Physical activity and exercise prescription: Senior physiotherapists' knowledge, attitudes and beliefs

2012 ◽  
Vol 33 (2) ◽  
pp. 71-80 ◽  
Author(s):  
N. Mohan ◽  
E. Collins ◽  
T. Cusack ◽  
G. O'Donoghue
2020 ◽  
Vol 2020 ◽  
pp. 1-15 ◽  
Author(s):  
Adria Quigley ◽  
Marilyn MacKay-Lyons ◽  
Gail Eskes

Physical activity and exercise have emerged as potential methods to improve brain health among older adults. However, there are currently no physical activity guidelines aimed at improving cognitive function, and the mechanisms underlying these cognitive benefits are poorly understood. The purpose of this narrative review is to present the current evidence regarding the effects of physical activity and exercise on cognition in older adults without cognitive impairment, identify potential mechanisms underlying these effects, and make recommendations for exercise prescription to enhance cognitive performance. The review begins with a summary of evidence of the effect of chronic physical activity and exercise on cognition. Attention then turns to four main biological mechanisms that appear to underlie exercise-induced cognitive improvement, including the upregulation of growth factors and neuroplasticity, inhibition of inflammatory biomarker production, improved vascular function, and hypothalamic-pituitary-adrenal axis regulation. The last section provides an overview of exercise parameters known to optimize cognition in older adults, such as exercise type, frequency, intensity, session duration, and exercise program duration.


Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Lindsay Bearne ◽  
Mandeep Sekhon ◽  
Rebecca Grainger ◽  
Anthony La ◽  
Mehrdad Shamali ◽  
...  

Abstract Background Physical activity and exercise (PA) are recommended for people with rheumatoid arthritis (RA), although adherence to PA tends to be low. Accessible, tailored interventions are needed to help people with RA change their behaviour to achieve public health PA recommendations and improve health outcomes. Use of smartphones and mobile applications (apps) is increasing and apps may assist people to reach PA recommendations. However, the availability, quality and content of evidence-based PA apps for people with RA is unknown. This study assessed the features, content and quality of apps targeting PA for adults with RA by i) systematically identifying apps ii) summarising their features and content iii) comparing their content to physical activity and exercise guidelines and iv) rating app quality. Methods A systematic search of the UK Apple AppStore and Google Play store was conducted to identify apps designed to facilitate PA in adults with RA between 19th-20th June 2019. Apps were excluded if they were i) not in English ii) for use by clinicians only or ii) solely focused on advertising a clinic/product. No fee restrictions were applied. Android and iOS apps were downloaded to smartphones, features/functionality described, content coded using Consensus on Exercise Reporting Template (CERT) and behaviour change technique taxonomy V1 (BCTTv1) and apps rated using the Mobile App Rating Scale (MARS range 0-5) by two independent reviewers. App features were compared with public health PA guidelines (150 minutes moderate PA/week or equivalent plus twice weekly resistance exercise) and American College of Sports Medicine recommendations for exercise prescription. Results Initially, 14,047 apps were identified. Following de-duplication, 2,737 apps were screened for eligibly and six apps were downloaded (two UK Apple AppStore, four Google Play store), yielding four unique apps. Only one app provided PA recommendations broadly aligned with public health PA guidelines and no apps aligned to ACSM exercise prescription guidelines or offered information on tailoring of PA to disease symptoms or health status. Apps included between 4-13 behaviour change techniques (BCTs) and three BCTs were common to all apps (demonstration of behaviour, instructions on how to perform behaviour, information about health consequences). Overall, MARS scores ranged between 2.25-4.17. Conclusion There is a lack of high-quality mobile apps which can be tailored to support PA for people with RA. Whilst all included apps incorporated some BCTs previously identified as effective for PA promotion, only one, high quality app provided PA recommendations which broadly aligned with public health PA guidelines but offered limited options for tailoring PA or exercise. Collaboration between adults with RA, clinicians, and app developers is needed to produce evidence informed apps, with embedded BCTs, which can be tailored to support people with RA achieve PA recommendations. Disclosures L. Bearne None. M. Sekhon None. R. Grainger None. A. La None. M. Shamali None. A. Amirova None. E. Godfrey None. C. White None.


Author(s):  
Lindsay M. Bearne ◽  
Christina H. Opava

This chapter provides an overview of the role of physical activity and exercise in the management of people with rheumatoid arthritis (RA). It defines the concepts of physical activity, exercise, and sedentary behaviour and considers how these are measured objectively and subjectively in research studies and clinical practice. The symptoms and disabilities targeted by appropriately prescribed interventions are discussed and the growing evidence base for the effects of exercise in people with RA is highlighted. The recommendations and guidelines for health-enhancing physical activity and exercise prescription are reviewed and the factors that influence adherence to these are acknowledged. Suggestions of how clinicians may adapt their management approach to facilitate the uptake and maintenance of health-enhancing physical activity and exercise are considered.


2018 ◽  
Vol 43 (5) ◽  
pp. 535-539 ◽  
Author(s):  
Jonathon R. Fowles ◽  
Myles W. O’Brien ◽  
Kara Solmundson ◽  
Paul I. Oh ◽  
Chris A. Shields

Exercise is Medicine Canada (EIMC) is an initiative that promotes physical activity (PA) counselling and exercise prescription within health care. The purpose of this study was to compare physicians’ perceptions and practices around PA counselling and exercise prescription following EIMC training. Physicians (n = 46) from 7 different provinces completed questionnaires initially and 3 months following an EIMC workshop. Three months after intervention, physicians reported greater confidence compared with baseline for providing physical activity and exercise (PAE) information to patients (79% vs 55%; p < 0.001), assessing patients’ PAE (69% vs 44%, p = 0.005), answering patients’ PAE questions (78% vs 54%, p < 0.001), providing PAE advice (71% vs 43%, p < 0.001), and identifying which patients would benefit from referral to qualified exercise professionals (77% vs 52%, p = 0.002). At follow-up, physicians reported PA prescription barriers as less impactful (out of 4; all p < 0.05), including perceived patients’ lack of interest (2.75 to 2.25), lack of available resources (2.59 to 2.00), and lack of time (2.41 to 2.14). The proportion of physicians providing written exercise prescriptions increased from 20% to 74%. This study suggests that the completion of a 1-day EIMC workshop increases physicians’ confidence, knowledge, and counselling behaviours of physicians in prescribing PAE.


2008 ◽  
Vol 32 (4) ◽  
pp. 336
Author(s):  
Carriej. Dillman ◽  
Jonathon R. Fowles ◽  
Christopher A. Shields ◽  
Rene J.L. Murphy ◽  
Shayne Fryia ◽  
...  

2017 ◽  
Vol 42 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Myles W. O’Brien ◽  
Christopher A. Shields ◽  
Paul I. Oh ◽  
Jonathon R. Fowles

The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.


2021 ◽  
Vol 7 (2) ◽  
pp. e001050
Author(s):  
Andrew O'Regan ◽  
Michael Pollock ◽  
Saskia D'Sa ◽  
Vikram Niranjan

BackgroundExercise prescribing can help patients to overcome physical inactivity, but its use in general practice is limited. The purpose of this narrative review was to investigate contemporaneous experiences of general practitioners and patients with exercise prescribing.MethodPubMed, Scopus, Science Direct and Cochrane reviews were reviewed using the terms ‘exercise prescription’, ‘exercise prescribing’, ‘family practice’, ‘general practice’, ‘adults’ and ‘physical activity prescribing’.ResultsAfter screening by title, abstract and full paper, 23 studies were selected for inclusion. Qualitative, quantitative and mixed-methods studies revealed key experiences of general practitioners and patients. Barriers identified included: physician characteristics, patients’ physical and psychosocial factors, systems and cultural failures, as well as ambiguity around exercise prescribing. We present a synthesis of the key strategies to overcome these using an ABC approach: A: assessment of physical activity: involves asking about physical activity, barriers and risks to undertaking an exercise prescription; B: brief intervention: advice, written prescription detailing frequency, intensity, timing and type of exercise; and C: continued support: providing ongoing monitoring, accountability and progression of the prescription. Multiple supports were identified: user-friendly resources, workshops for doctors, guidelines for specific illnesses and multimorbidity, electronic devices, health system support and collaboration with other healthcare and exercise professionals.DiscussionThis review has identified levers for facilitating exercise prescribing and adherence to it. The findings have been presented in an ABC format as a guide and support for general practitioners to prescribe exercise.


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 609
Author(s):  
Uchenna Benedine Okafor ◽  
Daniel Ter Goon

Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010–2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings.


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