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1. Improving Physical Activity in Adults Admitted to a Hospital With Interventions Developed and Implemented Through Cocreation: Protocol for a Pre-Post Embedded Mixed Methods Study

Author

Geelen, Sven J G, Giele, Boukje M, Nollet, Frans, Engelbert, Raoul H H, and van der Schaaf, Marike

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundAdmission to a hospital is often related with hospital-associated disabilities. Improving physical activity during hospitalization is considered effective to counteract hospital-associated disabilities, whereas many studies report on very low physical activity levels. Gradually developing and implementing interventions in cocreation with patients and health care professionals rather than implementing predefined interventions may be more effective in creating sustainable changes in everyday clinical practice. However, no studies have reported on the use of cocreation in the development and implementation of interventions aimed at improving physical activity. ObjectiveThis protocol presents a study that aims to investigate if interventions, which will be developed and implemented in cocreation, improve physical activity among patients in surgery, internal medicine, and cardiology hospital wards. The secondary aims are to investigate effectiveness in terms of the reduction in the time patients spend in bed, the length of hospital stay, and the proportion of patients going home after discharge. MethodsThe Better By Moving study takes place for 12 months at the following five different wards of a university hospital: two gastrointestinal and oncology surgery wards, one internal medicine hematology ward, one internal medicine infectious diseases ward, and one cardiology ward. The step-by-step implementation model of Grol and Wensing is used, and all interventions are developed and implemented in cocreation with health care professionals and patients. Outcome evaluation is performed across the different hospital wards and for each hospital ward individually. The primary outcome is the amount of physical activity in minutes assessed with the Physical Activity Monitor AM400 accelerometer in two individual groups of patients (preimplementation [n=110], and 13 months after the start of the implementation [n=110]). The secondary outcomes are time spent in bed measured using behavioral mapping protocols, and length of stay and discharge destination assessed using organizational data. A process evaluation using semistructured interviews and surveys is adopted to evaluate the implementation, mechanisms of impact, context, and perceived barriers and enablers. ResultsThis study is ongoing. The first participant was enrolled in January 2018. The last outcome evaluation and process evaluation are planned for May and June 2020, respectively. Results are expected in April 2021. ConclusionsThis study will provide information about the effectiveness of developing and implementing interventions in cocreation with regard to improving physical activity in different subgroups of hospitalized patients in a university hospital. By following step-by-step implementation and by performing process evaluation, we will identify the barriers and enablers for implementation and describe the effect of new interventions on improving physical activity among hospitalized patients. Trial RegistrationNetherlands Trial Register NL8480; https://www.trialregister.nl/trial/8480 International Registered Report Identifier (IRRID)DERR1-10.2196/19000

Published
2020
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2. Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis

Author

Hiensch, Anouk E., Beckhaus, Julia, Witlox, Lenja, Monninkhof, Evelyn M., Schagen, Sanne B., van Vulpen, Jonna K., Sweegers, Maike G., Newton, Robert U., Aaronson, Neil K., Galvão, Daniel A., Steindorf, Karen, Stuiver, Martijn M., Mesters, Ilse, Knoop, Hans, Goedendorp, Martine M., Bohus, Martin, Thorsen, Lene, Schulz, Karl-Heinz, Schmidt, Martina E., Ulrich, Cornelia M., Sonke, Gabe S., van Harten, Wim H., Winters-Stone, Kerri M., Velthuis, Miranda J., Taaffe, Dennis R., van Mechelen, Willem, Kersten, Marie José, Nollet, Frans, Wiskemann, Joachim, Buffart, Laurien M, and May, Anne M

Published
2024
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17. Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis

Author

Epi Kanker Team B, Cancer, Epi Kanker Team 1, Epi Kanker Team C, JC onderzoeksprogramma Cancer, Arts-assistenten Radiotherapie, Epi Kanker, Hiensch, Anouk E, Beckhaus, Julia, Witlox, Lenja, Monninkhof, Evelyn M, Schagen, Sanne B, van Vulpen, Jonna K, Sweegers, Maike G, Newton, Robert U, Aaronson, Neil K, Galvão, Daniel A, Steindorf, Karen, Stuiver, Martijn M, Mesters, Ilse, Knoop, Hans, Goedendorp, Martine M, Bohus, Martin, Thorsen, Lene, Schulz, Karl-Heinz, Schmidt, Martina E, Ulrich, Cornelia M, Sonke, Gabe S, van Harten, Wim H, Winters-Stone, Kerri M, Velthuis, Miranda J, Taaffe, Dennis R, van Mechelen, Willem, Kersten, Marie José, Nollet, Frans, Wiskemann, Joachim, Buffart, Laurien M, May, Anne M, Epi Kanker Team B, Cancer, Epi Kanker Team 1, Epi Kanker Team C, JC onderzoeksprogramma Cancer, Arts-assistenten Radiotherapie, Epi Kanker, Hiensch, Anouk E, Beckhaus, Julia, Witlox, Lenja, Monninkhof, Evelyn M, Schagen, Sanne B, van Vulpen, Jonna K, Sweegers, Maike G, Newton, Robert U, Aaronson, Neil K, Galvão, Daniel A, Steindorf, Karen, Stuiver, Martijn M, Mesters, Ilse, Knoop, Hans, Goedendorp, Martine M, Bohus, Martin, Thorsen, Lene, Schulz, Karl-Heinz, Schmidt, Martina E, Ulrich, Cornelia M, Sonke, Gabe S, van Harten, Wim H, Winters-Stone, Kerri M, Velthuis, Miranda J, Taaffe, Dennis R, van Mechelen, Willem, Kersten, Marie José, Nollet, Frans, Wiskemann, Joachim, Buffart, Laurien M, and May, Anne M

Published
2024

18. Dropout from exercise trials among cancer survivors : An individual patient data meta-analysis from the POLARIS study

Author

Western, Benedikte, Ivarsson, Andreas, Vistad, Ingvild, Demmelmaier, Ingrid, Aaronson, Neil K., Radcliffe, Gillian, van Beurden, Marc, Bohus, Martin, Courneya, Kerry S., Daley, Amanda J., Galvão, Daniel A., Garrod, Rachel, Goedendorp, Martine M., Griffith, Kathleen A., van Harten, Wim H., Hayes, Sandi C., Herrero-Roman, Fernando, Hiensch, Anouk E., Irwin, Melinda L., James, Erica, Kenkhuis, Marlou-Floor, Kersten, Marie José, Knoop, Hans, Lucia, Alejandro, May, Anne M., Mcconnachie, Alex, van Mechelen, Willem, Mutrie, Nanette, Newton, Robert U., Nollet, Frans, Oldenburg, Hester S., Plotnikoff, Ron, Schmidt, Martina E., Schmitz, Katie H., Schulz, Karl-Heinz, Short, Camille E., Sonke, Gabe S., Steindorf, Karen, Stuiver, Martijn M., Taaffe, Dennis R., Thorsen, Lene, Velthuis, Miranda J., Wenzel, Jennifer, Winters-Stone, Kerri M., Wiskemann, Joachim, Berntsen, Sveinung, Buffart, Laurien M., Western, Benedikte, Ivarsson, Andreas, Vistad, Ingvild, Demmelmaier, Ingrid, Aaronson, Neil K., Radcliffe, Gillian, van Beurden, Marc, Bohus, Martin, Courneya, Kerry S., Daley, Amanda J., Galvão, Daniel A., Garrod, Rachel, Goedendorp, Martine M., Griffith, Kathleen A., van Harten, Wim H., Hayes, Sandi C., Herrero-Roman, Fernando, Hiensch, Anouk E., Irwin, Melinda L., James, Erica, Kenkhuis, Marlou-Floor, Kersten, Marie José, Knoop, Hans, Lucia, Alejandro, May, Anne M., Mcconnachie, Alex, van Mechelen, Willem, Mutrie, Nanette, Newton, Robert U., Nollet, Frans, Oldenburg, Hester S., Plotnikoff, Ron, Schmidt, Martina E., Schmitz, Katie H., Schulz, Karl-Heinz, Short, Camille E., Sonke, Gabe S., Steindorf, Karen, Stuiver, Martijn M., Taaffe, Dennis R., Thorsen, Lene, Velthuis, Miranda J., Wenzel, Jennifer, Winters-Stone, Kerri M., Wiskemann, Joachim, Berntsen, Sveinung, and Buffart, Laurien M.

Abstract

Introduction The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. Methods This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree. Results Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m2, performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m2 and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m2 exercising during (5.2%) or post (9.5%) treatment. Conclusions There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.

Published
2024
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19. Dropout from exercise trials among cancer survivors-An individual patient data meta-analysis from the POLARIS study

Author

Epi Kanker Team B, Cancer, Epi Kanker, JC onderzoeksprogramma Kanker, Western, Benedikte, Ivarsson, Andreas, Vistad, Ingvild, Demmelmaier, Ingrid, Aaronson, Neil K, Radcliffe, Gillian, van Beurden, Marc, Bohus, Martin, Courneya, Kerry S, Daley, Amanda J, Galvão, Daniel A, Garrod, Rachel, Goedendorp, Martine M, Griffith, Kathleen A, van Harten, Wim H, Hayes, Sandi C, Herrero-Roman, Fernando, Hiensch, Anouk E, Irwin, Melinda L, James, Erica, Kenkhuis, Marlou-Floor, Kersten, Marie José, Knoop, Hans, Lucia, Alejandro, May, Anne M, McConnachie, Alex, van Mechelen, Willem, Mutrie, Nanette, Newton, Robert U, Nollet, Frans, Oldenburg, Hester S, Plotnikoff, Ron, Schmidt, Martina E, Schmitz, Katie H, Schulz, Karl-Heinz, Short, Camille E, Sonke, Gabe S, Steindorf, Karen, Stuiver, Martijn M, Taaffe, Dennis R, Thorsen, Lene, Velthuis, Miranda J, Wenzel, Jennifer, Winters-Stone, Kerri M, Wiskemann, Joachim, Berntsen, Sveinung, Buffart, Laurien M, Epi Kanker Team B, Cancer, Epi Kanker, JC onderzoeksprogramma Kanker, Western, Benedikte, Ivarsson, Andreas, Vistad, Ingvild, Demmelmaier, Ingrid, Aaronson, Neil K, Radcliffe, Gillian, van Beurden, Marc, Bohus, Martin, Courneya, Kerry S, Daley, Amanda J, Galvão, Daniel A, Garrod, Rachel, Goedendorp, Martine M, Griffith, Kathleen A, van Harten, Wim H, Hayes, Sandi C, Herrero-Roman, Fernando, Hiensch, Anouk E, Irwin, Melinda L, James, Erica, Kenkhuis, Marlou-Floor, Kersten, Marie José, Knoop, Hans, Lucia, Alejandro, May, Anne M, McConnachie, Alex, van Mechelen, Willem, Mutrie, Nanette, Newton, Robert U, Nollet, Frans, Oldenburg, Hester S, Plotnikoff, Ron, Schmidt, Martina E, Schmitz, Katie H, Schulz, Karl-Heinz, Short, Camille E, Sonke, Gabe S, Steindorf, Karen, Stuiver, Martijn M, Taaffe, Dennis R, Thorsen, Lene, Velthuis, Miranda J, Wenzel, Jennifer, Winters-Stone, Kerri M, Wiskemann, Joachim, Berntsen, Sveinung, and Buffart, Laurien M

Published
2024

23. Individualized Aerobic Exercise in Neuromuscular Diseases: A Pilot Study on the Feasibility and Preliminary Effectiveness to Improve Physical Fitness

Author

Voorn, Eric L., Koopman, Fieke S., Nollet, Frans, and Brehm, Merel-Anne

Subjects
Testing, Care and treatment, Methods, Health aspects, Neuromuscular diseases -- Care and treatment, Exercise therapy -- Testing, Aerobic exercises -- Methods -- Health aspects
Abstract

Introduction Physical inactivity is a common problem in individuals with neuromuscular diseases (NMD) and is caused by symptoms of muscle weakness, fatigue, and pain. (1-3) Inactivity leads to reduced physical [...], Objective. Clear guidelines to prescribe aerobic exercise in neuromuscular diseases (NMD) are lacking, which hampers effective application in neuromuscular rehabilitation. This pilot study evaluated the feasibility and preliminary effectiveness of an individualized aerobic exercise program according to a recently developed training guide (B-FIT) to improve physical fitness in individuals with NMD. Methods. Thirty-one individuals who were ambulatory and had 15 different slowly progressive NMD participated in a 4-month, polarized, home-based, aerobic exercise program. The program included 2 low-intensity sessions and 1 high-intensity session per week. Feasibility outcomes were the following: completion rate, proportion of followed sessions, adverse events, and participant and therapist satisfaction based on a self-designed questionnaire. Submaximal incremental exercise tests were used to assess the effects on physical fitness. Results. Twenty-six participants (84%) completed the B-FIT program, and the proportion of followed sessions was >75%>. Three adverse events were reported and resolved. Regarding satisfaction, participants (based on n = 9) reported feeling fitter, but training was considered insufficiently challenging. Physical therapists (n = 5) reported that B-FIT provides a clear, well-grounded guidance. They perceived the time investment for initiating the program and the carry-over to primary care as the main barriers. The mean (SD) submaximal heart rate (based on n = 20) reduced significantly by -6.5 beats per minute (95% CI = -11.8 to -1.2), from 121.7 (16.5) at baseline to 115.2 (14.3) after intervention. Submaximal ratings of perceived exertion, anaerobic threshold, and peak workload also improved significantly (P < .05). Conclusion. The outcomes of this pilot study suggest that individualized aerobic exercise according to B-FIT is feasible and has potential to improve physical fitness in a wide variety of slowly progressive NMD. However, some barriers must be addressed before investigating the efficacy in a randomized controlled trial. Impact. The outcomes of this study demonstrate the feasibility of individualized aerobic exercise according to the B-FIT training guide and the potential to improve physical fitness in NMD. Physical therapists indicated that the use of B-FIT provides a clear, well-grounded guidance. The training guide can support health care professionals in the application of aerobic exercise in adult neuromuscular rehabilitation. Lay Summary. Individualized exercise according to the B-FIT training guide is feasible in a wide variety of slowly progressive NMD and might help improve physical fitness. Keywords: Aerobic Exercise, Neuromuscular Diseases, Feasibility, Rehabilitation, Physical Fitness

Published
2021
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38. In-Shoe Pressure Measurements in Diabetic Footwear Practice: Success Rate and Facilitators of and Barriers to Implementation.

Author

Zwaferinkc, Jennefer B. J., Nollet, Frans, and Bus, Sicco A.

Abstract

We aimed to assess the success rate and facilitators of and the barriers to the implementation of in-shoe plantar pressure measurements in footwear practice for people with diabetes at high risk of foot ulceration. Eleven Dutch footwear practices were partly supported in purchasing a pressure measurement system. Over a 2.5-year period, trained shoe technicians evaluated 1030 people with diabetes (range: 13 to 156 across practices). The implementation success and associated facilitators and barriers were evaluated quantitatively using completed measurement forms and pressure measurement data obtained during four monitoring sessions and qualitatively through semi-structured interviews with technicians. Across the 11 practices, the primary target group (people with diabetes and a healed plantar foot ulcer) represented 25–90% of all the patients measured. The results showed that three practices were successful, five moderately successful, and three not successful. The facilitators included support by the company management board, collaboration with a prescribing physician, measurement sessions separate from the outpatient clinic, and a (dedicated) shoe technician experiencing a learning effect. The barriers included investment costs, usability aspects, and limited awareness among shoe technicians. In-shoe plantar pressure measurements can be implemented to a moderate to large degree in diabetic footwear practice. The barriers to and facilitators of implementation are organizational, logistical, financial, or technical, and the barriers are modifiable, supporting future implementation. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs

Author

Buffart, Laurien M., Kalter, Joeri, Sweegers, Maike G., Courneya, Kerry S., Newton, Robert U., Aaronson, Neil K., Jacobsen, Paul B., May, Anne M., Galvão, Daniel A., Chinapaw, Mai J., Steindorf, Karen, Irwin, Melinda L., Stuiver, Martijn M., Hayes, Sandi, Griffith, Kathleen A., Lucia, Alejandro, Mesters, Ilse, van Weert, Ellen, Knoop, Hans, Goedendorp, Martine M., Mutrie, Nanette, Daley, Amanda J., McConnachie, Alex, Bohus, Martin, Thorsen, Lene, Schulz, Karl-Heinz, Short, Camille E., James, Erica L., Plotnikoff, Ron C., Arbane, Gill, Schmidt, Martina E., Potthoff, Karin, van Beurden, Marc, Oldenburg, Hester S., Sonke, Gabe S., van Harten, Wim H., Garrod, Rachel, Schmitz, Kathryn H., Winters-Stone, Kerri M., Velthuis, Miranda J., Taaffe, Dennis R., van Mechelen, Willem, Kersten, Marie-José, Nollet, Frans, Wenzel, Jennifer, Wiskemann, Joachim, Verdonck-de Leeuw, Irma M., and Brug, Johannes

Published
2017
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42. Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data

Author

VAN VULPEN, JONNA K., SWEEGERS, MAIKE G., PEETERS, PETRA H. M., COURNEYA, KERRY S., NEWTON, ROBERT U., AARONSON, NEIL K., JACOBSEN, PAUL B., GALVÃO, DANIEL A., CHINAPAW, MAI J., STEINDORF, KAREN, IRWIN, MELINDA L., STUIVER, MARTIJN M., HAYES, SANDI, GRIFFITH, KATHLEEN A., MESTERS, ILSE, KNOOP, HANS, GOEDENDORP, MARTINE M., MUTRIE, NANETTE, DALEY, AMANDA J., MCCONNACHIE, ALEX, BOHUS, MARTIN, THORSEN, LENE, SCHULZ, KARL-HEINZ, SHORT, CAMILLE E., JAMES, ERICA L., PLOTNIKOFF, RONALD C., SCHMIDT, MARTINA E., ULRICH, CORNELIA M., VAN BEURDEN, MARC, OLDENBURG, HESTER S., SONKE, GABE S., VAN HARTEN, WIM H., SCHMITZ, KATHRYN H., WINTERS-STONE, KERRI M., VELTHUIS, MIRANDA J., TAAFFE, DENNIS R., VAN MECHELEN, WILLEM, KERSTEN, MARIE JOSÉ, NOLLET, FRANS, WENZEL, JENNIFER, WISKEMANN, JOACHIM, VERDONCK-DE LEEUW, IRMA M., BRUG, JOHANNES, MAY, ANNE M., and BUFFART, LAURIEN M.

Published
2020
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46. Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis

Author

Hiensch, Anouk E., primary, Beckhaus, Julia, additional, Witlox, Lenja, additional, Monninkhof, Evelyn M., additional, Schagen, Sanne B., additional, van Vulpen, Jonna K., additional, Sweegers, Maike G., additional, Newton, Robert U., additional, Aaronson, Neil K., additional, Galvão, Daniel A., additional, Steindorf, Karen, additional, Stuiver, Martijn M., additional, Mesters, Ilse, additional, Knoop, Hans, additional, Goedendorp, Martine M., additional, Bohus, Martin, additional, Thorsen, Lene, additional, Schulz, Karl-Heinz, additional, Schmidt, Martina E., additional, Ulrich, Cornelia M., additional, Sonke, Gabe S., additional, van Harten, Wim H., additional, Winters-Stone, Kerri M., additional, Velthuis, Miranda J., additional, Taaffe, Dennis R., additional, van Mechelen, Willem, additional, Kersten, Marie José, additional, Nollet, Frans, additional, Wiskemann, Joachim, additional, Buffart, Laurien M, additional, and May, Anne M, additional

Published
2023
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