ORCID Profile
0000-0002-7227-2406
Current Organisation
University of South Australia
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Publisher: Springer Science and Business Media LLC
Date: 22-05-2023
DOI: 10.1007/S40279-023-01862-9
Abstract: Cancer-related pain is common and undertreated. Exercise is known to have a pain-relieving effect in non-cancer pain. This systematic review aimed to evaluate (1) the effect of exercise on cancer-related pain in all cancers, and (2) whether the effect of exercise differed according to exercise mode, degree of supervision, intervention duration and timing (during or after cancer treatment), pain types, measurement tool and cancer type. Electronic searches were undertaken in six databases to identify exercise studies evaluating pain in people with cancer, published prior to 11 January 2023. All stages of screening and data extraction were conducted independently by two authors. The Cochrane risk of bias tool for randomised trials (RoB 2) was used and overall strength of evidence was assessed using the GRADE approach. Meta-analyses were performed overall and by study design, exercise intervention and pain characteristics. In total, 71 studies reported in 74 papers were eligible for inclusion. The overall meta-analysis included 5877 participants and showed reductions in pain favouring exercise (standardised mean difference − 0.45 95% confidence interval − 0.62, − 0.28). For most ( 82%) of the subgroup analyses, the direction of effect favoured exercise compared with usual care, with effect sizes ranging from small to large (median effect size − 0.35 range − 0.03 to − 1.17). The overall strength of evidence for the effect of exercise on cancer-related pain was very low. The findings provide support that exercise participation does not worsen cancer-related pain and that it may be beneficial. Better pain categorisation and inclusion of more erse cancer populations in future research would improve understanding of the extent of benefit and to whom. CRD42021266826.
Publisher: American Medical Association (AMA)
Date: 22-08-2023
DOI: 10.1001/JAMANETWORKOPEN.2023.30098
Abstract: Little is known about temporal trends in children’s well-being and how the COVID-19 pandemic may have influenced the well-being of young Australians. Certain demographic groups may be more vulnerable to experiencing declines in well-being. To examine well-being trends over 6 consecutive years among South Australian students and explore the influence of sociodemographic characteristics. Longitudinal analyses of annual (2017 to 2022) cross-sectional data of students in grades 4 through 9 (n = 40 392 to 56 897 per year) attending South Australian government schools from the Well-being and Engagement Collection (WEC) census. Calendar year (2017-2022) and sociodemographic characteristics (sex, school grade, parental education, language spoken at home, residential region) from school enrollment records. Students self-reported life satisfaction, optimism, happiness, cognitive engagement, emotional regulation, perseverance, worry, and sadness. Over 6 years (2017 to 2022), a total of 119 033 students (mean [SD] age, 12.1 y 51.4% male) participated in this study. Most well-being measures declined over time, with consistent worsening of well-being from 2020 onward. For ex le, compared with 2017, sadness was 0.26 (95% CI, 0.25-0.27) points higher in 2020 (standardized mean difference [SMD], 0.27) and remained elevated by more than 0.26 points (SMD, 0.27) in 2021 and 2022. At almost every time point, greatest well-being was reported by students of male sex (except cognitive engagement and perseverance), in earlier school grades, with highest parental education, speaking a language other than English at home, and residing in outer regional and remote settings (for satisfaction, optimism, and emotional regulation). Sociodemographic differences in well-being were generally consistent over time however, sex differences widened from 2020 for all indicators except cognitive engagement and perseverance. For ex le, between 2017 and 2022, sadness increased by 0.27 (95% CI, 0.25-0.29) more points among females than males (SMD, 0.28). In this longitudinal analysis of annual census data, there were downward trends in students’ well-being, especially since 2020. The largest sociodemographic disparities were observed for students of female sex, those in later school grades, and those with lowest parental education. Urgent and equitable support for the well-being of all young people, particularly those facing disparity, is imperative.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 03-2022
Publisher: Cold Spring Harbor Laboratory
Date: 15-03-2021
DOI: 10.1101/2021.03.12.21253378
Abstract: Despite evidence of selective outcome reporting across multiple disciplines, this has not yet been assessed in trials studying the effects of exercise in people with cancer. Therefore, the purpose of our study was to explore prospectively registered randomised controlled trials (RCTs) in exercise oncology for evidence of selective outcome reporting. Eligible trials were RCTs that 1) investigated the effects of at least partially supervised exercise interventions in people with cancer 2) were preregistered (i.e. registered before the first patient was recruited) on a clinical trials registry and 3) reported results in a peer-reviewed published manuscript. We searched the PubMed database from the year of inception to September 2020 to identify eligible exercise oncology RCTs clinical trial registries. Eligible trial registrations and linked published manuscripts were compared to identify the proportion of sufficiently preregistered outcomes reported correctly in the manuscripts, and cases of outcome omission, switching, and silently introduction of non-novel outcomes. We identified 31 eligible RCTs and 46 that were ineligible due to retrospective registration. Of the 405 total prespecified outcomes across the 31 eligible trials, only 6.2% were preregistered complete methodological detail. Only 16% (n=148/929) of outcomes reported in published results manuscripts were linked with sufficiently preregistered outcomes without outcome switching. We found 85 total cases of outcome switching. A high proportion (41%) of preregistered outcomes were omitted from the published results manuscripts, and many published outcomes (n=394 42.4%) were novel outcomes that had been silently introduced (median, min-max=10, 0-50 per trial). We found no ex les of preregistered efficacy outcomes that were measured, assessed, and analysed as planned. We found evidence suggestive of widespread selective outcome reporting and non-reporting bias (outcome switching, omitted preregistered outcomes, and silently introduced novel outcomes). The existence of such reporting discrepancies has implications for the integrity and credibility of RCTs in exercise oncology. osf.io/dtkar/ (posted: November 19, 2019)
Publisher: Springer Science and Business Media LLC
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 24-09-2020
DOI: 10.1186/S12966-020-01021-7
Abstract: This meta-analysis evaluated the safety, feasibility and effect of exercise among in iduals with colorectal cancer. A database search (CINAHL, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing, Science Direct) for randomised, controlled, exercise trials involving in iduals with colorectal cancer, published before January 1, 2020 was undertaken. Safety (adverse events), feasibility (withdrawal and adherence rates) and effect data (health outcomes including quality of life, QoL) were abstracted. Risk difference (RD) and standardised mean differences (SMD) were calculated to compare safety and effects between exercise and usual care (UC). Subgroup analyses were conducted to assess whether outcomes differed by exercise mode, duration, supervision and treatment. Risk of bias was assessed using the Physiotherapy Evidence Database tool. For the 19 trials included, there was no difference in adverse event risk between exercise and UC (RD = 0.00 95% CI:–0.01, 0.01, p = 0.92). Median withdrawal rate was 12% (0–22%) and adherence was 86% (42–91%). Significant effects of exercise compared to UC were observed for QoL, fatigue, aerobic fitness, upper-body strength, depression, sleep and reduced body fat (SMD = 0.21–0.66, p 0.05). Subgroup analyses suggested larger benefits (p 0.05) for QoL and fatigue for supervised interventions for QoL, aerobic fitness and reduced body fat for ≥12-week interventions and for aerobic fitness when interventions were during chemotherapy. Although reporting of safety and compliance data was lacking in most trials, findings support that exercise is safe and feasible in colorectal cancer. Further, participation in mixed-mode exercise, including unsupervised exercise, leads to improvements in various health-related outcomes.
Publisher: Springer Science and Business Media LLC
Date: 10-09-2022
DOI: 10.1186/S12890-022-02141-5
Abstract: Physiotherapy-related data, such as airway clearance techniques (ACTS), physical activity and aerobic fitness are not consistently included in international cystic fibrosis (CF) data registries. This study aimed to pilot the collection of ACTS, physical activity and fitness in a hospital CF clinic, as a step towards informing future national implementation. This study was undertaken in a CF clinic within a major tertiary hospital. Patients and families were invited to participate. Participants completed self-report questionnaires on ACT use and those aged ≥ 10 years completed a physical activity questionnaire (Core Indicators and Measures of Youth Health Survey) and aerobic fitness test (the A-STEP test). Participants also completed a survey to explore the tolerance and acceptability of the fitness test, and the perceived accuracy of the self-reported data collection. Forty patients agreed to participate in the study (mean age = 9.8, SD = 4.1 years old 52.5% female). All patients and/or families that were approached agreed to participate and completion rate for the ACTs and physical activity surveys was 98% and 100% (respectively). Completion rate for the fitness test was 55%, due to time constraints. Most participants agreed (≥ 90%) they could accurately provide ACT and physical activity data, and the assessments were tolerable and acceptable. Patients with CF and their families are able to and can acceptably provide physiotherapy-related data, and collecting self-report ACTs and physical activity data is highly feasibly during routine CF clinic visits. However, aerobic fitness testing using the A-STEP test may be less feasible in clinic environments, due to time constraints.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.APMR.2018.03.026
Abstract: To systematically evaluate the safety, feasibility, and effect of exercise among women with stage II+ breast cancer. CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published before March 1, 2017. Randomized, controlled, exercise trials involving at least 50% of women diagnosed with stage II+ breast cancer were included. Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal, and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also explored. There were no differences in adverse events between exercise and usual care (risk difference: <0.01 ([95% CI: -0.01, 0.01], P=0.38). Median recruitment rate was 56% (1%-96%), withdrawal rate was 10% (0%-41%) and adherence rate was 82% (44%-99%). Safety and feasibility outcomes were similar, irrespective of exercise mode, supervision, duration, or timing. Effects of exercise for quality of life, fitness, fatigue, strength, anxiety, depression, body mass index and waist circumference compared with usual care were significant (standardized mean difference range: 0.17-0.77, P<0.05). The findings support the safety, feasibility, and effects of exercise for those with stage II+ breast cancer, suggesting that national and international exercise guidelines appear generalizable to women with local, regional, and distant breast cancer.
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.JSAMS.2021.08.008
Abstract: To evaluate the effectiveness of exercise for improving bone-related outcomes among cancer survivors. Systematic review and meta-analysis. An electronic search using the following databases: SPORTDiscus, Science Direct, CINAHL, MEDLINE, Cochrane, Pubmed, Ebscohost, ProQuest Nursing and Allied Health Source. Randomised, controlled, exercise trials involving cancer survivors were eligible. Effect data on bone mineral content (BMC) and density (BMD) outcomes were extracted. Risk of bias was assessed using the Physiotherapy Evidence Database tool. Standardised mean differences (SMD) were calculated to compare differences between exercise and usual care. Subgroup analyses were conducted to assess whether effect differed by exercise mode, intervention length, supervision, treatment, cancer type and risk of bias. Twenty-six trials were included, with intervention durations ranging between 12 weeks and 2 years. Most trials involved breast cancer (n = 13, 50%), and most interventions were supervised (n = 18, 69%) and evaluated mixed-mode (i.e., combined aerobic and resistance) exercise (n = 13, 50%). Significant effects in favour of exercise (aerobic, resistance, mixed-mode and other exercise) were observed for whole body BMD, hip BMD, trochanter BMD and femoral neck BMD (SMD range: 0.19-0.39, all p < 0.05) compared to usual care. Participation in various modes (aerobic, resistance, mixed-mode and other) of supervised and unsupervised exercise is associated with improvements in BMD. The present results provide evidence for clinicians and other health care professionals (e.g., exercise physiologists and physiotherapists) to recommend exercise for cancer survivors to prevent bone loss during and following treatment.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Springer Science and Business Media LLC
Date: 08-04-2021
DOI: 10.1186/S40798-021-00316-8
Abstract: The Rating of Fatigue (ROF) scale can measure changes in perceived fatigue in a variety of contexts. The aim of the present study was to translate and subsequently validate the ROF scale in the French language. The study was composed of three phases. Phase 1 involved a comprehensive translation, back-translation, and consolidation process in order to produce the French ROF scale. During phase 2, the face validity of the French ROF scale was assessed. A cohort of 60 native French speaking participants responded to a range of Likert scale items which probed the purposes of the ROF scale and what it is intended to measure. During phase 3, the convergent and ergent validity of the ROF scale was assessed during r ed cycling to exhaustion and 10 min of resting recovery. The results from phase 1 demonstrated comparability and interpretability between the original and back-translated ROF scale. In phase 2, participants reported a high face validity, with a score of 3.48 ± 0.70 out of 4 when given the item probing whether the scale “measures fatigue”. This score further improved (3.67 ± 0.57, P = 0.01) after participants read the accompanying instructions. Participants were able to distinguish the purposes of the scale for measuring fatigue rather than exertion. In phase 3, strong correlations were found between ROF and heart rate (HR) both during exercise ( r = 0.91, P 0.01) and recovery ( r = 0.92, P 0.01), while discriminant validity between ROF and rating of perceived exertion (RPE) was found during recovery. The present study permits the applications of the ROF scale in the French language.
Publisher: MDPI AG
Date: 16-05-2022
Abstract: Androgen deprivation therapy (ADT) for prostate cancer treatment is associated with adverse physiological changes however, exercise can improve outcomes. This systematic review and meta-analysis aimed to determine exercise intervention adherence and its effects on physiological outcomes in men diagnosed with prostate cancer undergoing ADT. Uniquely, this review incorporated a meta-aggregation of qualitative data, providing perspectives from the men’s experiences. A systematic review and meta-analysis were completed following PRISMA guidelines. Databases (CINAHL, Cochrane, PubMed) were searched for studies using “prostate cancer”, “exercise intervention”, and “androgen deprivation therapy”. Quantitative randomised controlled trials describing adherence to exercise interventions were selected, with qualitative articles selected based on descriptions of experiences around participation. Subgroup meta-analyses of adherence, exercise mode, and intervention duration were completed for quality of life, aerobic fitness, fatigue, and strength. In total, 644 articles were identified, with 29 (n = 23 quantitative n = 6 qualitative) articles from 25 studies included. Exercise had no effects (p 0.05) on quality of life and fatigue. Significant effects (all p 0.05) were observed for aerobic fitness, and upper- and lower-body strength. Adherence to exercise-based interventions was 80.38%, with improvements observed in aerobic fitness and strength. Subgroup analysis revealed exercise adherence impacted fatigue and strength, with greater improvements observed in programs -weeks.
Publisher: Frontiers Media SA
Date: 17-05-2023
DOI: 10.3389/FDGTH.2023.1063277
Abstract: Major illnesses such as cancer, and other traumatic life events, can lead to sudden increases in supportive care needs. This study aimed to describe engagement, acceptability and satisfaction with a supportive care networking app under real-world conditions. A total of 10,952 in iduals used the app during the study period (2018–2022). The app is designed to enable “captains” to assemble a network of friends and family members to provide timely, and in idually tailored, supportive care (including assistance with tasks such as taking children to school, cooking meals, grocery shopping, and transport to appointments). Engagement was determined from server data, whilst acceptability and satisfaction were captured using purposed-designed surveys. Users were mostly female (76%) and aged between 30 and 49 years (61%). The most common reason for using the app was sudden illness (web: 81% mobile: 64%). An average of 42 tasks were requested per network, with a 32% acceptance rate. Significantly more tasks were requested (web: 52.2 tasks per network mobile: 31.7 tasks per network p & 0.001) and accepted (web: 43.2% mobile: 20.2% p & 0.001) in the web app vs. the mobile app. Task requests in the web app most commonly related to food (43% of requested tasks), social (15% of requested tasks) and children (13% of requested tasks). The task acceptance rate differed by task categories ( p & 0.001), with tasks relating to transport, medical appointments and children accepted at the highest rates (56%, 52% and 49%, respectively). Acceptability and satisfaction data suggested that the app was well received and overall, participants were satisfied with the app. Findings suggested that this support care networking app achieved widespread uptake for a wide variety of supportive care tasks. Future research focused on optimizing engagement with the mobile app and examining the effectiveness of the app for improving patient and hospital outcomes is warranted.
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.APMR.2015.09.012
Abstract: To evaluate the effects of exercise on cancer-related lymphedema and related symptoms, and to determine the need for those with lymphedema to wear compression during exercise. CINAHL, Cochrane, EBSCOhost, MEDLINE, PubMed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, ScienceDirect, and SPORTDiscus databases were searched for trials published before January 1, 2015. Randomized and nonrandomized controlled trials and single-group pre-post studies published in English were included. Twenty-one (exercise) and 4 (compression and exercise) studies met inclusion criteria. Data were extracted into tabular format using predefined data fields by 1 reviewer and assessed for accuracy by a second reviewer. Study quality was evaluated using the Effective Public Health Practice Project Quality Assessment Tool. Data were pooled using a random-effects model to assess the effects of acute and long-term exercise on lymphedema and lymphedema-associated symptoms, with subgroup analyses for exercise mode and intervention length. There was no effect of exercise (acute or intervention) on lymphedema or associated symptoms, with standardized mean differences from all analyses ranging between -0.2 and 0.1 (P values ≥.22). Findings from subgroup analyses for exercise mode (aerobic, resistance, mixed, other) and intervention duration (>12wk or ≤12wk) were consistent with these findings-that is, no effect on lymphedema or associated symptoms. There were too few studies evaluating the effect of compression during regular exercise to conduct a meta-analysis. In iduals with secondary lymphedema can safely participate in progressive, regular exercise without experiencing a worsening of lymphedema or related symptoms. However, there is insufficient evidence to support or refute the current clinical recommendation to wear compression garments during regular exercise.
Publisher: Wiley
Date: 18-04-2021
DOI: 10.1111/AJCO.13567
Publisher: American Medical Association (AMA)
Date: 15-06-2023
DOI: 10.1001/JAMANETWORKOPEN.2023.18478
Abstract: Low levels of physical activity during hospitalization are thought to contribute to a range of poor outcomes for patients. Using wearable activity trackers during hospitalization may help improve patient activity, sedentary behavior, and other outcomes. To evaluate the association of interventions that use wearable activity trackers during hospitalization with patient physical activity, sedentary behavior, clinical outcomes, and hospital efficiency outcomes. OVID MEDLINE, CINAHL, Embase, EmCare, PEDro, SportDiscuss, and Scopus databases were searched from inception to March 2022. The Cochrane Central Register for Controlled trials, ClinicalTrials.gov, and World Health Organization Clinical Trials Registry were also searched for registered protocols. No language restrictions were imposed. Randomized clinical trials and nonrandomized clinical trials of interventions that used wearable activity trackers to increase physical activity or reduce sedentary behavior in adults (aged 18 years or older) who were hospitalized were included. Study selection, data extraction, and critical appraisal were conducted in duplicate. Data were pooled for meta-analysis using random-effects models. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. The primary outcomes were objectively measured physical activity or sedentary behavior. Secondary outcomes included clinical outcomes (eg, physical function, pain, mental health), and hospital efficiency outcomes (eg, length of stay, readmission). Fifteen studies with a total of 1911 participants were included, representing various surgical cohorts (4 studies), stroke rehabilitation (3 studies), orthopedic rehabilitation (3 studies), mixed rehabilitation (3 studies), and mixed medical (2 studies). All studies were included in meta-analyses. There was a significant association between wearable activity tracker interventions with higher overall physical activity (standardized mean difference, 0.35 95% CI, 0.15 to 0.54 I 2 = 72% P & .002) and less sedentary behavior (mean difference, −35.46 min/d 95% CI, −57.43 to −13.48 min/d I 2 = 0 P = .002), and a significant association between wearable activity tracker interventions with improvements in physical function (standardized mean difference, 0.27 95% CI, 0.08 to 0.46 I 2 = 0 P = .006) compared with usual care. There was no significant association between wearable activity tracker interventions with pain, mental health, length of stay, or readmission risk. In this systematic review and meta-analysis, interventions that used wearable activity trackers with patients who are hospitalized were associated with higher physical activity levels, less sedentary behavior, and better physical functioning compared with usual care.
Publisher: BMJ
Date: 16-02-2023
DOI: 10.1136/BJSPORTS-2022-106195
Abstract: To synthesise the evidence on the effects of physical activity on symptoms of depression, anxiety and psychological distress in adult populations. Umbrella review. Twelve electronic databases were searched for eligible studies published from inception to 1 January 2022. Systematic reviews with meta-analyses of randomised controlled trials designed to increase physical activity in an adult population and that assessed depression, anxiety or psychological distress were eligible. Study selection was undertaken in duplicate by two independent reviewers. Ninety-seven reviews (1039 trials and 128 119 participants) were included. Populations included healthy adults, people with mental health disorders and people with various chronic diseases. Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=−0.43, IQR=−0.66 to –0.27), anxiety (median effect size=−0.42, IQR=−0.66 to –0.26) and psychological distress (effect size=−0.60, 95% CI −0.78 to –0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy in iduals. Higher intensity physical activity was associated with greater improvements in symptoms. Effectiveness of physical activity interventions diminished with longer duration interventions. Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress. CRD42021292710.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2023
DOI: 10.1186/S12889-023-15382-8
Abstract: High demand for services has resulted in lengthy waiting times being experienced across mental health services, both across Australia and internationally. Timely access to services is necessary to optimise the effectiveness of treatment, and prevent further mental health decline, risk of suicidality and hospitalisation for clients waiting for services to commence. The present study aims to better understand the experiences of in iduals who are waiting for ongoing mental health services to commence and their preferences for additional support whilst on the waitlist, as a means to recommend alternative supports. A link to the cross-sectional, anonymous survey was sent via text message to 2,147 clients of a mental health service, with a reminder text message sent approximately one week subsequent to those who did not opt out of the communication. Eligibility criteria included having been a client of the service in the previous 12 months, having spent time on the waiting list, being aged 16 or over and having sufficient English proficiency. A total of 334 participants responded to the needs assessment survey, 277 (82.9%) of which resided in the metropolitan region and 57 (17.1%) residing in the country region. Of the respondents, the majority presented with generalised anxiety anic attacks ( n = 205, 61.4%), followed by life stressors (e.g., financial concerns, relationships, n = 196, 58.7%) and lack of motivation/loss of interest ( n = 196, 58.7%). Most respondents (52.7%) waited 4–12 months for ongoing services to commence and almost half (47%) reported that their mental health deteriorated during this time. Of the additional support options, most participants expressed interest in additional mental health supports (78.4%, n = 262), such as telephone support and access to online materials. There was significant interest in other supports such as exercise support (57.4%, n = 192), sleep education (56.6%, n = 190) and healthy eating support (41%, n = 137). Mental health services are experiencing significant waiting times, increasing the risk of mental health deterioration for persons waiting for services to commence. However, the findings demonstrate that there is interest for alternative support options, such as lifestyle interventions, in the interim. Desire for lifestyle support services, particularly in-person exercise programs and self-directed sleep, was especially high amongst the population of respondents within this study. Future work to rigorously develop and evaluate such lifestyle support services for mental health clients is warranted.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 10-2020
Publisher: Wiley
Date: 12-07-2021
DOI: 10.1111/SMS.14004
Abstract: The etiology of changes in lower‐limb neuromuscular function, especially to the central nervous system, may be affected by exercise duration. Direct evidence is lacking as few studies have directly compared different race distances. This study aimed to investigate the etiology of deficits in neuromuscular function following short versus long trail‐running races. Thirty‐two male trail runners completed one of five trail‐running races as LONG ( km) or SHORT ( km). Pre‐ and post‐race, maximal voluntary contraction (MVC) torque and evoked responses to electrical nerve stimulation during MVCs and at rest were used to assess voluntary activation and muscle contractile properties of knee‐extensor (KE) and plantar‐flexor (PF) muscles. Transcranial magnetic stimulation (TMS) was used to assess evoked responses and corticospinal excitability in maximal and submaximal KE contractions. Race distance correlated with KE MVC ( ρ = −0.556) and twitch ( ρ = −0.521) torque decreases ( p ≤ .003). KE twitch torque decreased more in LONG (−28 ± 14%) than SHORT (−14 ± 10%, p = .005) however, KE MVC time × distance interaction was not significant ( p = .073). No differences between LONG and SHORT for PF MVC or twitch torque were observed. Maximal voluntary activation decreased similarly in LONG and SHORT in both muscle groups ( p ≥ .637). TMS‐elicited silent period decreased in LONG ( p = .021) but not SHORT ( p = .912). Greater muscle contractile property impairment in longer races, not central perturbations, contributed to the correlation between KE MVC loss and race distance. Conversely, PF fatigability was unaffected by race distance.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2023
DOI: 10.1186/S12889-023-16277-4
Abstract: Obesity is a growing, global public health issue. This study aimed to describe the weight management strategies used by a s le of Australian adults examine the socio-demographic characteristics of using each strategy and examine whether use of each strategy was associated with 12-month weight change. This observational study involved a community-based s le of 375 healthy adults (mean age: 40.1 ± 5.8 years, 56.8% female). Participants wore a Fitbit activity monitor, weighed themselves daily, and completed eight online surveys on socio-demographic characteristics. Participants also recalled their use of weight management strategies over the past month, at 8 timepoints during the 12-month study period. Most participants (81%) reported using at least one weight management strategy, with exercise hysical activity being the most common strategy at each timepoint (40–54%). Those who accepted their current bodyweight were less likely to use at least one weight management strategy (Odds ratio = 0.38, 95% CI = 0.22–0.64, p 0.01) and those who reported being physically active for weight maintenance had a greater reduction in bodyweight, than those who did not (between group difference: -1.2 kg, p 0.01). The use of supplements and fasting were associated with poorer mental health and quality of life outcomes (p 0.01). The use of weight management strategies appears to be common. Being physically active was associated with greater weight loss. In iduals who accepted their current body weight were less likely to use weight management strategies. Fasting and the use of supplements were associated with poorer mental health. Promoting physical activity as a weight management strategy appears important, particularly considering its multiple health benefits.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.JSAMS.2019.09.019
Abstract: The SAFE-Maintain study sought to evaluate the effect and acceptability of a physical activity counselling (PAC) session, versus a PAC session plus provision of a Fitbit (Charge HR® PAC+F), on maintenance of physical activity levels 12 weeks following participation in a supervised exercise intervention. Fifty-two women with stage II+breast cancer who had recently (within the previous 7 days) completed a 12-week supervised exercise program were randomised to the PAC or PAC+F group. Physical activity levels, including weekly minutes of total physical activity (min/week), daily step count (steps/day), and weekly minutes of moderate to vigorous physical activity (MVPA, min/week), were assessed using the Active Australia survey and Actigraph® GT3X+ accelerometers. Self-reported outcomes were assessed at baseline and 12-week follow-up, while objectively-measured outcomes were only available at 12-week follow-up. Compared with the PAC group, the PAC+F group had higher self-reported MVPA and self-reported total activity (between-group mean difference: 78.2 [95% CI=-8.3, 164.9] min/week, p<0.01, and 171.9 [95% CI=46.1, 297.8] min/week, p 80%) of the PAC+F group reported high levels of Fitbit use and considered the device to be beneficial for physical activity maintenance. Findings suggest that activity trackers show promise as an effective, feasible and acceptable approach to support physical activity maintenance following completion of a supervised exercise intervention. Prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR, Trial registration number: ACTRN12616000954426).
Publisher: American Medical Association (AMA)
Date: 27-07-2023
DOI: 10.1001/JAMANETWORKOPEN.2023.26038
Abstract: Obesity is a major global health concern. A better understanding of temporal patterns of weight gain will enable the design and implementation of interventions with potential to alter obesity trajectories. To describe changes in daily weight across 12 months among Australian adults. This cohort study conducted between December 1, 2019, and December 31, 2021 in Adelaide, South Australia, involved 375 community-dwelling adults aged 18 to 65 years. Participants wore a fitness tracker and were encouraged to weigh themselves, preferably daily but at least weekly, using a body weight scale. Data were remotely gathered using custom-developed software. Time assessed weekly, seasonally, and at Christmas/New Year and Easter. Data were visually inspected to assess the overall yearly pattern in weight change. Data were detrended (to remove systematic bias from intrain idual gradual increases or decreases in weight) by calculating a line of best fit for each in idual’s annual weight change relative to baseline and subtracting this from each participant’s weight data. Multilevel mixed-effects linear regression analysis was used to compare weight across days of the week and seasons and at Christmas/New Year and Easter. Of 375 participants recruited, 368 (mean [SD] age, 40.2 [5.9] years 209 [56.8%] female mean [SD] baseline weight, 84.0 [20.5] kg) provided at least 7 days of weight data for inclusion in analyses. Across the 12-month period, participants gained a median of 0.26% body weight (218 g) (range, −29.4% to 24.0%). Weight fluctuated by approximately 0.3% (252 g) each week, with Mondays and Tuesdays being the heaviest days of the week. Relative to Monday, participants’ weight gradually decreased from Tuesday, although not significantly so (mean [SE] weight change, 0.01% [0.03%] P = .83), to Friday (mean [SE] weight change, −0.18% [0.03%] P & .001) and increased across the weekend to Monday (mean [SE] weight change for Saturday, −0.16% [0.03%] P & .001 mean [SE] weight change for Sunday, −0.10% [0.03%] P & .001). Participants’ weight increased sharply at Christmas/New Year (mean [SE] increase, 0.65% [0.03%] z score, 25.30 P & .001) and Easter (mean [SE] weight change, 0.29% [0.02%], z score, 11.51 P & .001). Overall, participants were heaviest in summer (significantly heavier than in all other seasons), were lightest in autumn (mean [SE] weight change relative to summer, −0.47% [0.07%] P & .001), regained some weight in winter (mean [SE] weight change relative to summer, −0.23% [0.07%] P = .001), and became lighter in spring (mean [SE] weight change relative to summer, −0.27% [0.07%] P & .001). In this cohort study of Australian adults with weekly and yearly patterns in weight gain observed across 12 months, high-risk times for weight gain were Christmas/New Year, weekends, and winter, suggesting that temporally targeted weight gain prevention interventions may be warranted.
Publisher: Springer Science and Business Media LLC
Date: 18-01-2023
DOI: 10.1007/S11764-021-01153-0
Abstract: The purpose of this systematic review with meta-analysis was to evaluate the safety, feasibility and effectiveness of exercise in the palliative care phase for people with advanced cancer. Electronic databases were searched for exercise randomised controlled trials involving in iduals with incurable cancer that were published prior to April 14, 2021. Meta-analyses were performed to evaluate the effects of exercise on health outcomes. Subgroup effects for exercise mode, supervision, intervention duration and cancer diagnosis were assessed. Twenty-two trials involving interventions ranging between 2 weeks and 6 months were included. Interventions comprised of aerobic (n = 3), resistance (n = 4), mixed-mode (n = 14) and other exercise (n = 1) modalities. Cancer types consisted of lung (n = 6), breast (n = 3), prostate (n = 2), multiple myeloma (n = 1) and mixed cancer types (n = 10). Meta-analysis of 20 RCTs involving 1840 participants showed no difference in the risk of a grade 2-4 adverse event between exercise and usual care (n = 110 adverse events (exercise: n = 66 events usual care: n = 44 events), RD = - 0.01 (91% CI = - 0.01, 0.02) p = 0.24). Overall median recruitment, retention and adherence rates were 56%, 80% and 69%, respectively. Meta-analysis of health outcomes showed effects in favour of exercise for quality of life, fatigue, aerobic fitness and lower-body strength (SMD range = 0.27-0.48, all p < 0.05). Participants who engaged in exercise experienced an increase in quality of life, fitness and strength and a decrease in fatigue. Physical activity programs were found to be safe and feasible for people with advanced cancer in the palliative care phase.
Publisher: Springer Science and Business Media LLC
Date: 23-06-2023
DOI: 10.1038/S41746-023-00856-1
Abstract: Chatbots (also known as conversational agents and virtual assistants) offer the potential to deliver healthcare in an efficient, appealing and personalised manner. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of chatbot interventions designed to improve physical activity, diet and sleep. Electronic databases were searched for randomised and non-randomised controlled trials, and pre-post trials that evaluated chatbot interventions targeting physical activity, diet and/or sleep, published before 1 September 2022. Outcomes were total physical activity, steps, moderate-to-vigorous physical activity (MVPA), fruit and vegetable consumption, sleep quality and sleep duration. Standardised mean differences (SMD) were calculated to compare intervention effects. Subgroup analyses were conducted to assess chatbot type, intervention type, duration, output and use of artificial intelligence. Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment tool. Nineteen trials were included. S le sizes ranged between 25–958, and mean participant age ranged between 9–71 years. Most interventions ( n = 15, 79%) targeted physical activity, and most trials had a low-quality rating ( n = 14, 74%). Meta-analysis results showed significant effects (all p 0.05) of chatbots for increasing total physical activity (SMD = 0.28 [95% CI = 0.16, 0.40]), daily steps (SMD = 0.28 [95% CI = 0.17, 0.39]), MVPA (SMD = 0.53 [95% CI = 0.24, 0.83]), fruit and vegetable consumption (SMD = 0.59 [95% CI = 0.25, 0.93]), sleep duration (SMD = 0.44 [95% CI = 0.32, 0.55]) and sleep quality (SMD = 0.50 [95% CI = 0.09, 0.90]). Subgroup analyses showed that text-based, and artificial intelligence chatbots were more efficacious than speech/voice chatbots for fruit and vegetable consumption, and multicomponent interventions were more efficacious than chatbot-only interventions for sleep duration and sleep quality (all p 0.05). Findings from this systematic review and meta-analysis indicate that chatbot interventions are efficacious for increasing physical activity, fruit and vegetable consumption, sleep duration and sleep quality. Chatbot interventions were efficacious across a range of populations and age groups, with both short- and longer-term interventions, and chatbot only and multicomponent interventions being efficacious.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-06-2021
DOI: 10.1249/MSS.0000000000002719
Abstract: Women have been shown to experience less neuromuscular fatigue than men in knee extensors (KE) and less peripheral fatigue in plantar flexors (PF) after ultratrail running, but it is unknown if these differences exist for shorter trail running races and whether this may impact running economy. The purpose of this study was to characterize sex differences in fatigability over a range of running distances and to examine possible differences in the postrace alteration of the cost of running (Cr). Eighteen pairs of men and women were matched by performance after completing different races ranging from 40 to 171 km, ided into SHORT versus LONG races ( and km, respectively). Neuromuscular function and Cr were tested before and after each race. Neuromuscular function was evaluated on both KE and PF with voluntary and evoked contractions using electrical nerve (KE and PF) and transcranial magnetic (KE) stimulation. Oxygen uptake, respiratory exchange ratio, and ventilation were measured on a treadmill and used to calculate Cr. Compared with men, women displayed a smaller decrease in maximal strength in KE (−36% vs −27%, respectively, P 0.01), independent of race distance. In SHORT only, women displayed less peripheral fatigue in PF compared with men (Δ peak twitch: −10% vs −24%, respectively, P 0.05). Cr increased similarly in men and women. Women experience less neuromuscular fatigue than men after both “classic” and “extreme” prolonged running exercises but this does not impact the degradation of the energy Cr.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-03-2022
DOI: 10.1249/MSS.0000000000002918
Abstract: The purpose of this systematic review and meta-analysis was to evaluate the effects of exercise on (i) the prevention of cancer-related lymphedema (CRL) and (ii) the treatment of CRL, lymphedema-associated symptoms, and other health outcomes among in iduals with CRL. An electronic search was undertaken for exercise studies measuring lymphedema and involving in iduals at risk of developing or with CRL. The Effective Public Health Practice Project Quality scale was used to assess study quality, and overall quality of evidence was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed to evaluate effects of exercise on CRL incidence, existing CRL status, lymphedema-associated symptoms, and health outcomes. Twelve studies ( n = 1955 75% moderate-high quality) and 36 studies ( n = 1741 58% moderate-high quality) were included in the prevention and treatment aim, respectively. Relative risk of developing CRL for those in the exercise group compared with the nonexercise group was 0.90 (95% confidence interval (CI), 0.72 to 1.13) overall and 0.49 (95% CI, 0.28 to 0.85) for those with five or more lymph nodes removed. For those with CRL in the exercise group, the standardized mean difference (SMD) before to after exercise of CRL was −0.11 (95% CI, −0.22 to 0.01), and compared with usual care postintervention, the SMD was −0.10 (95% CI, −0.24 to 0.04). Improvements after intervention were observed for pain, upper-body function and strength, lower-body strength, fatigue, and quality of life for those in the exercise group (SMD, 0.3–0.8 P 0.05). Findings support the application of exercise guidelines for the wider cancer population to those with or at risk of CRL. This includes promotion of aerobic and resistance exercise, and not just resistance exercise alone, as well as unsupervised exercise guided by symptom response.
No related grants have been discovered for Ben Singh.