ORCID Profile
0000-0002-5212-2937
Current Organisations
University of South Australia
,
University of Newcastle Australia
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Publications
Normative Cardiopulmonary Exercise Test Responses at the Ventilatory Threshold in Canadian Adults 40 to 80 Years of Age
Publisher: Elsevier BV
Date: 05-2021
Physiological and perceptual responses to exercise according to locus of symptom limitation in COPD
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.RESP.2019.103322
Abstract: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, with pulmonary and extra-pulmonary factors contributing to exercise intolerance. The primary self-reported exercise-limiting symptom may reflect the primary pathophysiological factor contributing to exercise intolerance. We compared physiological and perceptual responses at the symptom-limited peak of incremental cardiopulmonary cycle exercise testing between people with COPD reporting breathlessness (B, n = 34), leg discomfort (LD, n = 16), or a combination of B and LD (BOTH, n = 42) as their main exercise-limiting symptom(s). Despite similarly impaired health status, symptomology and peak exercise capacity, the B group had greater restrictive constraints on tidal volume expansion at end-exercise and was more likely to report unpleasant qualities of exertional breathlessness than LD and BOTH groups. In conclusion, reporting breathlessness as the primary exercise-limiting symptom indicated the presence of distinct lung pathophysiology and symptom perception during exercise in people with COPD.
Plasmonic metal oxides and their biological applications
Publisher: Royal Society of Chemistry (RSC)
Date: 2022
DOI: 10.1039/D2MH00263A
Abstract: Doped metal oxide nanostructures with tunable plasmonic features enable a variety of high-performance biological applications.
How to Assess Breathlessness in Chronic Obstructive Pulmonary Disease
Publisher: Informa UK Limited
Date: 06-2021
DOI: 10.2147/COPD.S277523
A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep
Publisher: Springer Science and Business Media LLC
Date: 06-01-2022
DOI: 10.1186/S12966-021-01236-2
Abstract: In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process . The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines. Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years). To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines.
“You either need help…you feel you don't need help…or you don't feel worthy of asking for it:” Receptivity to bereavement support
Publisher: Cambridge University Press (CUP)
Date: 21-01-2018
DOI: 10.1017/S1478951517001122
Abstract: Although the needs of the bereaved have been identified widely in the literature, how these needs translate into meaningful, appropriate, and client-centered programs needs further exploration. The application of receptivity to support is a critical factor in participation by the bereaved in palliative care bereavement programs. Receptivity is a complex multifactorial phenomenon influenced by internal and external factors that ultimately influences engagement in psychosocial support in bereavement. This study explored factors that influence receptivity to bereavement support from palliative care services in rural, regional, and remote Western Australia. The study comprised a qualitative descriptive research design using semistructured interviews with 24 bereaved in iduals, nine palliative care health professionals, and four Aboriginal Health Professionals. Participants were recruited via palliative care services in country Western Australia. Interviews were transcribed verbatim and thematically analyzed. Findings revealed that a range of in idual, social, and geographical factors influence receptivity to bereavement support and can impact on utilization of bereavement support services. Receptivity provides a frame of reference to enhance understanding of factors influencing engagement in psychosocial support in bereavement. Receptivity promotes a shift of service provider perspectives of effective supportive care to consumer-centric reasons for engagement.
Effects of exercise training with blood flow restriction on vascular function in adults: a systematic review and meta-analysis
Publisher: PeerJ
Date: 07-07-2021
DOI: 10.7717/PEERJ.11554
Abstract: Blood flow restricted exercise (BFRE) improves physical fitness, with theorized positive effects on vascular function. This systematic review and meta-analysis aimed to report (1) the effects of BFRE on vascular function in adults with or without chronic health conditions, and (2) adverse events and adherence reported for BFRE. Five electronic databases were searched by two researchers independently to identify studies reporting vascular outcomes following BFRE in adults with and without chronic conditions. When sufficient data were provided, meta-analysis and exploratory meta-regression were performed. Twenty-six studies were included in the review (total participants n = 472 n = 41 older adults with chronic conditions). Meta-analysis (k = 9 studies) indicated that compared to exercise without blood flow restriction, resistance training with blood flow restriction resulted in significantly greater effects on endothelial function (SMD 0.76 95% CI [0.36–1.14]). No significant differences were estimated for changes in vascular structure (SMD −0.24 95% CI [−1.08 to 0.59]). In exploratory meta-regression analyses, several experimental protocol factors (design, exercise modality, exercised limbs, intervention length and number of sets per exercise) were significantly associated with the effect size for endothelial function outcomes. Adverse events in BFRE studies were rarely reported. There is limited evidence, predominantly available in healthy young adults, on the effect of BFRE on vascular function. Signals pointing to effect of specific dynamic resistance exercise protocols with blood flow restriction (≥4 weeks with exercises for the upper and lower limbs) on endothelial function warrant further investigation.
Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma
Publisher: MDPI AG
Date: 15-09-2023
DOI: 10.3390/JCM12185998
The mBorg/6MWD ratio – a method to assess exertional breathlessness and leg discomfort using the 6-minute walk test
Publisher: European Respiratory Society (ERS)
Date: 03-08-2023
DOI: 10.1183/23120541.00281-2023
Abstract: The 6-minute walk test (6MWT) is widely used to assess exercise capacity across chronic health conditions, but is currently not useful to assess symptoms as the scores do not account for the walk distance (6MWD). We aimed to: (1) develop normative reference equations for breathlessness and leg discomfort intensity expressed as modified Borg (mBorg)/6MWD ratios and (2) validate the equations in people with chronic obstructive pulmonary disease (COPD). Analysis of people aged ≥40 years who performed two 6MWTs in the Canadian Cohort Obstructive Lung Disease (CanCOLD) study a healthy cohort (n=291 aged 67.5±9.4 years 54% male) with normal 6MWD and lung function and a COPD cohort (n=156 aged 66.2±9.0 years 56% male FEV 1 /FVC 56.6±8.2% FEV 1 74.4±18.6%pred). The mBorg score was calculated as the Borg 0–10 category ratio intensity rating of breathlessness or leg discomfort recorded at the end of the 6MWT +1 (range 1–11), to avoid zeros and yield ratios proportional to the symptom score and 6MWD −1 . Using data from the healthy cohort, sex-specific normative reference equations for breathlessness and leg discomfort mBorg/6MWD ratios were developed using multivariable linear regression, accounting for age, and body mass or body mass index. In the COPD cohort, abnormal breathlessness and leg discomfort (mBorg/6MWD upper limit of normal [ULN]) showed strong concurrent validity with worse airflow limitation, Medical Research Council (MRC) breathlessness, and COPD Assessment Test scores. Normative references for the mBorg/6MWD ratio are presented to assess breathlessness and leg discomfort responses to the 6MWT in COPD.
Chronic Breathlessness Explanations and Research Priorities: Findings From an International Delphi Survey
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.JPAINSYMMAN.2019.10.012
Abstract: Explanations provided by health professionals may underpin helpful or harmful symptom beliefs and expectations of people living with chronic breathlessness. This study sought perspectives from health professionals with clinical/research expertise in chronic breathlessness on priority issues in chronic breathlessness explanations and research. Authors (n = 74) of publications specific to chronic breathlessness were invited to a three-round Delphi survey. Responses to open-ended questions (Round 1 "What is important to: include/avoid when explaining chronic breathlessness prioritize in research?") were transformed to Likert scale (1-9) items for rating in subsequent rounds. A priori consensus was defined as ≥70% of respondents rating an item as important (Likert rating 7-9) and interquartile range ≤2. Of the 31 Round 1 respondents (nine countries, five professional disciplines), 24 (77%) completed Rounds 2 and 3. Sixty-three items met consensus (include n = 28 avoid n = 9 research n = 26). Explanations of chronic breathlessness should use patient-centered communication acknowledge the distress, variability, and importance of this sensation emphasize current management principles clarify maladaptive beliefs and expectations and avoid moral culpability and inappropriate reassurance. Research priorities included the need 1) for a comprehensive understanding of breathlessness science 2) to optimize, explore, and develop effective interventions, both pharmacological and nonpharmacological and 3) determine effective models of care including strategies for education and training of health professionals and people caring for, or living with, chronic breathlessness. These consensus-based concepts for chronic breathlessness explanations and research provide a starting point for conversations between patients, carers, clinicians, and researchers within the chronic breathlessness community.
Reference equations for breathlessness during incremental cycle exercise testing
Publisher: European Respiratory Society (ERS)
Date: 03-2023
DOI: 10.1183/23120541.00566-2022
Abstract: Exertional breathlessness is commonly assessed using incremental exercise testing (IET), but reference equations for breathlessness responses are lacking. We aimed to develop reference equations for breathlessness intensity during IET. A retrospective, consecutive cohort study of adults undergoing IET was carried out in Sweden. Exclusion criteria included cardiac or respiratory disease, death or any of the aforementioned diagnoses within 1 year of the IET, morbid obesity, abnormally low exercise capacity, submaximal exertion or an abnormal exercise test. Probabilities for breathlessness intensity ratings (Borg CR10) during IET in relation to power output (%predW max ), age, sex, height and body mass were analysed using marginal ordinal logistic regression. Reference equations for males and females were derived to predict the upper limit of normal (ULN) and the probability of different Borg CR10 intensity ratings. 2581 participants (43% female) aged 18–90 years were included. Mean breathlessness intensity was similar between sexes at peak exertion (6.7±1.5 versus 6.4±1.5 Borg CR10 units) and throughout exercise in relation to %predW max . Final reference equations included age, height and %predW max for males, whereas height was not included for females. The models showed a close fit to observed breathlessness intensity ratings across %predW max values. Models using absolute W did not show superior fit. Scripts are provided for calculating the probability for different breathlessness intensity ratings and the ULN by %predW max throughout IET. We present the first reference equations for interpreting breathlessness intensity during incremental cycle exercise testing in males and females aged 18–90 years.
Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain?
Publisher: MDPI AG
Date: 22-01-2019
DOI: 10.3390/HEALTHCARE7010015
Abstract: Chronic pain is highly prevalent and more common in people with chronic obstructive pulmonary disease (COPD) than people of similar age/sex in the general population. This systematic review aimed to describe how frequently and in which contexts pain is considered in the clinical practice guidelines (CPGs) for the broad management of COPD. Databases (Medline, Scopus, CiNAHL, EMbase, and clinical guideline) and websites were searched to identify current versions of COPD CPGs published in any language since 2006. Data on the frequency, context, and specific recommendations or strategies for the assessment or management of pain were extracted, collated, and reported descriptively. Of the 41 CPGs (English n = 20) reviewed, 16 (39%) did not mention pain. Within the remaining 25 CPGs, pain was mentioned 67 times (ranging from 1 to 10 mentions in a single CPG). The most frequent contexts for mentioning pain were as a potential side effect of specific pharmacotherapies (22 mentions in 13 CPGs), as part of differential diagnosis (14 mentions in 10 CPGs), and end of life or palliative care management (7 mentions in 6 CPGs). In people with COPD, chronic pain is common adversely impacts quality of life, mood, breathlessness, and participation in activities of daily living and warrants consideration within CPGs for COPD.
Efficacy of interventions to alter measures of fat-free mass in people with COPD: a systematic review and meta-analysis
Publisher: European Respiratory Society (ERS)
Date: 20-04-2023
DOI: 10.1183/23120541.00102-2023
Abstract: Low fat-free mass (FFM) is linked to poor health outcomes in COPD, including impaired exercise tolerance and premature death. The aim of this systematic review was to synthesise evidence on the effectiveness of interventions for increasing FFM in COPD. Searches of electronic databases (MEDLINE, Cochrane Library, Embase, Web of Science, Scopus) and trial registers ( ClinicalTrials.gov ) were undertaken from inception to August 2022 for randomised studies of interventions assessing measures of FFM in COPD. The primary outcome was change in FFM (including derivatives). Secondary outcomes were adverse events, compliance and attrition. 99 studies (n=5138 people with COPD) of 11 intervention components, used alone or in combination, were included. Exercise training increased mid-thigh cross-sectional area ( k =3, standardised mean difference (SMD) 1.04, 95% CI 0.02–2.06 p=0.04), but not FFM ( k =4, SMD 0.03, 95% CI −0.18–0.24 p=0.75). Nutritional supplementation significantly increased FFM index ( k =11, SMD 0.31, 95% CI 0.13–0.50 p .001), but not FFM ( k =19, SMD 0.16, 95% CI −0.06–0.39 p=0.16). Combined exercise training and nutritional supplementation increased measures related to FFM in 67% of studies. Anabolic steroids increased FFM ( k =4, SMD 0.98, 95% CI 0.24–1.72 p=0.009). Neuromuscular electrical stimulation increased measures related to FFM in 50% of studies. No interventions were more at risk of serious adverse events, low compliance or attrition. Exercise training and nutritional supplementation were not effective in isolation to increase FFM, but were for localised muscle and index measures, respectively. Combined, exercise and nutritional supplementation shows promise as a strategy to increase FFM in COPD. Anabolic steroids are efficacious for increasing FFM in COPD.
Improving physical activity, sedentary behaviour and sleep in COPD: Perspectives of people with COPD and experts via a Delphi approach
Publisher: PeerJ
Date: 27-04-0027
DOI: 10.7717/PEERJ.4604
Abstract: Little is known about how to achieve enduring improvements in physical activity (PA), sedentary behaviour (SB) and sleep for people with chronic obstructive pulmonary disease (COPD). This study aimed to: (1) identify what people with COPD from South Australia and the Netherlands, and experts from COPD- and non-COPD-specific backgrounds considered important to improve behaviours and (2) identify areas of dissonance between these different participant groups. A four-round Delphi study was conducted, analysed separately for each group. Free-text responses (Round 1) were collated into items within themes and rated for importance on a 9-point Likert scale (Rounds 2–3). Items meeting a priori criteria from each group were retained for rating by all groups in Round 4. Items and themes achieving a median Likert score of ≥7 and an interquartile range of ≤2 across all groups at Round 4 were judged important. Analysis of variance with Tukey’s post-hoc tested for statistical differences between groups for importance ratings. Seventy-three participants consented to participate in this study, of which 62 (85%) completed Round 4. In Round 4, 81 items (PA n = 54 SB n = 24 sleep n = 3) and 18 themes (PA n = 9 SB n = 7 sleep n = 2) were considered important across all groups concerning: (1) symptom/disease management, (2) targeting behavioural factors, and (3) less commonly, adapting the social hysical environments. There were few areas of dissonance between groups. Our Delphi participants considered a multifactorial approach to be important to improve PA, SB and sleep. Recognising and addressing factors considered important to recipients and providers of health care may provide a basis for developing behaviour-specific interventions leading to long-term behaviour change in people with COPD.
Life on holidays
Publisher: Springer Science and Business Media LLC
Date: 23-10-2019
DOI: 10.1186/S12889-019-7671-7
Abstract: Emerging evidence suggests that children become fatter and less fit over the summer holidays but get leaner and fitter during the in-school period. This could be due to differences in diet and time use between these distinct periods. Few studies have tracked diet and time use across the summer holidays. This study will measure rates of change in fatness and fitness of children, initially in Grade 4 (age 9 years) across three successive years and relate these changes to changes in diet and time use between in-school and summer holiday periods. Grade 4 Children attending Australian Government, Catholic and Independent schools in the Adelaide metropolitan area will be invited to participate, with the aim of recruiting 300 students in total. Diet will be reported by parents using the Automated Self-Administered 24-h Dietary Assessment Tool. Time use will be measured using 24-h wrist-worn accelerometry (GENEActiv) and self-reported by children using the Multimedia Activity Recall for Children and Adults (e.g. chores, reading, sport). Measurement of diet and time use will occur at the beginning (Term 1) and end (Term 4) of each school year and during the summer holiday period. Fitness (20-m shuttle run and standing broad jump) and fatness (body mass index z -score, waist circumference, %body fat) will be measured at the beginning and end of each school year. Differences in rates of change in fitness and fatness during in-school and summer holiday periods will be calculated using model parameter estimate contrasts from linear mixed effects model. Model parameter estimate contrasts will be used to calculate differences in rates of change in outcomes by socioeconomic position (SEP), sex and weight status. Differences in rates of change of outcomes will be regressed against differences between in-school and summer holiday period diet and time use, using compositional data analysis. Analyses will adjust for age, sex, SEP, parenting style, weight status, and pubertal status, where appropriate. Findings from this project may inform new, potent avenues for intervention efforts aimed at addressing childhood fitness and fatness. Interventions focused on the home environment, or alternatively extension of the school environment may be warranted. Australia New Zealand Clinical Trials Registry, identifier ACTRN12618002008202 . Retrospectively registered on 14 December 2018.
Recommendations for 24-Hour Movement Behaviours in Adults with Asthma: A Review of Current Guidelines
Publisher: MDPI AG
Date: 10-03-2020
Abstract: Background: Many countries have clinical practice guidelines (CPG) for asthma that serve as an important resource for healthcare professionals and inform the development of policies and practices relevant to asthma care. The purpose of this scoping review was to search for CPGs related to asthma to determine what recommendations related to the 24-h movement behaviours are provided. Methods: We searched for the most recent CPGs published by a national authoritative body from 195 countries. Guidelines were reviewed for all movement behaviours that is, physical activity, sedentary behaviour, and sleep. Results: In total, 82 documents were searched for eligibility and 19 were included in our review. Of these, only 10 CPGs provided information on physical activity none provided recommendations consistent with the FITT principle, while seven recommended activity levels similar to the general population. None of the guidelines included information on sedentary behaviour. Nine guidelines included information on sleep: recommendations mostly focused on changes to medication to reduce disruptions in sleep. Conclusions: It is recommended that future work be conducted to create comprehensive movement behaviour guidelines accompanied with relevant precautions and strategies to ensure that adults with asthma are able to safely and effectively engage in movement behaviours throughout the day.
Standardized measurement of breathlessness during exercise
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2019
Treatable traits for long COVID
Publisher: Wiley
Date: 16-09-2016
DOI: 10.1111/RESP.14596
Compliance With Mobile Ecological Momentary Assessment of Self-Reported Health-Related Behaviors and Psychological Constructs in Adults: Systematic Review and Meta-analysis
Publisher: JMIR Publications Inc.
Date: 03-03-2021
DOI: 10.2196/17023
Abstract: Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. This study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical s les of adults. In total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults ( years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets. Of the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%) median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2 %), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. In this 10-year s le of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
Dyspnoea-12 and Multidimensional Dyspnea Profile: Systematic Review of Use and Properties
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.JPAINSYMMAN.2021.06.023
Abstract: The Dyspnoea-12 (D-12) and Multidimensional Dyspnea Profile (MDP) were specifically developed for assessment of multiple sensations of breathlessness. This systematic review aimed to identify the use and measurement properties of the D-12 and MDP across populations, settings and languages. Electronic databases were searched for primary studies (2008-2020) reporting use of the D-12 or MDP in adults. Two independent reviewers completed screening and data extraction. Study and participant characteristics, instrument use, reported scores and minimal clinical important differences (MCID) were evaluated. Data on internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient, ICC) were pooled using random effects models between settings and languages. A total 75 publications reported use of D-12 (n = 35), MDP (n = 37) or both (n = 3), reflecting 16 chronic conditions. Synthesis confirmed two factor structure, internal consistency (Cronbach's α mean, 95% CI: D-12 Total = 0.93, 0.91-0.94 MDP Immediate Perception [IP] = 0.88, 0.85-0.90 MDP Emotional Response [ER] = 0.86, 0.82-0.89) and 14 day test-rest reliability (ICC: D-12 Total = 0.91, 0.88-0.94 MDP IP = 0.85, 0.70-0.93 MDP ER = 0.84, 0.73-0.90) across settings and languages. MCID estimates for clinical interventions ranged between -3 and -6 points (D-12 Total) with small variability in scores over 2 weeks (D-12 Total 2.8 (95% CI: 2.0 to 3.7), MDP-A1 0.8 (0.6 to 1.1) and six months (D-12 Total 2.9 (2.0 to 3.7), MDP-A1 0.8 (0.6 to 1.1)). D-12 and MDP are widely used, reliable, valid and responsive across various chronic conditions, settings and languages, and could be considered standard instruments for measuring dimensions of breathlessness in international trials.
Behaviour change techniques to optimise participation in physical activity or exercise in adolescents and young adults with chronic cardiorespiratory conditions: a systematic review
Publisher: Wiley
Date: 10-2019
DOI: 10.1111/IMJ.14141
Abstract: Participation in regular physical activity decreases the risk of developing cardiometabolic disease. However, the proportion of people who participate in the recommended amount of physical activity is low, with common barriers including competing interests and inclement weather. In people with chronic cardiorespiratory conditions, participation in physical activity is reduced further by disease-specific barriers, time burden of treatment and unpleasant symptoms during physical activity. Addressing these barriers during adolescence and early adulthood may promote greater physical activity participation into older age. The aim of this review was to classify interventions aimed at optimising participation in physical activity as 'promising' or 'not promising' in people aged 15-45 years with chronic cardiorespiratory conditions and categorise the behaviour change techniques (BCT) within these interventions. Nine databases and registries were searched (October 2017) for studies that reported objective measures of physical activity before and after an intervention period. Interventions were classified as 'promising' if a between-group difference in physical activity was demonstrated. Michie et al.'s (2013) v1 Taxonomy was used to unpack the BCT within interventions. Across the six included studies (n = 396 participants), 19 (20%) of 93 BCT were described. The interventions of three studies were classified as 'promising'. The most commonly used BCT comprised goal setting, action planning and social support. Five BCT were solely used in 'promising' interventions. Our review demonstrated that only 20% of BCT have been utilised, and those BCT that were used only in 'promising' physical activity interventions in adolescents and adults with chronic cardiorespiratory conditions were isolated.
Normative Peak Cardiopulmonary Exercise Test Responses in Canadian Adults Aged ≥40 Years
Publisher: Elsevier BV
Date: 12-2020
Routinely collected clinical and laboratory data can reliably predict longer survival in malignant pleural mesothelioma
Publisher: Wiley
Date: 24-03-2014
DOI: 10.1111/RESP.12263_8
Breathlessness Isn’t Cool, But Its Treatment Can Be
Publisher: Elsevier BV
Date: 06-2020
Compliance With Mobile Ecological Momentary Assessment of Self-Reported Health-Related Behaviors and Psychological Constructs in Adults: Systematic Review and Meta-analysis (Preprint)
Publisher: JMIR Publications Inc.
Date: 12-11-2019
Abstract: obile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. his study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical s les of adults. n total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (& years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance ( i P /i ≤.05) assessed differences between nonclinical and clinical data sets. f the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%) median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I sup /sup & %), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. n this 10-year s le of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
Counseling for health behavior change in people with COPD: systematic review
Publisher: Informa UK Limited
Date: 07-2017
DOI: 10.2147/COPD.S111135
Physical activity, sedentary behaviour and sleep in COPD guidelines: A systematic review
Publisher: SAGE Publications
Date: 24-02-2017
Abstract: Physical activity, sedentary and sleep behaviours have strong associations with health. This systematic review aimed to identify how clinical practice guidelines (CPGs) for the management of chronic obstructive pulmonary disease (COPD) report specific recommendations and strategies for these movement behaviours. A systematic search of databases (Medline, Scopus, CiNAHL, EMbase, Clinical Guideline), reference lists and websites identified current versions of CPGs published since 2005. Specific recommendations and strategies concerning physical activity, sedentary behaviour and sleep were extracted verbatim. The proportions of CPGs providing specific recommendations and strategies were reported. From 2370 citations identified, 35 CPGs were eligible for inclusion. Of these, 21 (60%) provided specific recommendations for physical activity, while none provided specific recommendations for sedentary behaviour or sleep. The most commonly suggested strategies to improve movement behaviours were encouragement from a healthcare provider (physical activity n = 20 sedentary behaviour n = 2) and referral for a diagnostic sleep study (sleep n = 4). Since optimal physical activity, sedentary behaviour and sleep durations and patterns are likely to be associated with mitigating the effects of COPD, as well as with general health and well-being, there is a need for further COPD-specific research, consensus and incorporation of recommendations and strategies into CPGs.
Multidimensional breathlessness assessment during cardiopulmonary exercise testing in healthy adults
Publisher: Springer Science and Business Media LLC
Date: 03-11-2020
Title: Blood flow restricted exercise training: perspectives of people with chronic obstructive pulmonary disease and health professionals
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/14799731211056092
Abstract: This descriptive qualitative study explored perspectives of people with chronic obstructive pulmonary disease (COPD) and health professionals concerning blood flow restricted exercise (BFRE) training. People living with COPD and health professionals (exercise physiologists, physiotherapists, and hospital-based respiratory nurses and doctors) participated in interviews or focus groups, which included information about BFRE training and a facilitated discussion of positive aspects, barriers and concerns about BFRE training as a possible exercise-based intervention. Sessions were audio-recorded, and transcript data analysed using inductive content analysis. Thirty-one people participated (people with COPD n = 6 health professionals n = 25). All participant groups expressed positive perceptions of BFRE as a potential alternative low-intensity exercise mode where health benefits might be achieved. Areas of overlap in perceived barriers and concerns included the need to address the risk of potential adverse events, suitability of training sites and identifying processes to appropriately screen potential candidates. While potential benefits were identified, concerns about determining who is safe and suitable to participate, delivery processes, health professional training and effects on a variety of health-related outcomes need to be addressed before implementation of BFRE training for people with COPD.
The Association between Fat-Free Mass and Exercise Test Outcomes in People with Chronic Obstructive Pulmonary Disease: A Systematic Review
Publisher: Informa UK Limited
Date: 12-04-2022
DOI: 10.1080/15412555.2022.2049737
Abstract: People with chronic obstructive pulmonary disease (COPD) tend to have abnormally low levels of fat-free mass (FFM), which includes skeletal muscle mass as a central component. The purpose of this systematic review was to synthesise available evidence on the association between FFM and exercise test outcomes in COPD. MEDLINE, Cochrane Library, EMBASE, Web of Science, and Scopus were searched. Studies that evaluated exercise-related outcomes in relation to measures of FFM in COPD were included. Eighty-three studies, containing 18,770 (39% female) COPD participants, were included. Considerable heterogeneity was identified in the ways that FFM and exercise test outcomes were assessed however, higher levels of FFM were generally associated with greater peak exercise capacity. This association was stronger for some exercise test outcomes (e.g. peak rate of oxygen consumption during incremental cycle exercise testing) than others (e.g. six-minute walking distance). This review identified heterogeneity in the methods used for measuring FFM and exercise capacity. There was, in general, a positive association between FFM and exercise capacity in COPD. There was also an identified lack of studies investigating associations between FFM and temporal physiological and perceptual responses to exercise. This review highlights the significance of FFM as a determinant of exercise capacity in COPD.
Multidimensional breathlessness response to exercise: Impact of COPD and healthy ageing
Publisher: Elsevier BV
Date: 05-2021
Updates in opioid and nonopioid treatment for chronic breathlessness
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2019
Use of time in chronic obstructive pulmonary disease: Longitudinal associations with symptoms and quality of life using a compositional analysis approach
Publisher: Public Library of Science (PLoS)
Date: 21-03-2019
Predicting the rate of oxygen consumption during the 3-minute constant-rate stair stepping and shuttle tests in people with COPD
Publisher: AME Publishing Company
Date: 05-2020
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