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Objective: Although center-based supervised physical activity interventions have proved to be successful in attenuating health declines in older adults, such methods can be costly and have limited reach. In the present study, we examined the effects of a DVD-delivered exercise intervention on self-esteem and its subdomains and the extent to which these effects were maintained. In addition, we examined whether psychological, demographic, and biological factors acted as determinants of self-esteem., Methods: Low-active, older adults (n = 307; mean [standard deviation] age =71.0 [5.1] years) were randomly assigned to a 6-month, home-based exercise program consisting of a DVD-delivered exercise intervention focused on increasing flexibility, toning, and balance (FlexToBa) or an attentional control DVD condition focused on healthy aging. Physical self-worth and three subdomains of self-esteem, global self-esteem, and self-efficacy were assessed at baseline, 6 months, and 12 months., Results: There was a differential effect of time for the two groups for physical self-worth (F interaction(2,530.10) = 4.17, p = .016) and perception of physical condition (F interaction(1,630.77) = 8.31, p = .004). Self-efficacy, sex, body mass index, and age were significant predictors of changes in physical self-worth and perception of physical condition., Conclusion: Our findings suggest that a DVD-delivered exercise intervention is efficacious for improving and maintaining subdomain and domain levels of self-esteem in older adults. In addition, self-efficacy was the strongest predictor of changes in physical self-worth and perceptions of physical condition. This innovative method of delivering an exercise training program via DVD is practical and effective and has the potential for broad reach and dissemination., Trial Registration: Clinicaltrials.govidentifier:NCT01030419.

Background: Persons with multiple sclerosis (MS) often experience a decrease in walking performance while simultaneously performing a cognitive task. This decrease in walking performance is termed dual task cost (DTC). Objective: To examine if mobility and cognitive function are correlates of DTC in persons with MS. Methods: Participants were 96 persons with MS who had Expanded Disability Status Scale scores that ranged between 2.0 and 6.5. To determine DTC, participants walked at a self-selected pace with and without a cognitive task while gait velocity was recorded. The effect of the cognitive task was quantified as the percent change in walking velocity between conditions. Participants further completed the timed 25-foot walk (T25FW) and Symbol Digit Modalities Test (SDMT). Centered scores for the T25FW and SDMT, and the product of the center scores, were placed into a linear regression to determine the correlates of DTC. Results: DTC averaged 12.5% (SD = 9.3) and ranged between −14.1 and 42.4%. Performance on the T25FW ranged between 3.1 and 24.5 s with an average of 6.8 s (SD = 3.1 s). SDMT scores ranged between 15 and 79 with an average of 45 items (SD = 12). Regression analysis revealed that age, disability, walking and cognitive performance explained 17% of the variance in DTC. The interaction between walking and cognition did not explain additional variance. Conclusions: Mobility and cognitive impairment were both independent predictors of DTC of walking in persons with MS. This raises the possibility that DTC could be reduced with modifications of either mobility or cognition. [ABSTRACT FROM AUTHOR]

Background: There is a need to identify why multiple sclerosis exercise research is not translating into real-world participation. To lay the foundations of strong clinical research, considering the translational element of implementation science at the feasibility phase of a trial is vital. Methods: Document analysis was used to examine document sources on exercise activity interventions designed for people living with multiple sclerosis. Document sources focused on multiple sclerosis research that incorporated exercise prescription elements and behaviour change and were feasibility studies incorporating aspects of implementation science. Results: Implementation science should come much earlier than the efficacy or effectiveness research pipeline. An alternate view is outlined where feasibility and implementation science should meet based on case examples that have not yet shown strong efficacy or effectiveness. Findings from our key themes indicate a need for a cyclical iterative approach to the translational process. Multiple aspects of feasibility and how it can be assessed using an implementation science lens to support more successful interventions are provided. The determination of feasibility in behaviour change should involve implementation science as feasibility is drawn on for theory development, optimising the intervention design and quality of implementation strategies, and identifying those delivering the intervention before conducting efficacy and effectiveness research. Conclusions: Document analysis methodology is underused in qualitative research and was appropriate to use as it was a very resource, time-efficient and an unobtrusive process that could track change and development to explore the integration of implementation science at the feasibility phase, with the findings indicating the earlier implementation science is introduced into multiple sclerosis exercise interventions the better. [ABSTRACT FROM AUTHOR]

It is common for some participants in self-report surveys to be careless, inattentive, or lacking in effort. Data quality can be severely compromised by responses that are not based on item content (non-content-based [nCB] responses), leading to strong biases in the results of data analysis and misinterpretation of individual scores. In this study, we propose a specification of factor mixture analysis (FMA) to detect nCB responses. We investigated the usefulness and effectiveness of the FMA model in detecting nCB responses using both simulated data (Study 1) and real data (Study 2). In the first study, FMA showed reasonably robust sensitivity (.60 to .86) and excellent specificity (.96 to .99) on mixed-worded scales, suggesting that FMA had superior properties as a screening tool under different sample conditions. However, FMA performance was poor on scales composed of only positive items because of the difficulty in distinguishing acquiescent patterns from valid responses representing high levels of the trait. In Study 2 (real data), FMA detected a minority of cases (6.5%) with highly anomalous response patterns. Removing these cases resulted in a large increase in the fit of the unidimensional model and a substantial reduction in spurious multidimensionality., (© 2023. The Author(s).)

There is debate in the literature regarding the magnitude, nature, and influence of cognitive impairment in individuals with relapsing-remitting multiple sclerosis (RRMS). Therefore, we conducted a meta-analysis that quantified the overall magnitude of cognitive impairment in individuals with RRMS and identified the domains of cognition and clinical/demographic variables that were moderators of the overall effect. We included 57 studies with 3891 participants that yielded a total of 755 effect sizes. Overall, there was a moderate decline in cognitive functioning in individuals with RRMS compared with healthy controls. Larger effects were observed in cognitive domains of motor functioning, mood status and memory and learning. Regarding demographic and clinical variables, age and gender were moderators of cognitive impairment in all cognitive domains, whereas neurological disability and disease duration primarily moderated performance on tasks assessing memory and learning. [ABSTRACT FROM AUTHOR]

Using meta-analytic procedures, this study examined the overall effect of exercise training interventions on quality of life (QOL) among individuals with multiple sclerosis (MS). We searched MEDLINE, PSYCHINFO and CURRENT CONTENTS PLUS for the period of 1960 to November 2006 using the key words exercise, physical activity and physical fitness in conjunction with QOL and MS. We further conducted a manual search of bibliographies of the retrieved papers as well as literature reviews and contacted study authors about additional studies. Twenty-five journal articles were located and reviewed, and only 13 provided enough data to compute effect sizes expressed as Cohen's d. One hundred and nine effect sizes were retrieved from the 13 studies with 484 MS participants and yielded a weighted mean effect size of g = 0.23 (95% CI = 0.15, 0.31). There were larger effects associated with MS-specific measures of QOL and fatigue as an index of QOL. The nature of the exercise stimulus further influenced the magnitude of the mean effect size. The cumulative evidence supports that exercise training is associated with a small improvement in QOL among individuals with MS. [ABSTRACT FROM AUTHOR]

Background. We previously developed questionnaires based on contemporary theories to measure physical activity determinants among youth [Motl et al., Prev Med 2000; 31:584–94]. The present study examined the factorial invariance and latent mean structure of unidimensional models fit to the questionnaires measuring attitude, subjective norm, perceived behavioral control, and self-efficacy about physical activity among black and white adolescent girls.Methods. Black (n = 896) and white (n = 823) girls in the 8th grade completed the questionnaires measuring attitude, subjective norm, perceived behavioral control, and self-efficacy about physical activity. The responses were subjected to analyses of factorial invariance and latent mean structure using confirmatory factor analysis with full-information maximum likelihood estimation in AMOS 4.0.Results. The unidimensional models of the four questionnaires generally demonstrated invariance of the factor structure, factor loadings, and factor variance across race but not invariance of the variance-covariance matrices or item uniquenesses. The analyses of latent mean structure demonstrated that white girls had higher latent mean scores on the measures of attitude and self-efficacy than black girls; there were similar, but smaller, differences between white and black girls on the measures of subjective norm and perceived behavioral control.Conclusions. The questionnaires can be employed in interventions to test the mediating influences of attitude, subjective norm, perceived behavioral control, and self-efficacy on participation in physical activity by black and white adolescent girls. [Copyright &y& Elsevier]

Background: Aging is commonly accompanied by increased arterial and ventricular stiffness (determined by arterial elastance (Ea) and ventricular elastance (Elv)), augmented ventricular-vascular coupling ratios (Ea/Elv) and systemic inflammation. Acute inflammation may impact ventricular-vascular coupling and predispose older adults to cardiovascular events. However, physically active older adults have more compliant large arteries and left ventricles and lower inflammation than sedentary older adults. We hypothesized that acute inflammation would alter Ea, Elv, and Ea/Elv more in older versus younger adults but that higher levels of physical activity would attenuate inflammation-induced changes., Methods: End-systolic and central blood pressures were obtained using applanation tonometry before and at 24 and 48 h post-influenza vaccination in 24 older and 38 younger adults. Ultrasonography was used to measure ventricular volumes and other indices of cardiac performance. Physical activity was measured with accelerometry., Results: Ea and Ea/Elv were maintained (p > 0.05), but Elv was reduced (p < 0.05) 24 h post-inflammation. Other indices of systolic performance were reduced in older but not younger adults; diastolic performance was attenuated in both groups 24 h post-inflammation (p < 0.05 for all). Older, but not younger, adults decreased central pressure during inflammation (p < 0.05). When controlled for age, physical activity was not related to the inflammation-induced changes in elastance (p > 0.05) except in the most active group of seniors (p < 0.05)., Conclusions: Aging did not affect the elastance responses but did affect central blood pressure and other ventricular systolic responses to acute inflammation. Aging, not physical activity, appears to modulate cardiovascular responses to acute inflammation, except in the most active older adults., (© The European Society of Cardiology 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

After an initial meeting in 2013 that reviewed adherence to disease modifying therapy, the AD@MS group conducted a follow-up meeting in 2014 that examined adherence to behavioural interventions in MS (e.g. physical activity, diet, psychosocial interventions). Very few studies have studied adherence to behavioural interventions in MS. Outcomes beyond six months are lacking, as well as implementation work in the community. Psychological interventions need to overcome stigma and other barriers to facilitate initiation and maintenance of behaviour change. A focus group concentrated on physical activity and exercise as one major behavioural intervention domain in MS. The discussion revealed that patients are confronted with multiple challenges when attempting to regularly engage in physical activity. Highlighted needs for future research included an improved understanding of patients' and health experts' knowledge and attitudes towards physical activity as well as a need for longitudinal research that investigates exercise persistence.

Background and purpose: Individuals with multiple sclerosis (MS) want health advice regarding participation in their choice of exercise. To address this need, a flexible exercise participation programme (FEPP) was developed, underpinned by the MS aerobic exercise guidelines and supported by a physiotherapist using behaviour change techniques. The aim of this study was to investigate the feasibility of the FEPP for individuals with minimal disability from MS. Methods: A feasibility study utilising a single group pre/post‐intervention design was conducted. The 12‐week FEPP was completed by 10 individuals with MS (EDSS 0–3.5). Exercise progression in duration, intensity or frequency of exercise (in line with MS exercise guidelines) was guided by a self‐perceived weekly energy level score, and weekly telephone coaching sessions using behavioural change techniques. Trial feasibility was assessed via measures of process (recruitment and retention), resources/management (communication time; data entry) and scientific feasibility (safety; compliance). Secondary FEPP feasibility outcomes included the Goal Attainment Scale (GAS) T‐score, exercise participation (weekly exercise diary), high‐level mobility (HiMAT), vitality (Subjective Vitality Scale), biomarkers for inflammation (cytokines levels [IL2, IL4, IL6, IL10, TNF and IFNγ]), and acceptability (participant survey). Results: Process: In total, 11 (85%) of 13 eligible participants enroled at baseline with 10 (91%) completing the study. Resources/management: Coaching sessions included a baseline interview—mean 39 min (SD: 6.6) and telephone coaching—mean 10 min (SD: 3.8) per week. Outcome measure data collection time—mean 44 min (SD: 2.1). Scientific feasibility: Two participants experienced a fall during their exercise participation. Self‐reported compliance was high (99%). GAS T‐scores increased significantly, indicating achievement of exercise participation goals. Secondary outcomes showed trends towards improvement. Discussion: The FEPP was feasible, safe and highly acceptable for use with individuals with MS and warrants a larger trial to explore effectiveness. [ABSTRACT FROM AUTHOR]

Background: We reported that a social cognitive theory-based (SCT), Internet-delivered behavioral intervention increased device-measured minutes/day of moderate-to-vigorous physical activity (MVPA) over a 6-month period among persons with multiple sclerosis (MS). This paper examined the pattern and predictors of heterogeneity in change for MVPA. Based on previous research, we hypothesized that mild MS disability, fewer MS symptoms, lower baseline MVPA, and positive SCT characteristics (e.g., high exercise self-efficacy) would be associated with greater change in MVPA. Method: Persons with MS (N = 318) were randomized into behavioral intervention (n = 159) or attention/social contact control (n = 159) conditions that were administered via Internet websites and supported with behavioral coaching. Demographic, clinical, symptom, behavioral, and SCT data were from before the 6-month period of delivering the conditions, and MVPA data were from before and after the 6-month period. We examined heterogeneity based on waterfall plots, box plots, and the Levene statistic. We identified predictors of MVPA change using bivariate correlation and multiple, linear regression analyses per condition. Results: The Levene statistic indicated statistically significant heterogeneity of variances for MVPA change between conditions (p =.003), and the waterfall plots and box plots indicated greater heterogeneity in MVPA change for the behavioral intervention. MVPA change score was correlated with baseline MVPA (r = −.33 and r = −.34, p =.0004 and p =.0001) in both conditions and walking impairment (r = −.188, p =.047) and race (r =.233, p =.014) in the behavioral intervention condition. The regression analysis indicated that baseline MVPA (Standardized B = −.449, p =.000002), self-reported walking impairment (Standardized B = −.310, p =.0008), and race (Standardized B =.215, p =.012) explained 25.6% of variance in MVPA change for the behavioral intervention condition. Conclusion: We provide evidence for walking impairment, baseline MVPA, and race as predictors of the heterogeneity in the pattern of MVPA change with a behavioral intervention. [ABSTRACT FROM AUTHOR]

Background: Fatigue and inactivity are linked to decreased health-related quality of life (HRQoL) in chronic conditions. A multidimensional approach to activity pacing may improve HRQoL by promoting physical activity (PA) and alleviating fatigue. Addressing fatigue across chronic conditions is crucial, especially when underlying causes are unknown. This study aimed to (1) examine associations between HRQoL, fatigue, pacing, risk of overactivity, PA, and self-regulation of PA in adults with chronic conditions and (2) examine if these associations differ across HRQoL domains: physical, social, emotional, and functional well-being. Methods: Sixty-six adults with chronic conditions were recruited from UK fatigue clinics and the community. HRQoL, pacing, risk of overactivity, PA, and self-regulation of PA were assessed with standardised questionnaires and Actigraph monitor. Associations were analysed with linear mixed models, correcting for confounders. Results: HRQoL was significantly associated with fatigue (B=-7.82), pacing (B=-0.23), and self-regulation of PA (B = 0.11). Interaction effects revealed fatigue's impact on HRQoL varied significantly in physical (β=-13.49), social (β=-6.81), and emotional (β=-4.10) domains. Pacing showed significant differences in physical (β=-0.49), social (β=-7.12), and emotional (β=-7.45) domains. Perceived overactivity differed in social domain (β=-6.27), while device-based PA differed in physical (β = 0.35) and social (β = 5.73). Conclusion: The negative association between fatigue and HRQoL underscores the importance of effective fatigue management. Higher pacing engagement and lower HRQoL may indicate higher fatigue. Positive associations between self-regulation and PA with HRQoL emphasise benefits of appropriate PA behaviours. The stronger impact of decreased fatigue, increased pacing, and PA on physical well-being suggests a multidimensional fatigue management approach. [ABSTRACT FROM AUTHOR]

Aphasia, a communication disorder caused primarily by left-hemisphere stroke, affects millions of individuals worldwide, with up to 70% experiencing significant reading impairments. These deficits negatively impact independence and quality of life, highlighting the need for effective treatments that target the cognitive and neural processes essential to reading recovery. This Randomized Clinical Trial (RCT) aims to test the efficacy of a combined intervention incorporating aerobic exercise training (AET) and phono-motor treatment (PMT) to enhance reading recovery in individuals with post-stroke aphasia. AET, known for its positive impact on cerebral blood flow (CBF) and oxygenation, is hypothesized to facilitate neuroplasticity when administered before PMT, an intensive therapy aimed at strengthening phonological processing. While most existing treatments focus on spoken language production, this study builds on evidence that PMT can also improve reading skills. The study is structured as a Phase I/II clinical trial and compares the effects of AET plus PMT to a control condition of stretching plus PMT on reading and other language outcomes including naming, auditory comprehension, and spontaneous speech. Additionally, it investigates the immediate and sustained impacts of the intervention on CBF, functional connectivity, and task-evoked brain activity. The central hypothesis posits that AET will increase CBF and, when combined with PMT, will lead to enhanced reading recovery, supporting treatment-induced plasticity. This trial represents one of the first large-scale interventions targeting post-stroke reading impairments and provides critical insights into the potential of combining AET with cognitive rehabilitation to improve language recovery in aphasia. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is a significant public health concern associated with numerous adverse health outcomes and substantial economic costs. This study describes the prevalence, trends and correlates for adherence to moderate to vigorous physical activity (MVPA) guidelines among a large sample of U.S. adults. Methods: Data from the 2011, 2013, 2015, 2017, and 2019 Behavioral Risk Factor Surveillance System surveys were analyzed. Self-reported MVPA was assessed by the same item across each survey. Population-weighted prevalence was calculated for meeting MVPA guidelines (150+ mins/wk). Adjusted prevalence ratios for reporting sufficient MVPA across sociodemographic, behavioral and health variables were calculated by multivariate Poisson regression. Results: Data was available for 2,052,288 respondents (≥ 18 years). Across the surveys, the prevalence of sufficient MVPA fluctuated but remained between 49.5% and 51.1%. Among those aged 18 to 24, the prevalence of sufficient MVPA declined between surveys, from 56.5% in 2011 to 49.7% in 2019. Notable correlates of adhering to guidelines included male sex, higher education, former and never smokers, normal body mass index and increased fruit and vegetable consumption. Conclusion: From 2011 to 2019, approximately half of US adults reported sufficient MVPA, with a steady decline observed among young adults. While many identified correlates of adhering to PA guidelines were observed, this study has provided further evidence for correlates that had previously provided inconsistent or inconclusive results. These findings emphasize the complexity of addressing physical inactivity and the importance of multifaceted public health strategies tailored to diverse populations. [ABSTRACT FROM AUTHOR]

Improvisation is a form of theater with no predetermined script. All actors create a flow based on two core principles: "Yes, and..." and "No mistakes," referring to accepting what the partner offers unconditionally, and embracing all contributions to creating content without judgment. This pilot study investigated whether 12 weeks of improv intervention can help alleviate individuals' obsessive-compulsive disorder symptoms. A questionnaire package was given to participants to complete at three different points. The results showed statistically significant decreases in participants' OCD, depression, and anxiety scores from pretest to posttest measurements. By its very nature, improv intervention may help create an atmosphere full of unpredictability and invite participants to be a part of it. In improv, participants are encouraged to take risks, be in the moment, and trust each other to manage challenges. This paper will also present a discussion of possible mechanisms of change to explain the effects of improv. [ABSTRACT FROM AUTHOR]

Background/Objectives: Patients with COPD have altered self-esteem, and good self-esteem promotes personal, health, and social success. Improving self-esteem could be a method for encouraging the maintenance of physical activity. Only one study has evaluated the effects of pulmonary rehabilitation (PR) on self-esteem in moderate COPD patients. The objective was to assess the evolution of self-esteem in COPD patients of all stages of severity during PR. Methods: COPD patients undergoing PR were included in this prospective observational study. Patients were evaluated before and after the 4-week PR program. The objectives were to (1) assess the evolution of self-esteem using the Physical Self Inventory-6 questionnaire (PSI-6), (2) assess the evolution in each sub-score of PSI-6, (3) examine the correlations between the evolution of self-esteem and the evolution of parameters usually used during PR, and (4) determine an MID for self-esteem. Results: In total, 76 patients were included. We found that there was a significant increase in the total score in PSI-6 (9.29, p < 0.001), CI 95% [6.74; 11.83], and in the sub-scores of PSI-6. The evolution of the PSI-6 score was moderately correlated with changes in exercise capacity using STST1 (r = 0.352, p = 0.002) and quality of life (r = −0.361, p = 0.001) and weakly correlated to changes in dyspnea (r = −0.245, p = 0.03), anxiety (r = −0.248, p = 0.03), and depression (r = −0.290, p = 0.01). Using a distribution-based analysis, we found an MID between 5.2 and 5.6. Conclusions: We showed a significant increase in global score and in each sub-score of self-esteem using PSI-6 in COPD patients undergoing a PR program. We propose an MID of 5.6. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a neurodegenerative disease that often leads to severe disability. Although exercise, particularly strength training, improves health outcomes in MS, no standardized, reliable tool exists for functional assessment to inform tailored exercise prescriptions and patients' categorization. This study aimed to validate the reliability of the MScope battery, a comprehensive tool incorporating structural, functional, and neuromuscular assessments to objectively evaluate patients with MS. A reproducibility study was conducted with 40 MS patients who completed the MScope battery twice, 72 h apart. Tests included structural (muscle thickness of the vastus lateralis and rectus femoris), functional (sit-to-stand, timed up-and-go, 10 m and six-minute walking test), and neuromuscular tests (isometric strength during the squat and leg extension exercises and handgrip strength). Intraclass correlation coefficients (ICCs), Bland–Altman plots, and the coefficient of variation (CV) were used to evaluate intra- and inter-day reliability. The MScope battery showed high intra- and inter-day reliability, with ICC values ranging from 0.79 to 0.99. Muscle thickness measurements, along with handgrip strength, demonstrated excellent reliability (ICC > 0.9, CV < 5%). Functional tests, including the timed up-and-go, 10 m walk, and sit-to-stand variations, maintained consistent scores (ICC > 0.85, CV < 10%). The six-minute walking test exhibited excellent inter-day reliability (ICC = 0.94, CV < 4%). Neuromuscular assessments showed strong reliability with minor day-to-day variability (ICC = 0.75–0.95, CV < 8%). The battery's overall consistency supports its use as a reliable tool for assessing functional status in MS patients. [ABSTRACT FROM AUTHOR]

Parkinson's disease is a neurodegenerative disorder principally manifested as motor disabilities. In clinical practice, diagnostic rating scales are available for broadly measuring, classifying, and characterizing the disease progression. Nonetheless, these scales depend on the specialist's expertise, introducing a high degree of subjectivity. Thus, diagnosis and motor stage identification may be affected by misinterpretation, leading to incorrect or misguided treatments. This work addresses how to learn multimodal representations based on compact gait and eye motion descriptors whose fusion improves disease diagnosis prediction. This work introduces a noninvasive multimodal strategy that combines gait and ocular pursuit motion modalities into a geometrical Riemannian Neural Network for PD quantification and diagnostic support. Markerless gait and ocular pursuit videos were first recorded as Parkinson's observations, which are represented at each frame by a set of frame convolutional deep features. Then, Riemannian means are computed per modality using frame-level covariances coded from convolutional deep features. Thus, a geometrical learning representation is adjusted by Riemannian means, following early, intermediate, and late fusion alternatives. The adjusted Riemannian manifold combines input modalities to obtain PD prediction. The geometrical multimodal approach was validated in a study involving 13 control subjects and 19 PD patients, achieving a mean accuracy of 96% for early and intermediate fusion and 92% for late fusion, increasing the unimodal accuracy results obtained in the gait and eye movement modalities by 6 and 8%, respectively. The proposed method was able to discriminate Parkinson's patients from healthy subjects using multimodal geometrical configurations based on covariances descriptors. The covariance representation of video descriptors is highly compact (with an input size of 625 and an output size of 256 (1 BiRe)), facilitating efficient learning with a small number of samples, a crucial aspect in medical applications. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to 1) examine relationships between contexts of PA, personality traits, and high school sports participation (sports) and 2) determine significant PA correlates in a college population. Participants: 237 undergraduates at a university in the United States between September 2020 and May 2021 participated. Methods: Participants completed a survey evaluating PA, personality traits, sports, and demographic variables. Pearson partial correlations assessed correlations between different PA domains, personality traits, and sports. Conscientiousness was positively associated with all PA measures (r =.14-.30), except for active transport PA. Sports were related to vigorous and leisure PA. Conscientiousness is related to PA measures and is a significant PA correlate. However, more research is necessary to understand if leisure time PA can enhance Conscientiousness. [ABSTRACT FROM AUTHOR]

Purpose: As people with long-standing disabling conditions age, the interplay between pre-existing conditions and new comorbidities can present unique challenges. Therefore, the current study explored relationships between resilience and health, health promotion, and quality of life among older adults living with multiple sclerosis (MS). Method: Adults recruited from National MS Society chapters completed a mailed survey about their health, health promotion, and well-being. Results: The 147 respondents (mean age = 72 years) reported an average of three additional comorbidities and had been diagnosed with MS for 35 years on average. Resilience scores were most highly correlated with depressive symptoms, spiritual growth, social support, incapacity status, and quality of life. Resilience scores significantly improved prediction of emotional health, after controlling for other functional and psychosocial variables. Conclusion: Nurses can help patients with chronic conditions, such as MS, develop strategies for regulating their emotional health to adapt to new health challenges. [Journal of Gerontological Nursing, 51(1), 15–23.] [ABSTRACT FROM AUTHOR]

Aims: To investigate the prevalence of physical inactivity in older adults living in nursing homes and explore the determinants of physical inactivity by using the Capability, Opportunity, Motivation–Behaviour model. Design: A multisite, cross‐sectional study was performed by convenience sampling and questionnaire survey. Methods: A total of 390 nursing home residents were recruited from three nursing homes in Southern China from May 2022 to April 2023. The participants completed a self‐designed general information questionnaire, Physical Activity Scale for the Elderly, Self‐Efficacy for Exercise Scale, Exercise Benefits Scale, Patient Health Questionnaire‐9 and the Short Physical Performance Battery test. Descriptive statistics, univariate analysis, Spearman correlation analysis, and ordinal logistic regression were applied for data analysis. Results: The prevalence of physical inactivity among the nursing home residents reached 88.46%. Ordinal logistic regression results showed that exercise self‐efficacy, perceived exercise benefits, physical function, availability of physical activity instruction, having depression, number of chronic diseases and living with spouse were the main influencing determinants of physical inactivity and explained 63.7% of the variance. Conclusions: Physical inactivity was considerable in nursing home residents in China and influenced by complex factors. Tailored measures should be designed and implemented based on these factors to enhance physical activity while considering the uniqueness of Chinese culture. Implications for the profession and patient care: Healthcare professionals should enhance physical activity of residents by increasing benefits understanding, boosting self‐efficacy, improving physical function, alleviating depression and integrating personalized physical activity guidance into routine care services. And more attention should be paid to the residents who had more chronic diseases or did not live with spouse. Impact: Physical inactivity is a significant problem in nursing home residents. Understanding physical inactivity and its determinants enables the development of tailored interventions to enhance their physical activity level. Reporting method: This study was reported conforming to the STROBE statement. Patients or Public Contribution: Nursing home residents who met the inclusion criteria were recruited. [ABSTRACT FROM AUTHOR]

Introduction: Anodal transcranial direct current stimulation (tDCS) has been reported to modulate gamma-aminobutyric acid levels and cerebral energy consumption in the brain. This study aims to investigate long-term GABA and cerebral energy modulation following anodal tDCS over the primary motor cortex. Method: To assess GABA and energy level changes, proton and phosphorus magnetic resonance spectroscopy data were acquired before and after anodal or sham tDCS. In anodal stimulation, a 1 mA current was applied for 20 min, and the duration of ramping the current up/down at the start and end of the intervention was 10 s. In the sham-stimulation condition, the current was first ramped up over a period of 10 s, then immediately ramped down, and the condition was maintained for the next 20 min. Results: The GABA concentration increased significantly following anodal stimulation in the first and second post-stimulation measurements. Likewise, both ATP/Pi and PCr/Pi ratios increased after anodal stimulation in the first and second post-stimulation measurements. Conclusion: The approach employed in this study shows the feasibility of measuring long-term modulation of GABA and high-energy phosphates following anodal tDCS targeting the left M1, offering valuable insights into the mechanisms of neuroplasticity and energy metabolism, which may have implications for applications of this intervention in clinical populations. [ABSTRACT FROM AUTHOR]

Introduction: Neuropsychiatric symptoms such as depression and anxiety are a significant burden on patients with multiple sclerosis (MS). Their pathophysiology is complex and yet to be fully understood. There is an urgent need for non-invasive treatments that directly target the brain and help patients with MS. One such possible treatment is transcranial direct current stimulation (tDCS), a popular and effective non-invasive brain stimulation technique. Methods: This mechanistic review explores the efficacy of tDCS in treating depression and anxiety in MS while focusing on the underlying mechanisms of action. Understanding these mechanisms is crucial, as neuropsychiatric symptoms in MS arise from complex neuroinflammatory and neurodegenerative processes. This review offers insights that may direct more focused and efficient therapeutic approaches by investigating the ways in which tDCS affects inflammation, brain plasticity, and neural connections. Searches were conducted using the PubMed/Medline, ResearchGate, Cochrane, and Google Scholar databases. Results: The literature search yielded 11 studies to be included in this review, with a total of 175 patients participating in the included studies. In most studies, tDCS did not significantly reduce depression or anxiety scores as the studied patients did not have elevated scores indicating depression and anxiety. In the few studies where the patients had scores indicating mild/moderate dysfunction, tDCS was more effective. The risk of bias in the included studies was assessed as moderate. Despite the null or near-null results, tDCS may still prove to be an effective treatment option for depression and anxiety in MS, because tDCS produces a neurobiological effect on the brain and nervous system. To facilitate further work, several possible mechanisms of action of tDCS have been reported, such as the modulation of the frontal–midline theta, reductions in neuroinflammation, the modulation of the HPA axis, and cerebral blood flow regulation. Conclusions: Although tDCS did not overall demonstrate positive effects in reducing depression and anxiety in the studied MS patients, the role of tDCS in this area should not be underestimated. Evidence from other studies indicates the effectiveness of tDCS in reducing depression and anxiety, but the studies included in this review did not include patients with sufficient depression or anxiety. Future studies are needed to confirm the effectiveness of tDCS in neuropsychiatric dysfunctions in MS. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a chronic neurological condition resulting in decreased aerobic capacity (peak VO2). The hemodynamic responses to peak exercise in MS are unknown. Further, it is unknown if the hemodynamic responses are due to disease or fitness. Therefore, the purpose was to compare hemodynamic response to peak exercise between individuals with and without MS, with similar peak VO2. Individuals with MS (n = 21) and CON (n = 21) underwent maximal incremental cycle exercise test to assess peak aerobic capacity (peak VO2). Heart rate, stroke volume, cardiac output, and blood pressure were obtained every other minute of the exercise test. There were no significant group differences in peak VO2. All hemodynamic variables increased similarly from baseline to peak exercise in both MS and CON. There was a significant group by time interaction for HR in individuals with MS (p < 0.01), accounted for by age, but no group by time interactions in MAP (p = 0.78), SV (p = 0.11), or Q (p = 0.86). Our findings suggest that individuals with and without MS, with similar peak VO2, have similar hemodynamic responses to peak exercise. Our data suggest that fitness is a key underlying determinants of hemodynamics responses in individuals with MS. [ABSTRACT FROM AUTHOR]

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Background: Lifestyle interventions can promote improvement in dietary intake and physical activity (PA), on average, by strengthening motivation, self-regulatory efforts, and commitment to behavioral change. However, maintenance of behavioral change is challenging, and slow responders during treatment often experience less overall success. Adaptive intervention sequences tailored to treatment response may be more effective in sustaining behavioral change. Methods: Adults ≥ 21 years old with prediabetes (n = 187) were stratified at week five to the standard Group Lifestyle Balance (GLB) intervention, if they achieved > 2.5% weight loss, or to the augmented intervention GLB Plus (GLB+) at week five, if they did not. At month five, each person in a matched pair was randomly assigned to GLB or GLB + for the extended intervention phase (months 5-12) followed by no study conduct (months 13-18). The primary comparison of interest was the change in outcomes between the standard (GLB followed by GLB) and augmented (GLB + followed by GLB+) intervention sequences post-intervention at 12 – and 18-months using linear mixed effect models. Results: The augmented GLB + intervention sequence reported a decline in the change in self-efficacy for reducing fat intake, self-efficacy for 'sticking to' healthy eating and exercise, and hopeful thought and planning compared to the standard GLB intervention sequence (all P < 0.0167) at 18-months. However, there were no significant differences between these intervention sequences at 18-months in the change in dietary intake or minutes of PA (all P > 0.05). Conclusions: No significant change in behavioral measures across intervention sequences occurred at study end. An 18-month decline in self-efficacy regarding diet and PA and hopeful thought and planning among slow responders following no intervention for six months indicates greater extended care is likely needed. The type of extended care that is most effective for slow treatment responders requires additional research. [ABSTRACT FROM AUTHOR]

Despite growing interest in public confidence in criminal justice, robust confidence measures have not yet been established. Two studies were conducted to develop multidimensional measures of public confidence in criminal justice. Study 1 involved two-phased construction of scales in which a preliminary inventory was generated and then finalized after psychometric evaluations. Six multidimensional scales (62 items) were constructed for measuring efficiency-, finality-, fairness-, lawfulness-, accuracy-, and transparency-oriented confidence. Study 2 tested the predictive ability of the scale scores for cooperation with criminal justice institutions. Results highlight that higher confidence in authorities' accurate fact-finding and fair treatment predicted greater willingness to assist institutions. Higher confidence in authorities' lawfulness predicted greater compliance with the law. The six scales developed are a reliable and valid tool for measuring confidence in criminal justice and predicting cooperation with criminal institutions. [ABSTRACT FROM AUTHOR]

Copyright of Revija Šport is the property of Sport: Revija Za Teoreticna in Praticna Vprasanja Sporta and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revija Šport is the property of Sport: Revija Za Teoreticna in Praticna Vprasanja Sporta and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Cannabis-based medication has recently been made available in the NHS for reducing pain and spasticity in patients with multiple sclerosis (MS). The currently available preparation of Sativex (nabiximols) contains a combination of botanical cannabis extracts with cannabidiol (CBD) and tetrahydrocannabinol (THC) with almost equal amounts in addition to minor cannabinoids and terpenoids and is delivered via an oro-mucosal spray. The present study aims to examine the use and trends in prescribing cannabinoid-based Sativex to control pain in patients diagnosed with MS. Methods: Primary care prescribing data for cannabinoid-based Sativex (2013-2022) from the Prescription Cost Analysis were extracted and analysed. Linear regression analyses were performed to examine prescription trends and prescription costs (average change per year). Results: There was a general increasing trend in the number of prescriptions each year, from 4.42 items dispensed per 100,000 people in 2013 to 5.15 in 2022. Overall, prescription items for cannabinoid-based Sativex increased by 0.34% per year (95% CI:−3.98, 4.67, p = 0.860) on average between 2013 and 2022. On average, a 2.43% (95% CI: −5.78, 0.92, p = 0.133) increase per year was observed for the costs of cannabinoid-based Sativex from 2013 to 2022. Conclusion: The results suggested that cannabinoid-based Sativex should be considered an option due to its effectiveness, acceptable tolerance, and safety profile in the prescribing of Sativex. [ABSTRACT FROM AUTHOR]

This study aims to demonstrate the effect of a transtheoretical model (TTM)-based physical activity program on the exercise behavior of adolescents using WhatsApp. The study was conducted with high school students (N = 185) in a pre-/posttest, quasi-experimental design. TTM-based text messages were sent to the intervention group (n = 95) over WhatsApp every day for 8 weeks. The intervention group demonstrated more statistically significant progression in the exercising stages of change compared to the control group (n = 90) (χ2 = 20.10; p =.00). It was also found that this group had a higher exercising self-efficacy score (t = 2.647; p =.009) and a higher physical activity total metabolic equivalent of task score (Z = −3.521; p =.000). There was no significant difference in BMI and perception of pros and cons (p >.05). The program was found to be effective in terms of recording progress in the exercising stages of change, increasing exercising self-efficacy, and maintaining a physical activity program. [ABSTRACT FROM AUTHOR]

Drawing on the self-injury and self-conscious emotion literatures, this study examined the functions of and motivations for self-injury in 67 women, 25 of whom had a history of nonsuicidal self-injury (NSSI). Specifically, the present study tested whether women with a history of NSSI engaged in such behavior in order to reduce shame, in particular, and whether shame-related constructs represent important motivational factors for NSSI. To do so, participants completed (a) self-reports of NSSI functions and relevant personality dimensions (e.g., shame-proneness; shame aversion); and (b) a pain-inducing laboratory task with assessments of state emotions pre- and post-task. Elevations in aversion to general negative affect were associated with presence (vs. absence) of an NSSI history. However, consistent with a role for shame in NSSI, among women with an NSSI history, endorsement of shame regulation functions was positively associated with the frequency of NSSI. Moreover, elevations in shame-proneness were associated with more frequent NSSI, even after taking relevant, broader personality dimensions (e.g., proneness to general negative affect) into account. Finally, following the laboratory task, women with and without an NSSI history experienced reductions in state shame. Future directions for and clinical implications of the present research are discussed., (PsycINFO Database Record (c) 2014 APA, all rights reserved)

Background: Sedentary behaviour (SB) among adults with Down syndrome (DS) may differ based on personal or environmental factors., Objective: Investigate differences in SB levels and patterns of adults with DS based on sex, age, and residence-type across weekdays and weekends., Methods: Thirty-four adults with DS (15 men; 37 ± 12 years) underwent accelerometry-based measurements of sedentary time, bouts, and breaks for 7 days. We evaluated differences with 2 × 2 mixed-model (group-by-day) ANOVA., Results: Younger (19-36 years) individuals had less sedentary time (p = .042), and shorter (p = .048) and fewer (p = .012) bouts than older (37-60 years) individuals. Group home residents had more bouts on weekends than adults living with parent/guardians (p = .015)., Conclusions: Adults with DS spent half their waking hours in SB of short bouts. Age and residence may influence SB., (© 2023 John Wiley & Sons Ltd.)

The present review focuses on exercise as a treatment for depression in multiple sclerosis. While exercise has emerged as a potentially useful treatment in the general psychiatry-depression literature, the findings from a small number of multiple sclerosis-related treatment trials are equivocal. Methodological limitations, including the absence of depression as a primary endpoint, characterize all the studies completed to date. Given that limitations in study design can be rectified, it is time to put exercise to the test once more. Depressed multiple sclerosis patients and those involved in their care are looking for guidance here because the prevailing zeitgeist promotes the benefits of exercise to mood. But first, some clarity is needed.

BACKGROUND: Fatigue is the most prevalent symptom among people with multiple sclerosis (PwMS). Although exercise effectively reduces fatigue, the relationship between daily physical activity and fatigue has only recently been demonstrated. OBJECTIVE: The aim of this study was to evaluate the prevalence of fatigue and to understand the relationship with several variables in French PwMS. METHODS: Data were collected from 191 PwMS using Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) for fatigue, and the Godin Leisure-Time Exercise Questionnaire (GLTEQ) for physical activity. RESULTS: 110 PwMS (57%), 35 PwMS (18%) and 46 PwMS (24%) were considered as fatigued, non-fatigued and in the grey zone, respectively. Greater physical activity was observed in non-fatigued PwMS (20.2±19.8) compared to fatigued PwMS (12.5±14.1). FSS and MFIS scores were associated with physical activity (r = –0.28 and r = –0.25, respectively, p < 0.05). Using multivariate analysis, disability, physical activity and being unemployed explained 21% of the variance of the MFIS. CONCLUSIONS: The present study confirms that physical activity and fatigue are associated. Disability and unemployment status should also to be consider when assessing fatigue. Activity-oriented health policies should be redesigned to improve fatigue among PwMS. [ABSTRACT FROM AUTHOR]

The present study examined the relationship between the worsening of symptoms across a 3-5-year period of time and self-reported physical activity in a sample of 51 individuals with multiple sclerosis (MS). Of the 51 participants, 35 reported a worsening of symptoms over the 3-5-year period of time. The worsening of symptoms was associated with significantly and moderately lower levels of selfreported physical activity independent of depression and EDSS scores and MS-disease course (P=0.04). This study provides novel evidence that a worsening of symptoms is associated with lower levels of physical activity in individuals with MS. [ABSTRACT FROM AUTHOR]

Background: Theoretically, self-regulatory strategies (e.g., goal setting, self-monitoring) are an important influence of behavior change, but very little research has examined the relationship between self-regulation and physical activity (PA) behavior. Petosa's (1993) 43-item PA self-regulation scale (PASR-43) affords the opportunity for studying this construct in the context of PA; however the PASR-43 has not been tested for structural aspects of validity. Therefore, this study examines the structural validity of the PASR-43 in older adults., Methods: The structural validity of the PASR-43 was tested in a large sample of older adults from North and South Carolina and Ohio (N = 460) using maximum likelihood estimation and confirmatory factor analysis in AMOS 5.0., Results: The original 6-factor model for the PASR-43 scale did not represent an acceptable fit to the data (chi2 = 4732.25, df = 845, P < .0001, RMSEA = 0.10, NNFI = 0.67, CFI = 0.71). Based on a post hoc specification search, iterative model modifications resulted in a 12-item PA self-regulation scale (PASR-12) that represented an excellent fit to the data (chi2 = 70.75, df = 39, P = .001, RMSEA = 0.04, NNFI = 0.98, CFI = 0.99)., Conclusions: The PASR-12 provides a concise and valid measure of PA self-regulation for use with older adults. Future studies should cross-validate the PASR-12 and examine invariance across time and between age, ethnic, gender, and geographical groups.

Multiple sclerosis (MS) is the most common neurological disorder in young adults. The prevalence of walking impairment in people with MS (pwMS) is estimated between 41% and 75%. To evaluate the walking capacity in pwMS, the patient reported outcomes (PROs) and performance-based tests (i.e., the 2-minute walk test, the 6-minute walk test, the Timed 25-Foot Walk Test, the Timed Up and Go Test, and the Six Spot Step Test) could be used. However, some studies point out that the results of both performance-based tests and objective measures (i.e., by accelerometer) could not reflect patient reports of walking performance and impact of MS on daily life. This review analyses different motion sensors embedded in smartphones and motion wearable device (MWD) that can be useful to measure free-living walking behavior, to evaluate falls, fatigue, sedentary lifestyle, exercise, and quality of sleep in everyday life of pwMS. Caveats and limitations of MWD such as variable accuracy, user adherence, power consumption and recharging, noise susceptibility, and data management are discussed as well. [ABSTRACT FROM AUTHOR]

Switching attention between or within tasks is part of the implementation and maintenance of executive control processes and plays an indispensable role in our daily lives: It allows us to perform on distinct tasks and with variable objects, enabling us to adapt to and respond in dynamically changing environments. Here, we tested if yoga could benefit switching of attention between distinct objects of one's focus (e.g., through practicing switching between one's own body, feelings, and different postures) in particular and executive control in general. We therefore conducted a randomized controlled trial with 98 participants and a waitlisted control group. In the intervention group, healthy yoga novices practiced Hatha yoga 3x a week, for 8 weeks. We conducted two experiments: A purely behavioral task investigating changes in behavioral costs during switching between attentional control sets (74 participants analyzed), and a modality-switching task focusing on electrophysiology (EEG data of 47 participants analyzed). At the electrophysiological level, frequency-tagging indicated no interventional effect on participants' ability to switch between the auditory and visual modalities. However, increases in task-related frontocentral theta activity, resulting from the intervention, indicated an ability to increasingly deploy executive resources to the prioritized task when needed. At the behavioral level, our intervention resulted in more efficient holding of target representations in working memory, indicated by decreased mixing costs. Again, however, intervention effects on switching costs were missing. We, thus, conclude that Hatha yoga has a positive influence on executive control, potentially through improvements in working memory rather than directly on switching. Clinical trial registration: clinicaltrials.gov , identifier [NCT05232422]. [ABSTRACT FROM AUTHOR]

Background: Self-esteem is a psychological term that, since its emergence in 1890 with William James, has been widely studied. Furthermore, this construct has been examined in different areas of psychology, including the clinical field, where its relationship with mental health and low levels of depression has been demonstrated. In the realm of positive psychology, its connection to resilience and life satisfaction has also been established. Evaluating self-esteem in military personnel is essential, as healthy self-esteem can enhance resilience, improve performance, and promote emotional well-being. Objective: To evaluate validity based on internal structure from the perspective of Classical Test Theory (CTT) and Item Response Theory (IRT), to obtain evidence of validity based on the relationship with other variables, and to estimate the reliability of the Rosenberg Self-Esteem Scale (RSES). Method: To this end, 584 military personnel from the three ranks of the Spanish Army (officers, non-commissioned officers, and professional soldiers and sailors) were evaluated, of which 511 were men (87.70%) and 72 were women (12.30%), with an age range of 18 to 66 years (M = 33.17, SD = 7.38). Results: The results indicate that the unidimensional structure of the RSES shows adequate fit indices (CFI = 0.94, TLI = 0.91, SRMR = 0.05), while the difficulty and discrimination parameters exhibited favorable values. Additionally, an acceptable reliability value was found (ɷ = 0.81; α = 0.80). Conclusions: Therefore, it is concluded that the RSES-JGA presents adequate psychometric properties of validity and reliability, making it a useful and relevant instrument for measuring self-esteem in military personnel of the Spanish Army. This will make it possible to measure the level of self-esteem in military personnel, i.e., the set of perceptions, thoughts, evaluations, feelings, and behavioral tendencies directed towards oneself, one's own way of being, and towards one's own body and character traits. [ABSTRACT FROM AUTHOR]

Background/Objectives: Individuals with subjective cognitive decline (SCD) have an increased risk of developing dementia, while non-pharmacological multicomponent lifestyle interventions are recommended for prevention/management. The Greek Interventional Geriatric Initiative to Prevent Cognitive Impairment and Disability (GINGER) is such a multicomponent approach, encompassing simultaneous interventions (cognitive training, depression and sleep management, etc.). Exercise/Physical activity (PA) is suggested as one such intervention. This study (i) presents the exercise protocol developed for GINGER and (ii) explores its feasibility (acceptability, applicability, adherence, users' satisfaction and reliability). Methods: Exercise/PA protocol development, targeting SCD individuals aged > 55 years, utilized relevant guidelines/literature followed by focus group involving exercise specialists. Data were synthesized through consensus to design optimal exercise interventions prescribed on participant's physical capacity (heart rate, exertion, etc.), comprising 6-month combined aerobic, strengthening, balance and dual-task exercises, delivered 3 times/weekly in two group-based supervised sessions (in-person and online) and one home-based session. Physical outcomes include balance, aerobic capacity [2-Minute Walk Test (2 MWT), IPAQ-7], strength [Hand Grip Strength (HGS), Sit-to-Stand], fear of falling. Eligibility for entering intervention is low IPAQ-7, 2 MWT or HGS scoring. Feasibility was explored with adherence (exercise diaries and Exercise Adherence Rating Scale) and satisfaction (Patient Satisfaction Questionnaire) Results: Intervention was easily delivered with good reliability across testers' assessments on 13 SCD participants (ICCs = 0.62–0.99), and improved physical outcomes, whereas users' adherence and satisfaction scored highly. Conclusions: The exercise protocol for SCD was feasible, acceptable, applicable, reliable, demonstrating adherence and satisfaction, while improving physical parameters. It is thus integrated in the GINGER study, where multiple simultaneous interventions will take place to prevent/enhance cognitive function. [ABSTRACT FROM AUTHOR]