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Background: Kidney transplantation offers meaningful health improvements compared to dialysis, yet the quality of life and life expectancy of kidney transplant recipients still lag behind those of their healthy peers. Physical inactivity and poor physical fitness are prevalent among kidney transplant recipients, affecting overall life participation. Objectives: To explore challenges hindering life participation for kidney transplant recipients and reveal facilitators and barriers to integrating rehabilitation into their daily lives. Design: An explorative study using a qualitative method. Participants: Fourteen purposively selected kidney transplant recipients. Approach: Semistructured, individual interviews were conducted posttransplantation. The following topics were covered: living with chronic kidney disease, pretransplantation challenges, posttransplantation recovery, engagement in various activities, including physical activity, and the need for supervised exercise rehabilitation programmes. Interviews were recorded and transcribed verbatim, and an inductive thematic analysis approach was used. Findings: Data saturation occurred after analysing 12 interviews, revealing two main themes: the impact on life participation and the impact on physical and mental functioning. Participants expressed the need for comprehensive posttransplant care, including mental health support, family education and guidance on returning to work. Structured support in managing physical fitness, tailored to individual preferences, was also recognised as important. Conclusions: The study underscores the necessity for a biopsychosocial approach to posttransplant care that addresses the multifaceted challenges faced by kidney transplant recipients. A multidisciplinary approach, tailored support, education and individualised exercise programmes are crucial for enhancing their overall well‐being and integrating rehabilitation into their daily lives, considering both physical and psychosocial aspects. [ABSTRACT FROM AUTHOR]

Aims: Ankle fractures are common, mainly affecting adults aged 50 years and over. To aid recovery, some patients are referred to physiotherapy, but referral patterns vary, likely due to uncertainty about the effectiveness of this supervised rehabilitation approach. To inform clinical practice, this study will evaluate the effectiveness of supervised versus self-directed rehabilitation in improving ankle function for older adults with ankle fractures. Methods: This will be a multicentre, parallel-group, individually randomized controlled superiority trial. We aim to recruit 344 participants aged 50 years and older with an ankle fracture treated surgically or non-surgically from at least 20 NHS hospitals. Participants will be randomized 1:1 using a web-based service to supervised rehabilitation (four to six one-to-one physiotherapy sessions of tailored advice and prescribed home exercise over three months), or self-directed rehabilitation (provision of advice and exercise materials that participants will use to manage their recovery independently). The primary outcome is participant-reported ankle-related symptoms and function six months after randomization, measured by the Olerud and Molander Ankle Score. Secondary outcomes at two, four, and six months measure health-related quality of life, pain, physical function, self-efficacy, exercise adherence, complications, and resource use. Due to the nature of the interventions, participants and intervention providers will be unblinded to treatment allocation. Conclusion: This study will assess whether supervised rehabilitation is more effective than self-directed rehabilitation for adults aged 50 years and older after ankle fracture. The results will provide evidence to guide clinical practice. At the time of submission, the trial is currently completing recruitment, and follow-up will be completed in 2024. Cite this article: Bone Jt Open 2024;5(6):499–513.

Objective: To analyse the components used in exercise interventions for people with symptoms of neurogenic claudication due to lumbar spinal stenosis and identify components associated with successful interventions. Data sources: Eligible papers published up to April 2023 from MEDLINE, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and trial registry websites. Review methods: Literature searches were performed by an Information Specialist. We searched for randomised trials evaluating exercise interventions for people with neurogenic claudication symptoms (the primary symptom of lumbar spinal stenosis). Two authors independently performed study selection, data extraction, and quality assessments using the Cochrane Risk of Bias tool Version 2 and the TIDieR checklist for intervention reporting. Details of intervention components were extracted, tabulated, and synthesised using an intervention component analysis approach. Results: We found thirteen trials reporting 23 exercise interventions delivered to 1440 participants. These featured 60 different components. Most exercise interventions included supervision and flexion-based exercises. Balance exercises were rarely included. Exercise components featured more frequently in successful interventions included stretches, strength or trunk muscle exercises, fitness exercises, especially cycling, and psychologically informed approaches. Interpretation is limited by low study numbers and heterogeneity. No conclusions could be drawn about exercise supervision or dose. Discussion: Exercise interventions for people with neurogenic claudication typically feature multiple components. Common features such as supervision, lumbar flexion, and aerobic fitness exercises and also less common features such as stretches, strengthening exercises, and psychologically informed approaches warrant consideration for inclusion when designing and optimising exercise interventions for people with lumbar spinal stenosis. [ABSTRACT FROM AUTHOR]

This study focuses on men undergoing androgen deprivation therapy (ADT) treatment for prostate cancer who also participated in an exercise programme as part of their rehabilitation. Our aim was twofold. First, we aimed to describe and analyse how the participants talk about their treatment and its side-effects in relation to the body and masculinity. Second, we aimed to describe the participants' understanding of and motivation to participate in a physical activity programme designed by healthcare professionals to deal with anticipated and unwanted bodily changes following treatment. Focus group interviews and individual interviews were conducted. Theoretically, the study leans on phenomenological theories of embodiment combined with a sociologically informed framework found in critical studies on men and masculinity. The results showed that the medical suspension of testosterone impacted not only the men's understanding of themselves as men but also how they approached their own bodies. Testosterone was discussed as a source of masculinity and masculine traits. Consequently, the absence of testosterone following treatment led to ongoing reflections on how to understand the (ageing) body and its relationship to masculinity. The ageing ADT body, with growing breasts and a lack of libido, became a site of emasculation and bodily detachment. The men addressed this by displaying stoic masculinity; instead of addressing the problem emotionally they turned their attention and aspirations to having a capable body and being able to carry out physical work. However, participation in the exercise programme depended on recruitment by their physicians and was motivated by the opportunity to socialise with other men in the same situation. [ABSTRACT FROM AUTHOR]

Background: While past research has underscored the benefits of physical activity for people with Down syndrome (DS), exercise programming that is customised to and/or accessible for children and adolescents with DS is limited. The objectives of this pilot were to (1) develop and refine an engaging exercise programme for adolescents with DS, called DSFit; (2) assess feasibility over the course of two pilot iterations; and (3) examine participant and parent feedback regarding exercise priorities and the DSFit exercise programme. Method: Participants were 12 unique adolescents (ages 11–17 years) with DS. Both pilot iterations of the programme consisted of weekly group exercise sessions and home exercises to complete between sessions. Physical fitness and mood/behaviour were assessed at baseline and at the end of the intervention. Parent and child goal‐setting and feedback surveys were collected before and immediately after the intervention, and a 2‐month follow‐up assessed physical activity and exercise attitudes. Quality improvement methodology and participant/parent feedback were used to modify the second iteration to better meet the needs of our study population. Changes included an expanded age range, modified physical assessments, decreased burden of questionnaires, and video‐recorded group sessions for at‐home practice. Results: Physical fitness evaluation of core/trunk strength and stability, lower‐ and upper‐body strength, balance, flexibility, and walking was feasible, and the majority of participants in both pilot iterations improved in at least one category of physical assessment between baseline and end of intervention. Assessment of symptoms of anxiety, depression and behavioural concerns was also feasible and results showed slight improvements in some participants. Both parent and participant feedback indicated that participants enjoyed the programme and appreciated the opportunity to start developing sustainable exercise habits. Conclusions: A group exercise programme with supported at‐home components is feasible for adolescents with DS. Future iterations will continue to examine programme efficacy with improved fitness testing and larger sample sizes. Strategies to increase at‐home compliance, such as virtual sessions and parent/guardian‐guided physical fitness assessments, will also be incorporated. [ABSTRACT FROM AUTHOR]

This study focuses on men undergoing androgen deprivation therapy (ADT) treatment for prostate cancer who also participated in an exercise programme as part of their rehabilitation. Our aim was twofold. First, we aimed to describe and analyse how the participants talk about their treatment and its side-effects in relation to the body and masculinity. Second, we aimed to describe the participants’ understanding of and motivation to participate in a physical activity programme designed by healthcare professionals to deal with anticipated and unwanted bodily changes following treatment. Focus group interviews and individual interviews were conducted. Theoretically, the study leans on phenomenological theories of embodiment combined with a sociologically informed framework found in critical studies on men and masculinity. The results showed that the medical suspension of testosterone impacted not only the men’s understanding of themselves as men but also how they approached their own bodies. Testosterone was discussed as a source of masculinity and masculine traits. Consequently, the absence of testosterone following treatment led to ongoing reflections on how to understand the (ageing) body and its relationship to masculinity. The ageing ADT body, with growing breasts and a lack of libido, became a site of emasculation and bodily detachment. The men addressed this by displaying stoic masculinity; instead of addressing the problem emotionally they turned their attention and aspirations to having a capable body and being able to carry out physical work. However, participation in the exercise programme depended on recruitment by their physicians and was motivated by the opportunity to socialise with other men in the same situation.

Lower back pain (LBP) is the most prevalent musculoskeletal condition in many industries, including the meat-processing industry, with previous research confirming that workers in poultry abattoirs are at risk of developing LBP. Lower back pain is a major cause of sickness absenteeism, and regular exercise is considered beneficial to manage LBP among workers. Little is known about LBP and poultry abattoir workers in South Africa. The purpose of the study therefore was to describe LBP among these workers and explore possible associations between LBP and specific job designations, exercise patterns and sickness absenteeism. A descriptive study with an analytical component was conducted among workers at a poultry abattoir in South Africa. A structured questionnaire was used to collect the data regarding back pain experienced in the previous 12 months. The results indicated a 12-month prevalence of LBP of 77.6% (95% CI 70.6%; 83.3%), while 24.2% had to reduce work activities because of their LBP symptoms. However, more than half of the workers with LBP (59.4%) were not absent from work due to LBP. There was no significant association between LBP and exercises with 40.0% indicating that they exercised on a regular basis. This study indicated a high prevalence of LBP among workers whose job designation has an increased risk for musculoskeletal disorders, as reported in previous research. Work-related factors, such as job designations with repetitive movements should be identified and addressed in the management of LBP. Even though this study did not find a significant association between LBP and exercises, nearly half of workers indicated that they exercise on a regular basis. Additional research is needed to study the effect of exercise on LBP among workers in poultry abattoirs in South Africa. [ABSTRACT FROM AUTHOR]

Study aim. The purpose of the current study is to determine the impact of single bouts of physical exercise of different duration and intensity on young adults’ executive functions.

Background: Preventing sports injuries is at the forefront of sports medicine. Although effective preventive strategies in scientific literature exist, their implementation is lagging behind. The Internet could support the translation of knowledge from the literature to end-users, but the quality of the online resources would have to be assured. This online-based systematic review is to assess availability, readability, quality, and content of the websites presenting exercise-based sports injury risk reduction (prevention) programmes. Moreover, the quality of reporting and contents of the exercise programmes were assessed. Methods: Google, Yahoo, and Bing were searched on 2 September 2018. We used 'sports injury prevention program*' and 'sports injury prevention warm-up' as search phrases. The owners/authors of the included websites were asked for further recommendations on online resources. Search updates were run in DuckDuckGo on 15 May 2020 and 22 August 2021. Eligible websites were active, in English, and contained instructions for the exercise/s aiming at sports injury prevention. Two reviewers independently screened the links and previews and performed an in-depth appraisal of included websites. The website quality was assessed using JAMA framework criteria and Health on the Net Foundation Code of Conduct (HONcode) certification. The readability of websites was assessed using the Flesch-Kincaid Reading Ease score. The reporting appraisal of exercise programmes was done using the modified Consensus on Exercise Reporting Template (CERT). Results: Among 480 websites screened, 16 were eligible with an additional four recommended and nine found in search updates (29 in total). None of the websites was certified by HONcode. The overall quality of websites was low 2.1 ± 1.0/4, but overall readability was high 67 ± 17/100. The average quality of reporting of exercise programmes was low 5.79 ± 3.1/12. Websites with community input had the lowest readability, but the highest quality, and vice versa websites run by businesses had the highest readability, but the lowest quality. Eight websites presented programmes tested for effectiveness. Conclusions: Overall, the quality of the websites was low, but their readability was high. Improvements required are relatively easy to implement (i.e. including the date when the website was updated, applying for HONcode certification) and extremely important (e.g. providing resources on which the website's content is based). There are some sports injury risk reduction programmes reported with high quality and effectiveness-tested available online for team sports, but none for individual sports. Trial Registration This review has been registered in the PROSPERO (CRD42019107104). [ABSTRACT FROM AUTHOR]

Aims This prospective, randomized, controlled, multicentre study aimed to evaluate efficacy and safety of exercise training in patients with pulmonary arterial (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods and results For the first time a specialized PAH/CTEPH rehabilitation programme was implemented in 11 centres across 10 European countries. Out of 129 enrolled patients, 116 patients (58 vs. 58 randomized into a training or usual care control group) on disease-targeted medication completed the study [85 female; mean age 53.6 ± 12.5 years; mean pulmonary arterial pressure 46.6 ± 15.1 mmHg; World Health Organization (WHO) functional class II 53%, III 46%; PAH n  = 98; CTEPH n  = 18]. Patients of the training group performed a standardized in-hospital rehabilitation with mean duration of 25 days [95% confidence interval (CI) 17–33 days], which was continued at home. The primary endpoint, change of 6-min walking distance, significantly improved by 34.1 ± 8.3 m in the training compared with the control group (95% CI, 18–51 m; P  < 0.0001). Exercise training was feasible, safe, and well-tolerated. Secondary endpoints showed improvements in quality of life (short-form health survey 36 mental health 7.3 ± 2.5, P  = 0.004), WHO-functional class (training vs. control: improvement 9:1, worsening 4:3; χ2 P  = 0.027) and peak oxygen consumption (0.9 ± 0.5 mL/min/kg, P  = 0.048) compared with the control group. Conclusion This is the first multicentre and so far the largest randomized, controlled study on feasibility, safety, and efficacy of exercise training as add-on to medical therapy in PAH and CTEPH. Within this study, a standardized specialized training programme with in-hospital start was successfully established in 10 European countries. [ABSTRACT FROM AUTHOR]

Purpose: There is emerging evidence that physical activity interventions have the potential to improve the physical function and psychosocial well-being of young adult cancer survivors. However, most existing interventions for young adult cancer survivors have been delivered in an in-patient hospital setting. The purpose of this study is to explore young adult cancer survivors' (YACS) experiences of the RENEW programme, a 12-week community-based exercise referral scheme delivered by Trekstock, a UK-based cancer charity. Methods: Sixteen semi-structured interviews were conducted with YACS (mean age, 33 years; 87.5% female) who participated in the RENEW exercise referral programme. Each interview followed the same semi-structured interview guide which asked participants about their experiences of the RENEW programme and their ideas for the future development of the scheme. Data was audio-recorded, transcribed full verbatim and analysed using framework analysis. Results: YACs predominantly chose to take part in the RENEW programme as a means to improve their health and overcome cancer related impairments (e.g. fatigue, loss of strength, low body confidence). The offer of one-to-one tailored support and unlimited gym access was often cited as a factor which motivated enrolment. Overall, YACS experience of the programme was positive with many describing improvements in physical function and general well-being. Barriers to participating in the programme included sign-off from clinicians prior to enrolment, travelling to the gym and fear of exercising alone. Conclusions: Exercise referral schemes are acceptable to YACS and provide a promising opportunity for young people with cancer to improve their physical and psychosocial health through physical activity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Efficacies of community-based exercise programmes have been well reported but there is scarce information on the expediency of community-based rehabilitation in a society where many of children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. The study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP). METHODS: Quasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I - II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40-80% maximum heart rate. Gross motor function (GMF), walk distance and quality of life were assessed pre and post CBFAE training. RESULTS: Significant improvement observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking+running+jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in Pain and impact of disability (67.93%, P=.049) and Participation and physical health (60.00%, P=.042). CONCLUSION: CBFAE training contributes majorly to improved standing, walking, jumping and running and selfesteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the effect of the exercise programme on the quality of life of prostate cancer (PCa) survivors. Methods: A randomized controlled, parallel trial was conducted from April 2017 to January 2018 on 80 PCa survivors. They were randomly assigned to intervention and control groups (n = 40 in each group). The exercise programme was designed based on the self‐management approach (SMA). The intervention group participated in a 12‐week exercise programme consisting of one session of group exercise and three sessions of individual exercise per week using exercise facilities in the community. Data were collected using the quality of life questionnaires and the follow‐up checklist. Results: In the intervention group, statistically significant improvements in physical, role, emotional, social and sexual functions were reported. Also, the patients in this group reported reduced fatigue, insomnia, constipation, diarrhoea, urinary, bowel and hormonal treatment‐related symptoms in comparison with before the exercise programme (p < 0.05). Conclusions: Nurses are suggested to plan for improving the participation of PCa survivors in exercise programmes using exercise facilities in the community in order to reduce the complications of treatment and improve their quality of life. SUMMARY STATEMENT: What is already known about this topic? Prostate cancer (PCa) is one of the most common types of cancer in men across the globe.Given the increased survival rate of patients with PCa, interventions are required for improving their quality of life.There is a lack of knowledge about the effect of physical activity on the quality of life of PCa survivors. What this paper adds? The exercise programme based on the self‐management approach, use of exercise facilities in the community and group exercise can improve the quality of life of PCa survivors.Participation in the exercise programme can help with the reduction of physical and psychological complications of PCa. The implications of this paper: Nurses should encourage PCa survivors to participate in the exercise programme for reducing treatment complications and improving their quality of life.Nurses can use exercise facilities in the community to improve the participation of PCa survivors in healthcare initiatives aiming at the improvement of their quality of life.The examination of the effect of exercise programmes on well‐being and health‐related quality of life of PCa survivors needs further research. [ABSTRACT FROM AUTHOR]

BACKGROUND: Efficacies of community-based exercise programmes have been well reported, but there is scarce information on the expediency of community-based rehabilitation in a society where many children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. This study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP). METHODS: Quasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I - II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40-80% maximum heart rate. Gross motor function (GMF), walking distance and quality of life were assessed pre and post CBFAE training. RESULTS: Significant improvement was observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking + running+ jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE were observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in pain and impact of disability (67.93%, P=.049) and participation and physical health (60.00%, P=.042). CONCLUSION: CBFAE training contributes majorly to improved standing, walking, jumping and running and selfesteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances. [ABSTRACT FROM AUTHOR]

To evaluate the impact of adding food education sessions to an exercise programme on cardiovascular risk factors in middle-aged and older patients with type 2 diabetes (T2D), a randomised parallel-group study was performed. Glycated haemoglobin, body mass index (BMI), waist circumference, fat mass (FM) and blood pressure were assessed at baseline and after 9 months. The recruitment was made in three primary healthcare centres from Vila Real, Portugal. Thirty-three patients (65⋅4 ± 5⋅9 years old) were engaged in a 9-month community-based lifestyle intervention programme: a supervised exercise programme (EX; n = 15; combined aerobic, resistance, agility/balance and flexibility exercise; three sessions per week; 75 min per session); or the same exercise programme plus concomitant food education sessions (EXFE; n = 18; 15-min lectures and dual-task strategies during exercise (answer nutrition questions while walking); 16 weeks). Significant differences between groups were identified in the evolution of BMI (P < 0.001, $\eta _{\rm p}^2 = 0{\cdot} 150$) and FM (P < 0.001, $\eta _{\rm p}^2 = 0{\cdot}130$), with best improvements observed in the EXFE group. The addition of a simple food education dietary intervention to an exercise programme improved body weight and composition, but not glycaemic control and blood pressure in middle-aged and older patients with T2D.

To evaluate the impact of adding food education sessions to an exercise programme on cardiovascular risk factors in middle-aged and older patients with type 2 diabetes (T2D), a randomised parallel-group study was performed. Glycated haemoglobin, body mass index (BMI), waist circumference, fat mass (FM) and blood pressure were assessed at baseline and after 9 months. The recruitment was made in three primary healthcare centres from Vila Real, Portugal. Thirty-three patients (65⋅4 ± 5⋅9 years old) were engaged in a 9-month community-based lifestyle intervention programme: a supervised exercise programme (EX; n = 15; combined aerobic, resistance, agility/balance and flexibility exercise; three sessions per week; 75 min per session); or the same exercise programme plus concomitant food education sessions (EXFE; n = 18; 15-min lectures and dual-task strategies during exercise (answer nutrition questions while walking); 16 weeks). Significant differences between groups were identified in the evolution of BMI (P < 0.001, $\eta _{\rm p}^2 = 0{\cdot} 150$) and FM (P < 0.001, $\eta _{\rm p}^2 = 0{\cdot}130$), with best improvements observed in the EXFE group. The addition of a simple food education dietary intervention to an exercise programme improved body weight and composition, but not glycaemic control and blood pressure in middle-aged and older patients with T2D. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the uptake and effect of RENEW, a 12-week exercise referral programme for young adult cancer survivors delivered by Trekstock, a UK-based cancer charity. Methods: The RENEW programme provides one-to-one individually tailored support from a level-4 cancer-rehabilitation-qualified gym instructor, free gym membership and access to information resources online. Objective and self-report data on cardiorespiratory function, strength, body composition, fatigue, sleep quality and general health-related quality of life (HRQoL) was collected from participants before the programme (week 0), immediately after (week 12) and 1 month later (week 16). Results: Forty-eight young adults (83% female; mean age, 29 years) with a history of cancer took part within the 12-week programme and completed the evaluation measures. Physical activity (PA) levels significantly increased following the programme and remained raised at follow-up. Improvements in physical function were significant: peak expiratory flow (mean change, 30.96, p = 0.003), sit-and-reach test (mean change, 6.55 ± 4.54, p < 0.0001), and 6-mine-walk test (mean change, 0.12 ± 0.04, p < 0.0001). No significant changes in BMI, weight or muscle mass were observed. Improvements in fatigue, sleep and HRQoL were observed across the programme and at follow-up (mean change, weeks 0–16; 8.04 ± 1.49 p < 0.01; 1.05 ± 0.49 p < 0.05; and − 0.9 ± 0.46 p = 0.051, respectively). Changes in self-efficacy to exercise and motivations to exercise were not observed at 12 weeks or at follow-up. Conclusions: Results suggest that the RENEW exercise referral programme has a positive impact upon some domains of physical function and well-being among young adult cancer survivors. Implication for cancer survivors: Exercise referral programmes delivered by charity organisations are one means by which PA behaviour change support may be widely disseminated to young adult cancer survivors. Health professionals and charitable bodies specialising in the care of young adults with cancer should look to address factors which prevent engagement and uptake of 'real-world' PA interventions such as the RENEW programme. [ABSTRACT FROM AUTHOR]

Background and Objectives: To investigate the feasibility of delivering a functional exercise-based prehabilitation intervention and its effects on postoperative length of hospital stay, preoperative physical functioning and health-related quality of life in elective colorectal surgery.Materials and Methods: In this randomised controlled feasibility trial, 22 elective colorectal surgery patients were randomly assigned to exercise prehabilitation (n = 11) or standard care (n = 11). Feasibility of delivering the intervention was assessed based on recruitment and compliance to the intervention. Impact on postoperative length of hospital stay and complications, preoperative physical functioning (timed up and go test, five times sit to stand, stair climb test, handgrip dynamometry and 6-min walk test) and health-related quality of life were also assessed.Results: Over 42% of patients (84/198) screened were deemed ineligible for prehabilitation due to insufficient time existing prior to scheduled surgery. Of those who were eligible, approximately 18% consented to the trial. Median length of hospital stay was 8 [range 6-27] and 10 [range 5-12] days respectively for the standard care and prehabilitation groups. Patterns towards preoperative improvements for the timed up and go test, stair climb test and 6-min walk test were observed for all participants receiving prehabilitation but not standard care.Conclusions: Despite prehabilitation appearing to convey positive benefits on physical functioning, short surgical wait times and patient engagement represent major obstacles to implementing exercise prehabilitation programmes in colorectal cancer patients. [ABSTRACT FROM AUTHOR]

Background: Patients with rheumatoid arthritis (RA) tend to be more overweight, take less physical exercise, exhibit decreased cardiorespiratory fitness and demonstrate reduced muscle strength compared with age- and sex-matched controls. Impaired cognitive function in RA is an important associated factor, although it has been less well-recognized. The aim of this study was to investigate the effects of a specifically designed exercise programme on body composition, aerobic capacity, muscle strength and cognition in RA. Methods: Sixty-six patients with RA were randomized to a specifically designed, personalized exercise programme or standard care. Assessments included body composition, fitness, grip strength and cognitive testing, in addition to disease related measures. Results: Significant improvements in C-reactive protein (p = 0.025), fatigue scores (p = 0.047) and truncal fat (p = 0.004) were observed in the exercise group compared with controls. Median waist circumference was significantly reduced (94.0 to 91.4 cm, p < 0.0001). Improvements were also seen in aerobic capacity (23.2 to 27.6 ml/kg/min, p = 0.002) and in median right (12.0 to 13.0 kg, p = 0.025) and left grip strength (8.0 to 10 kg, p = 0.005). Cognitive function improved in the exercise group, with median Montreal Cognitive Assessment score 25.5 at 0 months compared to 28.0 at 3 months (p = 0.001). Conclusion: This study demonstrates that exercise has a significant and positive impact on cognitive function in RA. Furthermore, physical activity is safe and effective in chronic inflammatory joint disease and is recommended as a vital component in the holistic management of these patients. Key Points • A dedicated physical exercise programme is feasible and safe in patients with rheumatoid arthritis (RA). • Physical exercise helps reduce fatigue scores and improves cardiovascular fitness in stable RA patients. • Physical exercise has a positive impact on cognition in patients with RA. • A structured exercise programme should be an integral part of chronic disease management protocols for patients with RA. [ABSTRACT FROM AUTHOR]

Background: Competition has been shown to improve motivation and physical performance in young people. This method has been rarely studied in older people. Aims: To evaluate the feasibility of senior physical activity (PA) contests between two nursing homes and to assess changes in the motivational level and physical performance of the residents over time. Methods: Residents from two Belgian nursing homes were invited to participate in PA contests. A pretest and three contest sessions were organized over a period of 3 months. The activities proposed were body balance, gait speed, sit-to-stand performance, arm curl and address tests. Feasibility was measured by contest session adherence (expected score > 80%), difficulty scores (expected score < 40%) and appreciation scores (expected score > 80%). Motivational questionnaires were administered: the BREQ-2 (assessing amotivation, introjected regulation, identified regulation, intrinsic motivation and external motivation) and the A-PMCEQ (assessing ego- and task-involving climates). Friedman's analysis of variance was performed to evaluate the changes in physical performance and motivational levels. Results: Of the 24 participants, seven did not complete all sessions because of medical or personal reasons not related to the study. During the three sessions, the adherence was 86%, the mean difficulty score was 30.8% and the satisfaction score was 87%. After three sessions, residents experienced a significant decrease ranged from 3 to 0 point for amotivation (p = 0.03), 1 to 0 point for external motivation (p = 0.03) and 2.5 to 2 points for ego-involving climate (p = 0.02) and a significant improvement ranged from 0.7 to 0.9 m/s for gait speed (p < 0.001), 18.5 to 15.6 s for sit-to-stand performance (p < 0.001) and 11.5 to 15 curls for arm curl scores (p < 0.001). Conclusions: In nursing home settings, senior PA contests are feasible and may improve the motivational climate and physical performance. [ABSTRACT FROM AUTHOR]

Purpose: The present small semi-controlled feasibility study investigated a possible efficacy of a combined upper limb and breathing exercise programme in managing pain in ambulatory and non-ambulatory patients with EDSS from 0.0-8.0.Method: People with MS (N = 19) were enrolled in this single-blind randomized controlled study and divided into 2 groups: exercise group (5 ambulatory, 5 non-ambulatory; Expanded Disability Status Scale (EDSS), 1.0-8.0) and related control group that performed no exercise (4 ambulatory, 5 non-ambulatory; EDSS, 1.0-7.5). The exercise group performed combined upper limb and breathing exercises in a group led by a physiotherapist (2 days/week, 60 min/session) accompanied by independent home exercises (3 days/week, ≥ 20 min/session). Participants underwent measures of pain level (visual analogue scale) for physical pain, functional independence of daily activities (Barthel index) and handgrip strength (HGS) for dominant (D) and non-dominant (ND) hand evaluated by a dynamometer before and after the 4-week period by the blinded assessor.Results: The VAS for pain showed statistically significant group-by-time interaction only in non-ambulatory (p = .049) individuals, but with large intervention effects on both subgroups (ambulatory, p = .159; non-ambulatory, d = 0.97). Functional independence in daily activities (Barthel index) showed statistically non-significant group-by-time interaction in ambulatory (p = .195, d = 0.89) and non-ambulatory (p = .102, d = 1.64) individuals, but despite the absence of statistical significance, there were large intervention effects. Handgrip strength was significantly improved for both hands in ambulatory (D, p = .012; d = 2.07; ND, p = .025, d = 1.77) and only non-dominant hand in non-ambulatory individuals (D, p = .288, d = 0.83; ND, p = .012, d = 2.21).Conclusion: This small pilot study provides preliminary proof-of-concept data supporting low-intensity upper limb and breathing exercise programme for potential reduction of pain and improvement of functional independence in both ambulatory and non-ambulatory individuals with MS in a larger sample and that strengthening the upper limbs might be an additional pain relief mechanism.Trial Registration: NTC03222596. [ABSTRACT FROM AUTHOR]

Objective: Longitudinal studies have consistently shown beneficial effects of positive self-perceptions of ageing (SPA) on health. However, SPA are more often negative than positive, particularly in older adults. For this reason, the present study tested the effectiveness of an intervention to promote more positive SPA in the context of an exercise programme for older adults. Design: Eighty-four community-dwelling older adults (66-88 years; M(SD)=76.8(5.29)) were randomly assigned to a group-based exercise programme over 12 weeks with (n = 46) or without (n = 38) a psychological intervention to change SPA, consisting of four intervention units over the programme period. Main Outcome Measures: A gain- and a loss-related domain of SPA were assessed at baseline, after the first half of the programme, directly after the programme and in a follow-up four weeks later. Results: Latent change score models showed an improvement of participants' SPA in the intervention group in both SPA domains after the programme, whereas SPA did not change in the control group. Both groups showed an improvement in physical performance, however, only the IG showed additional improvements in mental health. Conclusion: The implementation of an SPA intervention is a promising approach in regular health promotion programmes for older adults. [ABSTRACT FROM AUTHOR]

The study presents and points to the importance of implementing intervention exercise programmes in physical and sport education classes. It aims to explain diversification and realization of innovative syllabi through health-oriented exercise programmes with the focus on the primary level of preventive healthcare among the female secondary-school students and improvement of dynamic function of the spine that reflects proper function of the muscle system. The experimental groups comprised 25 second-year female students at one secondary school in the town of Liptovský Mikuláš (A group n=13: age 16.4±0.6 years, height=168.1±3.9 cm, weight=58.3±2.6 kg, B group n=12: age 16.9±0.9 years, height=167.1±4.5 cm, weight=56.6±3.1 kg). Their selection was intentional. The data were obtained by means of standardized methods used in pedagogical and clinical practice for assessment of dynamic function of the spine. The quantitative data obtained from individual groups were processed by means of the nonparametric test for dependent monitoring (one-sample Wilcoxon signed-rank, p<0.01) and the Kruskal-Wallis test (p<0.01). The results in both experimental groups A and B significantly (p<0.01) proved a positive effect of the 12-week health-oriented exercise programme on overall dynamic function of the spine in the sagittal and lateral planes. The results also confirmed a beneficial influence of the exercise programme on the monitored determinants without significant differences between the experimental groups (p>0.05). [ABSTRACT FROM AUTHOR]

The study presents and points to the importance of implementing intervention exercise programmes in physical and sport education classes. It aims to explain diversification and realization of innovative syllabi through health-oriented exercise programmes with the focus on the primary level of preventive healthcare among the female secondary-school students and improvement of dynamic function of the spine that reflects proper function of the muscle system. The experimental groups comprised 25 second-year female students at one secondary school in the town of Liptovský Mikuláš (A group n=13: age 16.4±0.6 years, height=168.1±3.9 cm, weight=58.3±2.6 kg, B group n=12: age 16.9±0.9 years, height=167.1±4.5 cm, weight=56.6±3.1 kg). Their selection was intentional. The data were obtained by means of standardized methods used in pedagogical and clinical practice for assessment of dynamic function of the spine. The quantitative data obtained from individual groups were processed by means of the nonparametric test for dependent monitoring (one-sample Wilcoxon signed-rank, p<0.01) and the Kruskal-Wallis test (p<0.01). The results in both experimental groups A and B significantly (p<0.01) proved a positive effect of the 12-week health-oriented exercise programme on overall dynamic function of the spine in the sagittal and lateral planes. The results also confirmed a beneficial influence of the exercise programme on the monitored determinants without significant differences between the experimental groups (p>0.05). [ABSTRACT FROM AUTHOR]

This paper describes the process evaluation of an 18‐week supervised exercise programme in 50 patients treated with high‐dose chemotherapy followed by autologous stem cell transplantation. The intervention included 30 exercise sessions with six resistance exercises and interval training. We evaluated the context, dose delivered and received, and patients’ and physiotherapists’ satisfaction with the intervention. Ninety‐two per cent of the patients trained within 15 km of their home address, with an average session attendance of 86%. Most patients trained at the prescribed intensity for four of the six resistance exercises, but the dose delivered and received of the two remaining resistance exercises and interval training could not be determined. Both patients and physiotherapists highly appreciated the programme (score of 8.3 and 7.9 out of 10 respectively). This process evaluation provided valuable lessons for future trials: (1) It is possible to deliver supervised exercise training to this patient group in local physiotherapy practices; (2) to determine dose received all intervention components should be standardised; and (3) to optimise data collection, all study materials should be tested more extensively prior to the start of the intervention. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Introduction: the study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. METHODS: one hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. RESULTS: a significant difference was noted in social function post training twice (MD = -13.85, 95% CI [-24.66, -3.38], p = 0.017, d = 0.674) and thrice (MD = -13.30, 95% CI [-21.81, -5.59], p = 0.003, d = 0.712) a week. Training thrice a week provided an additional benefit in vitality (MD = -7.55, 95% CI [-13.16, -1.91], p = 0.018,d =0. 379). Improvements in mental component summary scale post training twice (MD = -4.08, 95% CI [-7.67, -0.42], p = 0.033, d = 0.425) and thrice (MD = -6.67, 95% CI [-10.92, -2.33], p = 0.005, d = 0.567) a week was further noted. CONCLUSION: mental health and social health benefits can be obtained irrespective of exercise frequency 2X/week or 3X/week.The exercise intervention at a frequency of thrice a week was more effective in improving mental component summary due to a larger effect size obtained compared to the exercise frequency of twice a week. Additional benefits in vitality wasachieved by exercising 3X/week. This may assist the elderly in preserving their independence.

Background: Medial to lateral tapping and exercise programme has been found to be effective in Lateral epicondylitis. The purpose to find the combined effect of Medial to lateral tapping with exercise programme for subjects with lateral epicondylitis on pain intensity and functional ability. Method: An experimental study design, selected 40 subjects with Lateral epicondylitis randomized 20 subjects each into Study and Control group. Control group received only exercise programme while study group received combined medial to lateral tapping with exercise programme thrice a week for 4 weeks. Pain intensity was measured using Visual analogue scale and functional ability was measured using Patient Rated Tennis Elbow Evaluation questionnaire before and after 4 weeks of treatment. Results: When the post-intervention means were compared between Study and Control group after 4 weeks of treatment found statistically significant difference in the improvement in outcomes measures in means of VAS and PRTEE before and after intervention within the groups. Conclusion: It is concluded that the Medial to lateral tapping with exercise programme is more effective than the exercise programme in reduction of pain and improve functional abilities for subjects with Lateral epicondylitis.