ORCID Profile
0000-0002-8044-8520
Current Organisations
University of Sydney
,
University of Western Australia
,
University of East Anglia
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Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2020-040559
Abstract: Sciatica is a lower spine condition characterised by radiating leg pain below the knee. It may be accompanied by motor and sensory loss in the distribution of a spinal nerve. There are few effective treatments for sciatica. Orally administered glucocorticoids have shown some promise, however, any beneficial effects need to be confirmed and weighed against drug safety and cost-effectiveness, in a high-quality, definitive trial. The Oral Steroids In Sciatica (OASIS) trial is a randomised, placebo-controlled, double-blind trial that will evaluate a tapering regimen of oral prednisolone in 200 participants with acute sciatica. Participants will be recruited on presentation to general practice, specialist outpatient clinics or hospital emergency departments and randomised to receive orally administered prednisolone 50 mg per day, up to 3 days then tapering to cessation over 10 days, or placebo, for a maximum of 13 days, in addition to guideline advice. Participants will be followed for 1 year. The primary endpoint will be leg pain intensity at 2 weeks. Secondary outcomes will include back pain intensity, disability, time to recovery, quality of life and treatment success rate. Adverse events will be assessed and a cost-effectiveness analysis will be conducted. Ethical approval has been granted from the Human Research Ethics Committee, The University of Sydney. Trial results will be disseminated by publications and conference presentations and via the media. ACTRN12619001716156.
Publisher: FapUNIFESP (SciELO)
Date: 08-2016
DOI: 10.1590/1517-869220162204159647
Abstract: ABSTRACT Introduction: The International Classification of Functioning, Disability and Health (ICF) considers multiples aspects of functionality. It is believed that this tool can help to classify the functionality of older adults with low back pain (LBP) . Objectives: To describe the functionality of active older adults with LBP according to the ICF. Methods: A transversal study was conducted using the brief ICF core set for low back pain, to establish functional profiles of 40 older adults. The ICF categories were considered valid when ≥20% of participants showed some disability. Results: Thirty-two of the 35 categories of the brief ICF core set could be considered representative of the s le. Conclusion: The brief ICF core set for LBP results demonstrated that this classification system is representative for describing the functional profile of the s le.
Publisher: Research, Society and Development
Date: 09-11-2022
DOI: 10.33448/RSD-V11I15.36104
Abstract: Objective: We described sedentary behavior during the COVID-19 pandemic in Brazilian older adults and explored whether highly sedentary behavior was associated with multimorbidity, physical activity levels, adoption of physical distancing, perceived social isolation, disability, and depressive symptoms. Methods: We surveyed 184 older adults and gathered information on sedentary behavior, multimorbidity, physical activity, adoption of social distancing, perceived social isolation, disability, and depressive symptoms. Then, we investigated the association between highly sedentary behavior and these factors. Results: 26% of participants reported high levels of sedentary behavior, spending 5 hours per day in sitting (median). Highly sedentary behavior during COVID-19 pandemic was associated with multimorbidity (OR: 2.78, 95% CI 1.12-6.89) and disability (OR: 1.08, 95% CI 1.02-1.16). Conclusion: The prevalence of highly sedentary behavior in older adults during the pandemic was 26%. High sedentary behavior was associated with disability and multimorbidity in them. These findings can be used to guide the academia, the public sector, and health professionals to develop integrated initiatives to monitor and to decrease sedentary behavior especially in older adults with disability and multimorbidity during and beyond the COVID-19 pandemic.
Publisher: MDPI AG
Date: 27-08-2021
Abstract: Realist evaluation offers a valuable way to understand how interventions function and thus how they can be improved and locally adapted. Consequently, realist evaluation is increasingly conducted in parallel with intervention trials. It comprises a clear philosophical foundation and view of causality, pragmatic mixed data collection methods, and a theory-driven approach in which hypothesised program theories are tested and refined. However, detailed methods for data analysis are seldom well-described in realist studies and no clear method for analysing and presenting realist evaluation data has yet emerged. In this methodological paper we use the worked ex le of our realist process evaluation of the SAGE yoga trial to illustrate an applied process of data analysis and presentation of findings. We show how we drew on other realist studies for ideas, provide ex les of six key tasks involved in conducting a realist process evaluation (including coding data and structuring results) and describe strategies that did not work and our rationale for rejecting them. This detailed account of the decisions and methods that worked for us is intended to provide a practical and informed point of departure for researchers conducting a realist evaluation.
Publisher: BMJ
Date: 17-05-2023
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.PHYSIO.2015.08.008
Abstract: To determine the relationship between perceived fatigability and oxygen consumption, carbon dioxide production, respiratory exchange ratio and the energy cost of walking in older women. Observational, cross-sectional study. Forty-eight community-dwelling older women were recruited from senior centres in Natal, Rio Grande do Norte, Brazil. Participants were evaluated in two different sessions. In the first session, sociodemographic and clinical factors were assessed and accelerometers were delivered. In the second session, the 6-minute walking test (6MWT) was performed and expired gases were analysed. Self-reported levels of fatigue were evaluated on a numerical scale from 1 ('extremely energetic') to 7 ('extremely tired'). Severity scores for perceived and performance fatigability were calculated as the ratio of change in performance and fatigue, respectively, with walking distance. The O2 cost of walking was based on the oxygen consumption rate and the 6MWT walking speed. No correlation was found between the severity of perceived fatigability and metabolic measures. However, the severity of perceived fatigability was significantly correlated with greater O2 cost (r=0.579, P<0.01), physical activity (r=-0.654, P<0.01), walking distance (r=-0.712, P<0.01) and severity of performance fatigability (r=0.690, P<0.01). Perceived fatigability was not directly associated with metabolic measures however, greater severity of perceived fatigability was associated with an increase in the O2 cost of walking. Important relationships were also found between greater severity of perceived fatigability and poor functional fitness, high level of energy expenditure and lower level of physical activity.
Publisher: Human Kinetics
Date: 12-2020
Abstract: Background : Frailty and sarcopenia are common age-related conditions associated with adverse outcomes. Physical activity has been identified as a potential preventive strategy for both frailty and sarcopenia. The authors aimed to investigate the association between physical activity and prevention of frailty and sarcopenia in people aged 65 years and older. Methods : The authors searched for systematic reviews (January 2008 to November 2019) and in idual studies (January 2010 to March 2020) in PubMed. Eligible studies were randomized controlled trials and longitudinal studies that investigated the effect of physical activity on frailty and/or sarcopenia in people aged 65 years and older. The Grading of Recommendations Assessment, Development and Evaluation approach was used to rate certainty of evidence. Results : Meta-analysis showed that physical activity probably prevents frailty (4 studies frailty score pooled standardized mean difference, 0.24 95% confidence interval, 0.04–0.43 P = .017, I 2 = 57%, moderate certainty evidence). Only one trial investigated physical activity for sarcopenia prevention and did not provide conclusive evidence (risk ratio 1.08 95% confidence interval, 0.10–12.19). Five observational studies showed positive associations between physical activity and frailty or sarcopenia prevention. Conclusions : Physical activity probably prevents frailty among people aged 65 years and older. The impact of physical activity on the prevention of sarcopenia remains unknown, but observational studies indicate the preventive role of physical activity.
Publisher: Cold Spring Harbor Laboratory
Date: 30-12-2021
DOI: 10.1101/2021.12.21.21268178
Abstract: The objective of this scoping review is to describe how exercise has been prescribed for hemodialysis patients. Exercise interventions have received more attention from the nephrology community in the last few years. Despite some limitations in the findings, there is currently robust evidence suggesting that exercise is clinically important and provides benefits to hemodialysis patients. Even so, there is little evidence precisely detailing and describing how exercise can be prescribed and delivered for this population. Based on the PCC framework, we will review and include evidence from hemodialysis patients ( P articipants) describing exercise interventions ( C oncept) in all settings and designs ( C ontext). The evidence that included any other kidney replacement therapy other than hemodialysis will be excluded. This review will follow the JBI methodology for scoping reviews and the PRISMA-ScR. We will perform a comprehensive literature search using MEDLINE, EMBASE, SPORTDiscuss, CINAHL, and LILACS databases without date or language restrictions from inception until December 2021. Websites, books, and guidelines from prominent societies and associations will also be searched. Experimental, quasi-experimental, observational, and protocol evidence from adults with chronic kidney disease (≥18 years) undergoing hemodialysis that prescribed exercise as an intervention will be considered. Two independent reviewers will screen title and abstract and perform the full-text review. Data extraction will be done by the main reviewer and checked by a second reviewer. Data characterizing the exercise interventions ( e.g ., type, setting, frequency, duration, intensity, volume, progression, periodization, professionals involved, etc.) will be extracted from selected evidence. The qualitative and quantitative results will be synthesized and presented in tables and figures along with a narrative summary.
Publisher: Springer Science and Business Media LLC
Date: 26-11-2020
DOI: 10.1186/S12966-020-01040-4
Abstract: Various physical activity interventions for prevention and treatment of osteoporosis have been designed and evaluated, but the effect of such interventions on the prevention of osteoporosis in older people is unclear. The aim of this review was to investigate the association between physical activity and osteoporosis prevention in people aged 65 years and above. A systematic review was conducted and searches for in idual studies were conducted in PubMed (January 2010 to March 2020) and for systematic reviews were conducted in PubMed, Embase, CINAHL and SPORTDiscus (January 2008 to July 2020). Records were screened according to the following eligibility criteria: i) population: adults aged 65 years and older ii) exposure: greater volume, duration, frequency, or intensity of physical activity iii) comparison: no physical activity or lesser volume, duration, frequency, or intensity of physical activity iv) outcome: osteoporosis related measures (e.g., bone mineral density). The methodological quality of included studies was assessed and meta-analysis summarised study effects. The GRADE approach was used to rate certainty of evidence. We included a total of 59 studies, including 12 observational studies and 47 trials. Within the included trials, 40 compared physical activity with no intervention controls, 11 compared two physical activity programs, and six investigated different doses of physical activity. Included studies suggest that physical activity interventions probably improve bone health among older adults and thus prevent osteoporosis (standardised effect size 0.15, 95% CI 0.05 to 0.25, 20 trials, moderate-certainty evidence, main or most relevant outcome selected for each of the included studies). Physical activity interventions probably improve lumbar spine bone mineral density (standardised effect size 0.17, 95% CI 0.04 to 0.30, 11 trials, moderate-certainty evidence) and may improve hip (femoral neck) bone mineral density (standardised effect size 0.09, 95% CI − 0.03 to 0.21, 14 trials, low-certainty evidence). Higher doses of physical activity and programs involving multiple exercise types or resistance exercise appear to be most effective. Typical programs for which significant intervention impacts were detected in trials were undertaken for 60+ mins, 2–3 times/week for 7+ months. Observational studies suggested a positive association between long-term total and planned physical activity on bone health. Physical activity probably plays a role in the prevention of osteoporosis. The level of evidence is higher for effects of physical activity on lumbar spine bone mineral density than for hip. Higher dose programs and those involving multiple exercises and resistance exercises appear to be more effective.
Publisher: BMJ
Date: 30-11-2022
DOI: 10.1136/BJSPORTS-2022-105820
Abstract: To summarise evidence of benefits of sport for health among people aged 60+. Systematic review with meta-analysis of randomised controlled trials (RCTs). Medline, CINAHL, SPORTDiscus, the Physiotherapy Evidence Database from inception to April 2021. RCTs investigating the effect of sport on health-related outcomes in people aged 60+ compared with non-active control. Pooled effect sizes were calculated using random-effect models. Standardised mean differences (SMD), and mean difference (MD) were calculated. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the certainty of the evidence for analyses with ≥3 studies. Nine trials (628 participants) reported in 15 articles were included. Participation in sport improved cardiorespiratory fitness (n=5 trials SMD=0.43, 95% CI 0.17 to 0.70 low certainty evidence), physical function (n=4 SMD=0.62, 95% CI 0.05 to 1.18 very low certainty evidence), and mental health (n=2 SMD=0.28, 95% CI 0.06 to 0.51) and reduced fat mass (n=6 MD=−0.99 kg, 95% CI −1.75kg to −0.23 kg low certainty evidence) among older people. We found no significant effects of sport on overall physical activity participation, strength, balance, lean mass and bone mineral density (BMD). One study investigating quality of life reported a positive, but non-significant effect of sport. Sport may have a positive impact on health outcomes in people aged 60+. There was uncertainty on the effect of sport on strength, balance, lean mass and BMD. Further research is needed to investigate the optimal type and dose of sport to maximise the long-term benefits among older people.
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.BJPT.2021.10.003
Abstract: This statistical analysis plan details the Coaching for Healthy AGEing (CHAnGE) trial analysis methodology. To investigate the effect of a combined physical activity and fall prevention program on physical activity and falls compared to a healthy eating among people aged 60 years and over. The CHAnGE trial is a pragmatic parallel-group cluster-randomised controlled trial with allocation concealment and blinded assessors. Clusters are allocated to either (1) a physical activity and fall prevention intervention or (2) to a healthy eating intervention. The primary outcomes are: objectively measured physical activity at 12 months post-randomisation, and self-reported falls throughout the 12-month trial period. Secondary outcomes include the proportion of participants reporting a fall, the proportion of participants meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and use of health and community services. We will follow the intention-to-treat principle. All analysis will allow for cluster randomisation using a generalised estimating equation approach. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression models adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will take into account cluster randomisation and will be adjusted for baseline scores. A subgroup analysis will assess differential effects of the intervention by baseline physical activity levels and history of falls.
Publisher: Springer Science and Business Media LLC
Date: 09-05-2015
Publisher: Human Kinetics
Date: 07-2018
Abstract: This study aimed to summarize the function-related goals set by older people, and to explore gender differences in goal selection and associations between balance-related goals and fall history, self-rated balance, and fear of falling. We included community-dwelling people aged 60 years and older participating in two randomized controlled trials. Participants nominated two function-related goals, which were summarized into components of the International Classification of Functioning, Disability and Health. Chi-square analyses were used to explore associations between goal types and participant characteristics. Goals related to recreation and leisure and walking were the most common function-related goals selected. Men and women set similar goals. Participants who had poor/fair self-reported balance were more likely to set a balance-related goal than people with good self-rated balance. In contrast, fallers and participants who had a fear of falling were not more likely to select a balance-related goal than nonfallers and participants who had no fear of falling, respectively.
Publisher: Elsevier BV
Date: 04-2020
Publisher: BMJ
Date: 27-10-2022
DOI: 10.1136/BJSPORTS-2022-105747
Abstract: To investigate cost-effectiveness and costs of fall prevention exercise programmes for older adults. Systematic review. Medline, Embase, Web of Science, Scopus, National Institute for Health Research Economic Evaluation Database, Health Technology Assessment database, Tufts Cost-Effectiveness Analysis Registry, Research Papers in Economics and EconLit (inception to May 2022). Economic evaluations (trial-based or model-based) and costing studies investigating fall prevention exercise programmes versus no intervention or usual care for older adults living in the community or care facilities, and reporting incremental cost-effectiveness ratio (ICER) for fall-related outcomes or quality-adjusted life years (QALY, expressed as cost/QALY) and/or intervention costs. 31 studies were included. For community-dwelling older adults (21 economic evaluations, 6 costing studies), results ranged from more effective and less costly (dominant) interventions up to an ICER of US$279 802/QALY gained and US$11 986/fall prevented (US$ in 2020). Assuming an arbitrary willingness-to-pay threshold (US$100 000/QALY), most results (17/24) were considered cost-effective (moderate certainty). The greatest value for money (lower ICER/QALY gained and fall prevented) appeared to accrue for older adults and those with high fall risk, but unsupervised exercise appeared to offer poor value for money (higher ICER/QALY). For care facilities (two economic evaluations, two costing studies), ICERs ranged from dominant (low certainty) to US$35/fall prevented (moderate certainty). Overall, intervention costs varied and were poorly reported. Most economic evaluations investigated fall prevention exercise programmes for older adults living in the community. There is moderate certainty evidence that fall prevention exercise programmes are likely to be cost-effective. The evidence for older adults living in care facilities is more limited but promising. PROSPERO 2020 CRD42020178023.
Publisher: Human Kinetics
Date: 07-2023
Abstract: Background : Most reviews investigating physical activity interventions for older people consider evidence primarily from high-income countries. This review examined physical activity interventions for older people from low- and middle-income countries. Methods : We searched 9 electronic databases to identify randomized controlled trials or quasi-randomized trials studies investigating physical activity interventions for people aged 60+ in low- and middle-income countries. Following study selection, one reviewer extracted relevant data. A second reviewer double-checked the data extraction of a randomly selected s le of interventions (20%). Data were summarized using descriptive statistics. Results : We included 234 studies from 19 countries, investigating 259 distinct physical activity interventions. Studies were mostly conducted in upper middle-income countries (89%), often assessing physical activity interventions through randomized controlled trials (82%). Most studies investigated a mixed population in terms of sex (68%), with a mean age between 65 and 70 years (36%), not selected on the basis of having a specific health condition (55%). The intervention most commonly investigated was structured exercise (63%) and “no intervention” was the most frequent comparator (47%). The outcomes measured more often were intrinsic capacity (59%) and functional ability (51%), whereas physical activity, falls, and social outcomes were rare. Only 2 studies targeted underserved populations. Conclusion : Although we identified a substantial number of randomized controlled trials, most evidence for physical activity interventions for older people in low- and middle-income countries is limited to upper middle-income countries. Gaps identified included interventions targeting populations with underserved backgrounds, using sport as an intervention, and assessing the impact of physical activity interventions on physical activity, falls, and social outcomes.
Publisher: Wiley
Date: 05-12-2020
DOI: 10.1111/BJOP.12436
Abstract: Reports linking prenatal testosterone exposure to autistic traits and to a masculinized face structure have motivated research investigating whether autism is associated with facial masculinization. This association has been reported with greater consistency for females than for males, in studies comparing groups with high and low levels of autistic traits. In the present study, we conducted two experiments to examine facial masculinity/femininity in 151 neurotypical adults selected for either low, mid-range, or high levels of autistic traits. In the first experiment, their three-dimensional facial photographs were subjectively rated by 41 raters for masculinity/femininity and were objectively analysed. In the second experiment, we generated 6-face composite images, which were rated by another 36 raters. Across both experiments, findings were consistent for ratings of photographs and composite images. For females, a linear relationship was observed where femininity ratings decreased as a function of higher levels of autistic traits. For males, we found a U-shaped function where males with mid-range levels of traits were rated lowest on masculinity. Objective facial analyses revealed that higher levels of autistic traits were associated with less feminine facial structures in females and less masculine structures in males. These results suggest sex-specific relationships between autistic traits and facial masculinity/femininity.
Publisher: Springer Science and Business Media LLC
Date: 12-11-2022
DOI: 10.1007/S00198-022-06598-2
Abstract: The prevalence of low bone mineral density (LBMD) in people with chronic kidney disease (CKD) remains unknown. We identified a high prevalence of LBMD in CKD population. Thus, public health strategies should include efforts to prevent, early detect, and manage LBMD in CKD patients, especially in patients undergoing kidney replacement therapy. Mineral and bone disorders are common among patients with CKD, which affects bone mineral density. We conducted a systematic review and meta-analysis to estimate the prevalence of low bone mineral density (LBMD) in adults with CKD. We searched MEDLINE, EMBASE, Web of Science, CINAHL, and LILACS databases from inception to February 2021. Observational studies that reported the prevalence of LBMD in adults with CKD stages 3a-5D were included. The LBMD was defined according to the World Health Organization criterion (T-score ≤ - 2.5). Random-effect model meta-analyses were used to estimate the pooled prevalence of LBMD. Meta-regressions and subgroup analyses were conducted for stages of CKD, dialysis modality, gender, bone sites and morphology, and geographical region. This study was registered in PROSPERO, number CRD42020211077. One-hundred and fifty-three studies with 78,092 patients were included. The pooled global prevalence of LBMD in CKD was 24.5% (95% CI, 21.3 - 27.8%). Subgroup analyses indicated a higher prevalence of LBMD in dialysis patients (30%, 95% CI 25 - 35%) compared with non-dialysis CKD patients (12%, 95% CI 8 - 16%), cortical bone sites (28%, 95% CI 23 - 35%) relative to trabecular sites (19%, 95% CI 14 - 24%), while similar estimates in the European and the Asiatic continents (26%, 95% CI 21 - 30% vs 25%, 95% CI 21 - 29). The prevalence of LBMD in CKD patients is high, particularly in those undergoing dialysis and in cortical bone sites. Therefore, efforts to early diagnosis and management strategies should be implemented in clinical routine for an epidemiological control of LBMD in CKD patients.
Publisher: Faculdade de Filosofia e Ciências
Date: 31-10-2012
DOI: 10.7322/JHGD.46393
Abstract: Objetivo: Analisar o índice de percepção de esforço na avaliação das pressões respiratórias máximas de crianças e adolescentes. Método: Foram avaliadas 144 crianças e adolescentes saudáveis, de sete a onze anos, sendo 63 meninos e 81 meninas, estudantes das redes pública e privada. O instrumento utilizado foi o manovacuômetro digital MVD300 (Globalmed ®, Porto Alegre – RS, Brasil). Foram realizadas no máximo nove manobras, com um minuto de descanso entre cada manobra e cinco minutos entre a medição das pressões inspiratórias e expiratórias máximas. A sensação de esforço percebido foi determinada através da escala de Borg e foi utilizada em quatro momentos: antes das medições das pressões respiratórias máximas, previamente sorteadas imediatamente após a primeira medição sorteada após cinco minutos de descanso e imediatamente após a última avaliação. Resultados: O esforço percebido das crianças e adolescentes antes, imediatamente após e cinco minutos após a manovacuometria foi de 7,8±1,8 9,6±2,5 e 8,5±2,3, respectivamente. Houve aumento significativo após a mensuração das pressões inspiratórias e expiratórias máximas (p 0,001). A quantidade de esforço diminuiu significativamente após cinco minutos de descanso da realização das pressões respiratórias máximas (p 0,05). A percepção de esforço foi semelhante para as crianças e adolescentes que realizaram até cinco ou mais manobras. Conclusão: A avaliação das pressões respiratórias máximas, em crianças e adolescentes, mostrou-se um método seguro quanto à percepção de esforço. Sugere-se que a análise do índice de esforço percebido possa ser prática frequente durante a avaliação da força muscular respiratória.
Publisher: BMJ
Date: 20-03-2017
DOI: 10.1136/BJSPORTS-2016-096943
Abstract: Physical inactivity is common in older age, yet increased activity benefits older people in terms of preventing chronic disease and maximising independence. Health coaching is a behaviour change intervention that has been shown to increase physical activity in clinical populations. This systematic review and meta-analysis investigated the effect of health coaching on physical activity, mobility, quality of life and mood in older people. MEDLINE, EMBASE, CENTRAL, PsycINFO, PEDro, SPORTDiscus, LILACS and CINAHL databases were used to identify randomised controlled trials which evaluated the effect of health coaching on physical activity (primary outcome) among people aged 60+. Secondary outcomes were mobility, quality of life and mood. We calculated standardised mean differences (SMDs, Hedges' g) with 95% CIs from random effects meta-analyses. 27 eligible trials were included. Health coaching had a small, statistically significant effect on physical activity (27 studies SMD = 0.27 95% CI 0.18 to 0.37 p<0.001). There was no evidence of an effect of health coaching on mobility (eight studies SMD = 0.10 95% CI -0.03 to 0.23 p=0.13), quality of life (eight studies SMD = 0.07 95% CI -0.06 to 0.20 p<0.05) or mood (five studies SMD = 0.02 95% CI -0.12 to 0.16 p=0.83). Health coaching significantly increased physical activity in people aged 60+. There was no evidence of an effect of health coaching on quality of life, mobility and mood, so different approaches may be required to impact on these outcomes.
Publisher: Oxford University Press (OUP)
Date: 26-01-2021
DOI: 10.1093/RHEUMATOLOGY/KEAB025
Abstract: To describe the proportion of national health surveys that contain questions on the prevalence and consequences of musculoskeletal conditions. We used a comprehensive search strategy to obtain national health surveys from the 218 countries listed by the World Bank. Two authors independently extracted information from each national health survey. Outcomes were the proportion of surveys that contained questions on the prevalence of musculoskeletal conditions using the Global Burden of Disease categorization of RA, OA, low back pain, neck pain, gout and other and contained condition-specific questions about activity limitation, severity of pain and work absence. We also measured how frequently the prevalence of low back pain was measured using a consensus-based standard definition for low back pain prevalence studies. We identified national health surveys from 170 countries. Sixty-two (36.4%), the majority from high-income countries (n = 43), measured the prevalence of at least one musculoskeletal condition. OA [53 (85.4%)], low back pain [39 (62.9%)] and neck pain [37 (59.7%)] were most commonly measured, while RA and gout prevalence were only measured in 10 (5.9%) and 3 (1.8%) surveys, respectively. A minority of surveys assessed condition-specific activity limitations [6 (3.6%)], pain severity [5 (2.9%)] and work absence [1 (0.6%)]. Only one survey used the consensus-based standard definition for low back pain. Musculoskeletal conditions are neglected in the majority of national health surveys. Monitoring musculoskeletal conditions through ongoing surveys is crucial for the development and evaluation of health policies to reduce their burden.
Publisher: Public Library of Science (PLoS)
Date: 04-11-2015
Publisher: BMJ
Date: 09-08-2019
DOI: 10.1136/BJSPORTS-2018-100324
Abstract: Older people are at high risk of physical inactivity. Activity trackers can facilitate physical activity. We aimed to investigate the effect of interventions using activity trackers on physical activity, mobility, quality of life and mental health among people aged 60+ years. For this systematic review, we searched eight databases, including MEDLINE, Embase and CENTRAL from inception to April 2018. Randomised controlled trials of interventions that used activity trackers to promote physical activity among people aged 60+ years were included in the analyses. The study protocol was registered with PROSPERO, number CRD42017065250. We identified 23 eligible trials. Interventions using activity trackers had a moderate effect on physical activity (23 studies standardised mean difference (SMD)=0.55 95% CI 0.40 to 0.70 I 2 =86%) and increased steps/day by 1558 (95% CI 1099 to 2018 steps/day I 2 =92%) compared with usual care, no intervention and wait-list control. Longer duration activity tracker-based interventions were more effective than short duration interventions (18 studies, SMD=0.70 95% CI 0.47 to 0.93 vs 5 studies, SMD=0.14 95% CI −0.26 to 0.54, p for comparison=0.02). Interventions that used activity trackers improved mobility (three studies SMD=0.61 95% CI 0.31 to 0.90 I 2 =10%), but not quality of life (nine studies SMD=0.09 95% CI −0.07 to 0.25 I 2 =45%). Only one trial included mental health outcomes and it reported similar effects of the activity tracker intervention compared with control. Interventions using activity trackers improve physical activity levels and mobility among older people compared with control. However, the impact of activity tracker interventions on quality of life, and mental health is unknown.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.JPHYS.2018.11.005
Abstract: In people aged ≥ 60 years, does a combined physical activity and fall prevention intervention affect physical activity and mobility-related goal attainment? Does the combined intervention also improve fall rates, daily steps, the proportion of people meeting the physical activity guidelines, quality of life, mood, fear of falling, and mobility limitation? Randomised trial with concealed allocation, intention-to-treat analysis and assessor blinding. One hundred and thirty-one people living in the community and aged ≥ 60 years. The experimental group received one physiotherapist visit, fortnightly telephone-based health coaching, a pedometer, tailored fall prevention advice, and a fall prevention brochure. The control group received the same fall prevention brochure. Primary outcomes were mobility goal attainment (Goal Attainment Scale) and objectively measured physical activity (accelerometer counts per minute) at 6 and 12 months. Secondary outcomes were falls, other physical activity measures, quality of life, fear of falling, mood, and mobility. Participants had a mean age of 71 years (SD 6.5) and 31 (24%) had fallen in the past year. The experimental group reported significantly better mobility goal attainment at 6 months compared to controls (OR 2.0, 95% CI 1.1 to 3.7) but this was not maintained at 12 months (OR 1.1, 95% CI 0.6 to 2.1). Physical activity counts were not significantly different between groups at 6 months (MD 13 counts/minute, 95% CI -98 to 124) or 12 months (MD 56 counts/minute, 95% CI -14 to 125). There were no significant between-group differences in the secondary outcomes. A combined physical activity and fall prevention intervention was associated with significantly higher mobility goal attainment at 6 months. There was no significant impact on physical activity but future investigation in a larger trial is warranted. ACTRN12614000016639.
Publisher: Human Kinetics
Date: 10-2019
Abstract: To document the characteristics of participants aged 50 years and older in a local government group exercise program ( Strong Seniors ), to investigate the motivators and barriers to ongoing exercise, and to identify factors associated with more frequent exercise class attendance. Ninety-three participants completed a survey about exercise class attendance, motivators and barriers to participation, and exercise perceptions and self-reported exercise. The authors conducted a mixed-methods study involving both quantitative and qualitative analyses. Personal benefits of exercise and social influences were the most common motivators for regular exercise. Barriers to participation included health problems and lack of time (competing priorities). A higher score on the perceived exercise benefits scale is the only factor associated with a higher frequency of attendance at Strong Seniors classes. Exercise programs for people aged 50 years and older that emphasize associated health benefits and promote social support may be more likely to facilitate long-term attendance.
Publisher: Springer Science and Business Media LLC
Date: 30-06-2021
DOI: 10.1186/S12966-021-01140-9
Abstract: To inform implementation and future research, this scoping review investigates the volume of evidence for physical activity interventions among adults aged 60+. Our research questions are: (1) what is the evidence regarding interventions designed to increase total physical activity in adults aged 60+ years, in accordance with three of the four strategic objectives of GAPPA (active societies, active environments, active people) (2) what is the current evidence regarding the effectiveness of physical activity programmes and services designed for older adults? and (3) What are the evidence gaps requiring further research? We searched PEDro, MEDLINE, CINAHL and Cochrane from 1 January 2010 to 1 November 2020 for systematic reviews and meta-analyses of physical activity interventions in adults aged 60+. We identified interventions designed to: (1) increase physical activity and (2) deliver physical activity programmes and services in home, community or outpatient settings. We extracted and coded data from eligible reviews according to our proposed framework informed by TIDieR, Prevention of Falls Network Europe (PROFANE), and WHO’s International Classification of Functioning, Disability and Health (ICF). We classified the overall findings as positive, negative or inconclusive. We identified 39 reviews of interventions to increase physical activity and 342 reviews of programmes/services for older adults. Interventions were predominantly structured exercise programmes, including balance strength/resistance training, and physical recreation, such as yoga and tai chi. There were few reviews of health promotion/coaching and health professional education/referral, and none of sport, workplace, sociocultural or environmental interventions. Fewer reported outcomes of total physical activity, social participation and quality of life/well-being. We noted insufficient coverage in erse and disadvantaged s les and low-middle income countries. There is a modest but growing volume of evidence regarding interventions designed to increase total physical activity in older adults, although more interventional studies with long term follow-up are needed, particularly for GAPPA 1. Active Societies and GAPPA 2. Active Environments. By comparison, there is abundant evidence for GAPPA 3. specific programmes and services, but coverage of sport and workplace interventions, and erse s les and settings is lacking. Comprehensive reviews of in idual studies are now needed as well as research targeting neglected outcomes, populations and settings.
Publisher: BMJ
Date: 09-2020
DOI: 10.1136/BMJSEM-2020-000878
Abstract: Falls significantly reduce independence and quality of life in older age. Balance-specific exercise prevents falls in people aged 60+ years. Yoga is growing in popularity and can provide a high challenge to balance however, the effect of yoga on falls has not been evaluated. This trial aims to establish the effect on falls of a yoga exercise programme compared with a yoga relaxation programme in community-dwellers aged 60+ years. This randomised controlled trial will involve 560 community-dwelling people aged 60+ years. Participants will be randomised to either: (1) the Successful AGEing ( SAGE ) yoga exercise programme or (2) a yoga relaxation programme. Primary outcome is rate of falls in the 12 months post randomisation. Secondary outcomes include mental well-being, physical activity, health-related quality of life, balance self-confidence, physical function, pain, goal attainment and sleep quality at 12 months after randomisation. The number of falls per person-year will be analysed using negative binomial regression models to estimate between-group difference in fall rates. Generalised linear models will assess the effect of group allocation on the continuously scored secondary outcomes, adjusting for baseline scores. An economic analysis will compare the cost-effectiveness and cost-utility of the two yoga programmes. Protocol was approved by the Human Research Ethics Committee at The University of Sydney, Australia (approval 2019/604). Trial results will be disseminated via peer-reviewed articles, conference presentations, lay summaries. The protocol for this trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001183178).
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Juliana Souza de Oliveira.