based study of 2095 males. bT and fT were calculated in accordance with Vermeulens method. Information on total hours of sleep and sleep quality was obtained by questionnaire. Linear regression was used to calculate hormones according to total hours of sleep and the results were expressed as β-estimates and 95% confidence intervals (CI). The adjustment in the multivariable models was constructed taking age, BMI, smoking, alcohol intake and physical activity into account. RESULTS Excessive sleep (>9 h) compared to 7-9 h of sleep was significantly associated with lower tT, bT and fT, but not with SHBG or DHEAS, after multivariable adjustment. These significant associations were also found in our analyses with hormones as continuous variables but no associations were found in our general additive model analyses. CONCLUSIONS In this cross-sectional study in men, excessive sleep associated with lower levels of male reproductive hormones. Longitudinal studies are needed to determine the causal direction of the observed association between excessive sleep and lower male reproductive hormones levels.
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Affiliation(s)
- Morten Ruge
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Tea Skaaby
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Correspondence should be addressed to A-M Andersson:
| | - Allan Linneberg
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Brocki BC, Andreasen JJ, Westerdahl E. Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level. Integr Cancer Ther 2018; 17:1095-1102. [PMID: 30136589 PMCID: PMC6247561 DOI: 10.1177/1534735418796286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/15/2018] [Accepted: 07/24/2018] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To describe postoperative self-reported physical activity (PA) level and assess the effects of 2 weeks of postoperative inspiratory muscle training (IMT) in patients at high risk for postoperative pulmonary complications following lung resection. METHODS This is a descriptive study reporting supplementary data from a randomized controlled trial that included 68 patients (mean age = 70 ± 8 years), randomized to an intervention group (IG; n = 34) or a control group (CG; n = 34). The IG underwent 2 weeks of postoperative IMT added to a standard postoperative physiotherapy given to both groups. The standard physiotherapy consisted of breathing exercises, coughing techniques, and early mobilization. We evaluated self-reported physical activity (Physical Activity Scale 2.1 questionnaire) and health status (EuroQol EQ-5D-5L questionnaire), assessed the day before surgery and 2 weeks postoperatively. RESULTS A significant percentage of the patients in the IG reported less sedentary activity 2 weeks postoperatively when compared with the CG (sedentary 6% vs 22%, low activity 56% vs 66%, moderate activity 38% vs 12%, respectively; P = .006). The mean difference in EQ-5D-5L between the IG and CG 2 weeks postoperatively was nonsignificant ( P = .80). The overall preoperative EQ-5D-5L index score for the study population was comparable to a reference population. CONCLUSION Postoperative IMT seems to prevent a decline in PA level 2 weeks postoperatively in high-risk patients undergoing lung resection. More research is needed to confirm these findings.
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Vinge L, Jakobsen J, Andersen H. Muscle weakness and functional disability in patients with myasthenia gravis. Muscle Nerve 2018; 59:218-223. [DOI: 10.1002/mus.26356] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Lotte Vinge
- Department of Neurology; Aarhus University Hospital; Noerrebrogade 44, 8000 Aarhus Denmark
| | - Johannes Jakobsen
- Department of Neurology; Aarhus University Hospital; Noerrebrogade 44, 8000 Aarhus Denmark
| | - Henning Andersen
- Department of Neurology; Aarhus University Hospital; Noerrebrogade 44, 8000 Aarhus Denmark
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Jakobsen AS, Speyer H, Nørgaard HCB, Karlsen M, Hjorthøj C, Krogh J, Mors O, Nordentoft M, Toft U. Dietary patterns and physical activity in people with schizophrenia and increased waist circumference. Schizophr Res 2018; 199:109-115. [PMID: 29555213 DOI: 10.1016/j.schres.2018.03.016] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 03/01/2018] [Accepted: 03/11/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES People with severe mental disorders die 10-25years earlier than people in the Western background population, mainly due to lifestyle related diseases, with cardiovascular disease (CVD) being the most frequent cause of death. Major contributors to this excess morbidity and mortality are unhealthy lifestyle factors including tobacco smoking, unhealthy eating habits and lower levels of physical activity. The aim of this study was to investigate the dietary habits and levels of physical activity in people with schizophrenia spectrum disorders and overweight and to compare the results with the current recommendations and with results from the general Danish population. METHODS We interviewed a sample of 428 people with schizophrenia spectrum disorders and increased waist circumference enrolled in the CHANGE trial using a Food Frequency Questionnaire (FFQ) and a 24h recall interview, a Physical Activity Scale (PAS), scale for assessment of positive and negative symptoms (SAPS and SANS, respectively), Brief Assessment of Cognition in Schizophrenia (BACS) and Global Assessment of Functioning (GAF). We compared with information on dietary intake and physical activity in the general Danish population from the Danish National Survey of Dietary Habits and Physical Activity in 2011-2013 (DANSDA). RESULTS The CHANGE participants reported a very low energy intake and their distribution of nutrients (i.e. fat, protein and carbohydrates) harmonized with the recommendations from the Danish Health Authorities, and were similar to the latest report on the dietary habits in the Danish general population. However, the intake of saturated fat, sugar and alcohol exceed the recommended amounts and the corresponding intake in the general population. The intake of fiber, vegetables and fruit and fish were insufficient and also less than in the general population. The overall estimated quality of the dietary habits was poor, only 10.7% of the participants had healthy dietary patterns, and the quality was poorer than in the general population. Even with a very liberal definition of the term "homecooked", only 62% of the participants had taken any part in the preparation of their food. The level of physical activity was low and only one fifth of the participants complied with the recommendations of min. 30min daily moderate-to-vigorous activity. Half of the CHANGE participants were smokers, compared to 17% in the general population. Negative symptoms were significantly associated with poorer dietary quality and less physical activity, whereas no such significant associations were found for cognition, positive symptoms or antipsychotic medication. CONCLUSIONS Even when accounting for some error from recall - and social desirability bias, the findings point in the direction that the average energy intake in obese people with schizophrenia spectrum disorders is not exceeding that of the general population, and that overweight may to some degree be a result of physical inactivity and metabolic adverse effects of antipsychotic medication. The physical activity level is low and the rate of tobacco smoking is high, and our results suggest that negative symptoms play a significant role. Future research should focus on bringing about lifestyle changes in this fragile population in order to reduce the excess risk of CVD and mortality.
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Affiliation(s)
| | | | | | | | | | | | - Ole Mors
- Aarhus University Hospital, Denmark
| | | | - Ulla Toft
- Research Center for Prevention and Health, Copenhagen, Denmark
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Heffernan E, Coulson NS, Ferguson MA. Development of the Social Participation Restrictions Questionnaire (SPaRQ) through consultation with adults with hearing loss, researchers, and clinicians: a content evaluation study. Int J Audiol 2018; 57:791-799. [PMID: 29966457 DOI: 10.1080/14992027.2018.1483585] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This research aimed to evaluate the content of the Social Participation Restrictions Questionnaire (SPaRQ) in terms of its relevance, clarity, comprehensiveness, acceptability to adults with hearing loss, and responsiveness. DESIGN Cognitive interviews and a subject matter expert survey were conducted. The interview data were analysed using thematic analysis and a taxonomy of questionnaire clarity problems. Descriptive statistics were calculated for the survey data. STUDY SAMPLE Fourteen adults with hearing loss participated in the cognitive interviews. Twenty clinicians and academics completed the subject matter expert survey. RESULTS The majority of the SPaRQ content was found to be relevant, clear, comprehensive, and acceptable. However, an important clarity problem was identified: many adults with hearing loss struggled to switch from answering positively worded items (e.g. "I can attend social gatherings") to answering negatively-worded items (e.g. "I feel isolated"). Several subject matter experts found responsiveness difficult to assess. The SPaRQ was amended where necessary. CONCLUSION Few hearing-specific questionnaires have undergone content evaluation. This study highlights the value of content evaluation as a means of identifying important flaws and improving the quality of a measure. The next stage of this research is a psychometric evaluation of the measure.
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Affiliation(s)
- Eithne Heffernan
- a National Institute for Health Research Nottingham Biomedical Research Centre , Nottingham , UK.,b Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine , University of Nottingham , Nottingham , UK
| | - Neil S Coulson
- c Division of Rehabilitation and Ageing, School of Medicine , University of Nottingham , Nottingham , UK
| | - Melanie A Ferguson
- a National Institute for Health Research Nottingham Biomedical Research Centre , Nottingham , UK.,b Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine , University of Nottingham , Nottingham , UK.,d Nottingham University Hospitals National Health Service Trust , Nottingham , UK
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Mose LS, Pedersen SS, Debrabant B, Jensen RH, Gram B. The role of personality, disability and physical activity in the development of medication-overuse headache: a prospective observational study. J Headache Pain 2018; 19:39. [PMID: 29802536 PMCID: PMC5970129 DOI: 10.1186/s10194-018-0863-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/06/2018] [Indexed: 01/03/2023] Open
Abstract
Background Factors associated with development of medication-overuse headache (MOH) in migraine patients are not fully understood, but with respect to prevention, the ability to predict the onset of MOH is clinically important. The aims were to examine if personality characteristics, disability and physical activity level are associated with the onset of MOH in a group of migraine patients and explore to which extend these factors combined can predict the onset of MOH. Methods The study was a single-center prospective observational study of migraine patients. At inclusion, all patients completed questionnaires evaluating 1) personality (NEO Five-Factor Inventory), 2) disability (Migraine Disability Assessment), and 3) physical activity level (Physical Activity Scale 2.1). Diagnostic codes from patients’ electronic health records confirmed if they had developed MOH during the study period of 20 months. Analyses of associations were performed and to identify which of the variables predict onset MOH, a multivariable least absolute shrinkage and selection operator (LASSO) logistic regression model was fitted to predict presence or absence of MOH. Results Out of 131 participants, 12 % (n=16) developed MOH. Migraine disability score (OR=1.02, 95 % CI: 1.00 to 1.04), intensity of headache (OR=1.49, 95 % CI: 1.03 to 2.15) and headache frequency (OR=1.02, 95 % CI: 1.00 to 1.04) were associated with the onset of MOH adjusting for age and gender. To identify which of the variables predict onset MOH, we used a LASSO regression model, and evaluating the predictive performance of the LASSO-mode (containing the predictors MIDAS score, MIDAS-intensity and –frequency, neuroticism score, time with moderate physical activity, educational level, hours of sleep daily and number of contacts to the headache clinic) in terms of area under the curve (AUC) was weak (apparent AUC=0.62, 95% CI: 0.41-0.82). Conclusion Disability, headache intensity and frequency were associated with the onset of MOH whereas personality and the level of physical activity were not. The multivariable LASSO model based on personality, disability and physical activity is applicable despite moderate study size, however it can be considered as a weak classifier for discriminating between absence and presence of MOH.
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Affiliation(s)
- Louise S Mose
- Department of Neurology, Hospital Southwest Jutland, Esbjerg, Denmark. .,The Research Unit of Health Science, Hospital of Southwest Jutland, Esbjerg and Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Birgit Debrabant
- Epidemiology, Biostatistics and Biodemography Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Rigmor H Jensen
- Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Bibi Gram
- The Research Unit of Health Science, Hospital of Southwest Jutland, Esbjerg and Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Abstract
Little is known about the effect of long-term diet patterns on the composition and functional potential of the human salivary microbiota. In the present study, we sought to contribute to the ongoing elucidation of dietary effects on the oral microbial community by examining the diversity, composition and functional potential of the salivary microbiota in 160 healthy vegans and omnivores using 16S rRNA gene amplicon sequencing. We further sought to identify bacterial taxa in saliva associated with host inflammatory markers. We show that compositional differences in the salivary microbiota of vegans and omnivores is present at all taxonomic levels below phylum level and includes upper respiratory tract commensals (e.g. Neisseria subflava, Haemophilus parainfluenzae, and Rothia mucilaginosa) and species associated with periodontal disease (e.g. Campylobacter rectus and Porphyromonas endodontalis). Dietary intake of medium chain fatty acids, piscine mono- and polyunsaturated fatty acids, and dietary fibre was associated with bacterial diversity, community structure, as well as relative abundance of several species-level operational taxonomic units. Analysis of imputed genomic potential revealed several metabolic pathways differentially abundant in vegans and omnivores indicating possible effects of macro- and micro-nutrient intake. We also show that certain oral bacteria are associated with the systemic inflammatory state of the host.
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Pedersen ESL, Mortensen LH, Brage S, Bjerregaard AL, Aadahl M. Criterion validity of the Physical Activity Scale (PAS2) in Danish adults. Scand J Public Health 2017; 46:726-734. [PMID: 29081247 DOI: 10.1177/1403494817738470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Physical Activity Scale (PAS2) was developed to measure physical activity (PA) during work, transportation and leisure time, in the Danish adult population. The objective of this study was to assess the criterion validity of PAS2 against a combined accelerometer and heart rate monitor in Danish adults and to investigate if the criterion validity differed by socio-demographic factors and body mass index. METHOD A total of 330 Danish adults (mean age = 46.7 years, 38.5% men) participating in the Health2008 study completed the PAS2 questionnaire and wore a combined accelerometer and heart rate sensor for seven days. Average daily estimates from PAS2 were categorised into time spent in sedentary behaviour, light PA, moderate PA and vigorous PA and were compared to the objective measures. RESULTS PAS2 accounted for 19.5 hours/day on average. Time spent in sedentary behaviour, light and moderate-intensity PA was weakly correlated with objective data (polychoric correlation coefficients (PCC): 0.18-0.20), whereas vigorous intensity PA was moderately correlated (PCC: 0.54, p = 0.04). Mean bias was -2.3 hours/day (95% limits of agreement (LoA): -9.04 to 4.34) for sedentary behaviour, 1.68 hours/day (LoA: 8.02 to -4.62) for light activity, 0.55 hours/day (LoA: 3.37 to -2.26) for moderate activity and 0.12 hours/day (LoA: 0.57 to 0.33) for vigorous activity. Criterion validity was lower in women, in participants who were above 40 years, overweight, had short education and were unemployed. CONCLUSIONS PAS2 overestimated time spent on light, moderate and vigorous intensity PA and underestimated time spent on sedentary behaviour. Validity differed by key socio-demographic characteristics.
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Affiliation(s)
- E S L Pedersen
- 1 Institute of Social and Preventive Medicine, University of Bern, Switzerland.,2 Research Centre for Prevention and Health, Rigshospitalet, Glostrup, Denmark
| | - L H Mortensen
- 3 Section of Social Medicine, University of Copenhagen, Denmark.,4 Methods and Analysis, Statistics Denmark, Copenhagen, Denmark
| | - S Brage
- 5 MRC Epidemiology Unit, University of Cambridge, UK
| | - A L Bjerregaard
- 6 Section of General Practice, Department of Public Health, Aarhus University, Denmark
| | - M Aadahl
- 2 Research Centre for Prevention and Health, Rigshospitalet, Glostrup, Denmark.,7 Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Jakobsen AS, Speyer H, Nørgaard HCB, Karlsen M, Birk M, Hjorthøj C, Mors O, Krogh J, Gluud C, Pisinger C, Nordentoft M. Effect of lifestyle coaching versus care coordination versus treatment as usual in people with severe mental illness and overweight: Two-years follow-up of the randomized CHANGE trial. PLoS One 2017; 12:e0185881. [PMID: 28985228 PMCID: PMC5630147 DOI: 10.1371/journal.pone.0185881] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/30/2017] [Indexed: 12/23/2022] Open
Abstract
The objective of this trial was to assess the long-term effect of the CHANGE lifestyle coaching intervention for 428 people with abdominal obesity and schizophrenia spectrum disorders on cardiovascular risk. In this randomized, superiority, multi-center clinical trial, participants were randomized to 12 months of either lifestyle coaching plus care coordination (N = 138), care coordination alone, (N = 142) or treatment as usual (N = 148). There was no effect after 12 months, but we hypothesized that there might have been a delayed treatment effect. Our primary outcome at two-year follow-up was 10-year risk of cardiovascular disease standardized to 60 years of age. After two-years the mean 10-year cardiovascular-disease risk was 8.7% (95% confidence interval (CI) 7.6–9.9%) in the CHANGE group, 7.7% (95% CI 6.5–8.9%) in the care coordination group, and 8.9% (95% CI 6.9–9.2%) in the treatment as usual group (P = 0.24). Also, there were no intervention effects for any secondary or exploratory outcomes, including cardiorespiratory fitness, weight, physical activity, diet and smoking. No reported adverse events could be ascribed to the intervention. We conclude that there was neither any direct nor any long-term effect of individual lifestyle coaching or care coordination on cardiovascular risk factors in people with abdominal obesity and schizophrenia spectrum disorders. The trial was approved by the Ethics Committee of Capitol Region Copenhagen, Denmark (registration number: H-4-2012-051) and the Danish Data Protection Agency (registration number: 01689 RHP-2012-007). The trial was funded by the Mental Health Services of the Capital Region of Denmark, the Lundbeck Foundation, the Tryg Foundation, the Danish Ministry of Health, and the Dæhnfeldts Foundation.
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Affiliation(s)
- Ane Storch Jakobsen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Helene Speyer
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Christian Brix Nørgaard
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mette Karlsen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Birk
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Carsten Hjorthøj
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Jesper Krogh
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Charlotta Pisinger
- Research Centre for Prevention and Health, Capitol Region, Copenhagen, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Evans SF, Beebe M, Mahmood M, Janthachotikun S, Eldoumi H, Peterson S, Payton M, Perkins-Veazie P, Smith BJ, Lucas EA. Mango Supplementation Has No Effects on Inflammatory Mediators in Obese Adults. Nutr Metab Insights 2017; 10:1178638817731770. [PMID: 28983188 PMCID: PMC5621662 DOI: 10.1177/1178638817731770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/18/2017] [Indexed: 12/19/2022] Open
Abstract
This pilot study examined the effects of freeze-dried mango (Mangifera indica L.) supplementation on anthropometric measurements, lipid parameters, and inflammatory mediators in obese individuals. A total of 20 obese (body mass index [BMI]: 30-35 kg/m2) adults (11 men and 9 women), aged 20 to 50 years, received 10 g/d of ground freeze-dried mango pulp for 12 weeks. Anthropometrics, lipids, and inflammatory mediators were assessed at baseline and after 12 weeks of mango supplementation. There were no differences between baseline and final visits in inflammatory mediators, lipids, diet, physical activity, and anthropometrics. Relationships were present at baseline and final visits between adiponectin and high-density lipoprotein cholesterol and between leptin and fat mass. Correlations were found after 12 weeks of mango supplementation between leptin and the following variables: waist-to-height ratio, BMI, percent fat, and fat mass. Our findings demonstrate that 12-week consumption of freeze-dried mango by obese individuals has no impact on obesity-related inflammation.
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Affiliation(s)
- Shirley F Evans
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Maureen Beebe
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Maryam Mahmood
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | | | - Heba Eldoumi
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Sandra Peterson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Mark Payton
- Department of Statistics, Oklahoma State University, Stillwater, OK, USA
| | - Penelope Perkins-Veazie
- Department of Horticulture Science, North Carolina Research Campus, North Carolina State University, Kannapolis, NC
| | - Brenda J Smith
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Edralin A Lucas
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Shafiee G, Ostovar A, Heshmat R, Darabi H, Sharifi F, Raeisi A, Mehrdad N, Shadman Z, Razi F, Amini MR, Arzaghi SM, Meybodi HA, Soltani A, Nabipour I, Larijani B. Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II). BMJ Open 2017; 7:e013606. [PMID: 28780537 PMCID: PMC5577871 DOI: 10.1136/bmjopen-2016-013606] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Musculoskeletal disorders and cognitive diseases are prevalent, and they are significant determinants of morbidity and mortality in older adults. The aim of this study is to investigate the prevalence of musculoskeletal and cognitive diseases and their risk factors and also to assess their associations during future follow-ups. METHODS AND ANALYSIS Bushehr Elderly Health (BEH) programme is a population-based prospective cohort study being conducted in Bushehr, a southern province of Iran. A total of 3000 older people aged ≥60 years participated in the first stage from which 2772 were eligible to participate in the second stage, which started after 2.5 years. Data including demographic status, lifestyle factors, general healthandmedical history, and mentalandfunctional health are collected through a questionnaire. Anthropometric measures, performance testsandmuscle strength, blood pressure and and body composition measurements are done. A total 25 cc venous blood is taken, and sera are stored at -80°C for possible future analyses. ETHICS AND DISSEMINATION The study protocol was approved by the ethics committee of Endocrinology and Metabolism Research Institute, affiliated to Tehran University of Medical Science as well as the Research Ethics Committee of Bushehr University of Medical Sciences. A written informed consent was signed by all the participants. The study findings will show the prevalence of musculoskeletal disease, cognitive impairment and their risk factors in an elderly population. The participants will be followed during the study to measure the occurrence outcomes.This study will also have the potential to inform the development of beneficial interventions to improve the management of musculoskeletal and cognitive impairment in Iran and other countries in the Middle East.Our findings will be disseminated via scientific publication as well as presentation to stakeholders, including the patients, clinicians, the public and policymakers, via appropriate avenues.
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Affiliation(s)
- Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Darabi
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Raeisi
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Neda Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhaleh Shadman
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Faride Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Amini
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Aghaei Meybodi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Soltani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Lonkvist CK, Lønbro S, Vinther A, Zerahn B, Rosenbom E, Primdahl H, Hojman P, Gehl J. Progressive resistance training in head and neck cancer patients during concomitant chemoradiotherapy -- design of the DAHANCA 31 randomized trial. BMC Cancer 2017; 17:400. [PMID: 28578654 PMCID: PMC5457597 DOI: 10.1186/s12885-017-3388-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 05/25/2017] [Indexed: 02/06/2023] Open
Abstract
Background Head and neck cancer patients undergoing concomitant chemoradiotherapy (CCRT) frequently experience loss of muscle mass and reduced functional performance. Positive effects of exercise training are reported for many cancer types but biological mechanisms need further elucidation. This randomized study investigates whether progressive resistance training (PRT) may attenuate loss of muscle mass and functional performance. Furthermore, biochemical markers and muscle biopsies will be investigated trying to link biological mechanisms to training effects. Methods At the Departments of Oncology at Herlev and Aarhus University Hospitals, patients with stage III/IV squamous cell carcinoma of the head and neck, scheduled for CCRT are randomized 1:1 to either a 12-week PRT program or control group, both with 1 year follow-up. Planned enrollment is 72 patients, and stratification variables are study site, sex, p16-status, and body mass index. Primary endpoint is difference in change in lean body mass (LBM) after 12 weeks of PRT, assessed by dual-energy X-ray absorptiometry (DXA). The hypothesis is that 12 weeks of PRT can attenuate the loss of LBM by at least 25%. Secondary endpoints include training adherence, changes in body composition, muscle strength, functional performance, weight, adverse events, dietary intake, self-reported physical activity, quality of life, labor market affiliation, blood biochemistry, plasma cytokine concentrations, NK-cell frequency in blood, sarcomeric protein content in muscles, as well as muscle fiber type and fiber size in muscle biopsies. Muscle biopsies are optional. Discussion This randomized study investigates the impact of a 12-week progressive resistance training program on lean body mass and several other physiological endpoints, as well as impact on adverse events and quality of life. Furthermore, a translational approach is integrated with extensive biological sampling and exploration into cytokines and mechanisms involved. The current paper discusses decisions and methods behind exercise in head and neck cancer patients undergoing concomitant chemoradiotherapy. Trial registration Approved by the Regional Ethics Committee for the Capital Region of Denmark (protocol id: H-15003725) and registered retrospectively at ClinicalTrials.gov (NCT02557529) September 11th 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3388-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Camilla K Lonkvist
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Simon Lønbro
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Section for Sports Science, Aarhus University, Aarhus, Denmark
| | - Anders Vinther
- Department of Rehabilitation, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Eva Rosenbom
- Nutritional Research Unit, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Hanne Primdahl
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Julie Gehl
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
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Phelan A, Fealy G, Downes C. Piloting the older adult financial exploitation measure in adult safeguarding services. Arch Gerontol Geriatr 2017; 70:148-154. [DOI: 10.1016/j.archger.2017.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 01/16/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
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