Volume 2, Issue 3

Objectives Physical activity (PA) levels in young people with cerebral palsy (YPwCP) remain consistently low. Previous research suggests that fitness parameters such as muscular strength and cardiovascular capacity are interrelated with mobility and PA levels in YPwCP. This study aimed to (1) describe fitness parameters and PA levels in YPwCP, (2) explore associations between fitness parameters and PA, and (3) evaluate the reliability of accelerometer-based PA measurement. Methods A cross-sectional study was conducted with an embedded test–retest reliability assessment of accelerometer-measured PA over a one-month interval. Participants included 36 YPwCP (19 males, 17 females; mean age 15.5 ± 0.7 years), classified within GMFCS levels I–III. Cardiorespiratory endurance (VO 2 max) was assessed using an incremental cycle ergometer test, and leg power was measured using the Five-Times Sit-to-Stand (5xSTS). PA was measured via self-report using the Physical Activity Questionnaire for Adolescents (PAQ-A) and via device-measured data using a wrist-worn accelerometer over seven consecutive days. Results We found low levels of PA. The 5xSTS completion time showed moderate to strong correlations with self-reported PA ( ρ =−0.384, p≤0.01) and device-measured vigorous PA ( ρ =−0.566, p≤0.01). VO 2 max was positively but not significantly associated with total PA ( ρ =0.173) and moderate-to-vigorous PA ( ρ =0.115). Accelerometry demonstrated good reliability (ICC=0.796). Conclusions These findings suggest that accelerometer has good reliability in YPwCP but highlight low levels of PA measured by self-report and accelerometer. Higher lower-limb power, assessed by faster 5xSTS test, was associated with greater PA.

Objectives People living with severe mental illness have a reduced life expectancy when compared to the general population largely due to physical health comorbidities. Exercise is a valuable, evidence-based component of mental healthcare, with positive effects on physical health, mental health, and quality of life. However, to date, there is limited evidence regarding the implementation of varied styles of supported exercise therapy within outpatient, transdiagnostic mental health services. This protocol paper outlines the methods for a hybrid effectiveness-implementation trial implementing two styles of supported exercise within an outpatient mental health hospital. Methods Participants will be allocated to either in-person supervised exercise sessions, or independent, remotely supported exercise programs. Both intervention arms will have the target of 150  minutes of moderate intensity exercise per week across the 12-week intervention period, along with a 12-week maintenance period following the intervention periods. Assessments will be conducted at intake, intervention midpoint (i.e., week 6–7), intervention conclusion (i.e., week 13), and at follow-up (i.e., week 25). Results The evaluation of the exercise interventions will consist of implementation and effectiveness outcomes during the intervention and at follow-up. Conclusions The outcomes from this trial will add to the ever-increasing evidence for the incorporation of exercise within care for severe mental illness. This trial will report on the implementation and effectiveness of varied levels of support in exercise therapy for consumers with severe mental illness, which may in turn guide the future implementation and improve provision of exercise therapy in hospital mental health services.

Objectives Cardiorespiratory fitness (CRF) and skeletal muscle mass (SMM) are both key parameters of intrinsic capacity. To date, the impact of adherence to physical activity guidelines by older adults on these facets is poorly understood. Therefore, this study aimed to assess the impact of 4 weeks adherence to UK physical activity guidelines on parameters of intrinsic capacity in older adults, with a secondary aim to determine the utility of a bedside-suitable predictive model of assessing CRF for predicting change in this parameter. Methods 14 older adults (22 % female, age: 66–80 years) completed a 4-week intervention in which they adhered to UK physical activity guidelines via a combination of supervised and home-based exercise. In addition to assessments of CRF via cardiopulmonary exercise testing and SMM via ultrasonography, whole-body and handgrip strength (HGS) and step-box test (SBT) variables were also measured before and after the intervention. Results Our intervention resulted in significant increases in CRF (ventilatory threshold (VT): +2.7 ± 0.9 mL/kg/min, p<0.01), vastus lateralis muscle thickness (+9 %, p=0.02) and whole-body strength (+47 %, p<0.01). There was no change in HGS or SBT performance. The bedside-suitable predictive model of CRF was not able to determine change (R 2 =0.11, p=0.25). Conclusions Adherence to UK physical activity guidelines for just 4 weeks improves the CRF, SMM and whole-body strength of community-dwelling older adults. Collectively, these findings illustrate that adherence to current guidelines can improve key aspects of intrinsic capacity in older individuals. The impact of such interventions in populations at risk of accelerated physiological decline, warrant further investigation.

Objectives Walking sports, whereby traditional disciplines of sport modify gameplay by limiting physical activity to walking only, may offer benefits for physical activity engagement and subjective wellbeing outcomes in older adults. Questionnaires were used to collect physical activity and health related data from a cross section of older South Australian walking sports participants (n=56), which was compared to a population-based sample of their peers (n=1817) to explore these potential benefits. Methods Ordinal logistic regression and linear regression were used for between-group comparisons across three subgroups of participants, who reported engaging in: (1) walking sports, (2) traditional sports, and (3) no sport. All analyses were adjusted for age, marital status, education and employment status. Results Compared to walking sports participants, those who did not participate in sports were more than twice as likely to report poorer self-rated health. Walking sports and traditional sports participants reported meeting the minimum weekly physical activity requirements. No significant differences in subjective wellbeing were found between the three participant subgroups. Conclusions Older adults who participated in walking sports had significantly higher self-rated health and physical activity levels, than those not involved in sports. Therefore, sport organisations should consider offering walking sports programs to engage older adults who face barriers to engaging in traditional sports, supporting their continued involvement in physical activity.

Objectives The objective of this study was to examine communication effectiveness (CE) in conjunction with participant satisfaction in a multicultural fitness program. Methods Adults from a fitness program site with participant diversity and multicultural backgrounds were selected and asked to complete a three-part Fitness CE Evaluation Scale questionnaire: CE Questionnaire and Customer Satisfaction (CS) Scale plus a short demographic survey. A sample of 95 participants was recruited from a Midwest Functional 45 Fitness Training Program site in the U.S.A. Multivariate Analysis of Variance (MANOVA) tests were conducted for CE and CS variable vectors. Results The results showed that there were significant main effects on CE and CS for nationality (p=0.001; p<0.001) and language (p=0.006; p<0.001), but no effect for participation frequency, respectively; there were also significant main effects on CS for gender (p=0.006) and membership type (p=0.019). Univariate tests revealed that domestics and/or first language participants scored significantly higher on reaction to strangers (p=0.001; p=0.001), uncertainty (p<0.001; p<0.001), facilities/services (p<0.001; p<0.001), individual/psychological factor (p=0.009; p=0.034), relaxation (p=0.018; p=0.021), social factor (p<0.001; p=0.002), and health/fitness (p<0.001; p=0.001), respectively. Conclusions Being highly aware of fitness participants’ uncertainty and reaction to strangers can help multicultural fitness program managers or trainers improve their communication effectiveness, which will continue improving their customers’ satisfaction.

Objectives To assess the effects of a wearable-sensor-assisted multicomponent exercise program on physical fitness, cognition and quality of life in a practical setting involving frail older adults. Methods Frail older adults (n=130) were randomly divided into a control (CG, n=68) group and an exercise group (EG, n=62) in a 12-week intervention, which included stride gait training with wearable sensors; aerobic exercise; and resistance, flexibility, balance, and cognitive training. Primary outcomes (physical fitness) were evaluated via the SPPB and SFT. Secondary outcomes (cognitive ability, quality of life and frailty) were evaluated via the MoCA-BC, SF-36 and Fried frailty criteria, respectively. Results After the 12-week intervention, the EG demonstrated significant improvements (p<0.05) vs. the CG in gait speed (β 3 =0.424, coefficient of interaction effect between group and time from the generalized linear mixed model), chair stand (β 3 =0.501) and total score (β 3 =65.466) of SPPB and all SFT components including 6MWT (walked distance, β 3 =1.098; walking speed, β 3 =0.105; stride length, β 3 =0.041), back scratch (β 3 =4.926), chair sit and reach (β 3 =3.762), 30s arm curl (β 3 =6.124), 30s sit-to-stand (β 3 =3.04), and TUG (β 3 =−6.712). The MoCA-BC total, verbal fluency and delayed recall scores; the physical function, general health, vitality, and mental health scores of the SF-36; and the frailty phenotype in the EG were significantly improved compared with those of the CG. Conclusions The progressive wearable-sensor-assisted multicomponent exercise program designed in this study enhanced physical fitness, cognitive ability and quality of life and slowed down the progression of frailty in frail older adults, supporting its potential as a feasible community-based health intervention.

Objectives People living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may face unique barriers to physical activity. Active video games may overcome these barriers and increase physical activity. The primary aim of this pilot study was to determine the feasibility and acceptability of active video games to increase physical activity levels of people with ME/CFS. Methods A mixed method design was employed. Adults living with ME/CFS were randomised to a six-month intervention of (1) pacing, (2) pacing and conventional physical activity, or (3) pacing and active video gaming. Feasibility and acceptability were determined through semi-structured interviews. Health-related outcomes (e.g., physical activity, blood samples, quality of life, and functioning) were also collected. Results Fifteen people were assigned an intervention group with 12 completing. Three themes were identified from post-intervention interviews (1) positivity led to overall acceptability, (2) flexibility enabled participant autonomy, and (3) knowledge was gained about the self. No changes were seen in physical activity levels. An active video gaming intervention is acceptable but not feasible for people living with ME/CFS. Conclusions Taken together, results suggest that physical activity can be managed safely by some people living with ME/CFS. Trial registration ACTRN12616000285459.