Identifying barriers to remaining physically active after rehabilitation: differences in perception between physical therapists and older adult patients.

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To describe readiness for change and barriers to physical activity in older adults and to contrast perceptions of physical therapists and patients using the Barriers to Being Active Quiz. BACKGROUND: Regular physical activity is vital to recovery after discharge from physical therapy. Physical therapists are positioned to support change in physical activity habits for those transitioning to home care. Understanding of readiness for change and barriers to physical activity could optimize recovery. METHODS: Thirteen physical therapists enrolled in the study and invited patients who met the inclusion criteria to enroll (79 patients enrolled). The physical therapists provided the ICD-9 code, the physical therapist diagnosis, and completed the Barriers to Being Active Quiz as they perceived their patients would. The enrolled patients provided demographics and filled out the Satisfaction With Life Scale, the stages-of-change scale for physical activity, and the Barriers to Being Active Quiz. RESULTS: Patients were predominantly in the early stages of readiness for change. Both patients and physical therapists identified lack of willpower as the primary barrier to physical activity. Patients identified lack of willpower and social influence as critical barriers more often than physical therapists, whereas physical therapists identified fear of injury and lack of time more often than their patients did. Differences between physical therapists and their patients were noted for fear of injury (z = 2.66, P = .008) and lack of time (z = 3.46, P = .001). The stage of change for physical activity impacted perception of social influence (χ2 = 9.64, P<.05), lack of willpower (χ2 = 21.91, P<.01), and lack of skill (χ2 = 12.46, P<.05). Women ranked fear of injury higher than men did (χ2 = 6.76, P<.01). CONCLUSION: Understanding readiness for change in and barriers to physical activity may allow physical therapists to better tailor intervention strategies to impact physical activity behavior change.

Muscle endurance, cancer-related fatigue, and radiotherapy in prostate cancer survivors.

INTRODUCTION: In this study we investigated muscle and cancer-related fatigue (CRF) in prostate cancer survivors (CS) undergoing radiotherapy (RT). METHODS: In 13 CS and 12 controls, CRF was assessed by the Piper Fatigue Scale (PFS), Epworth Sleepiness Scale--Depression subscale (CES-D), physical activity (accelerometer), and hemoglobin levels (Hb). Muscle measures included strength, activation, contractile properties, and endurance during intermittent dorsiflexion. Testing occurred before and after 6 weeks of RT in CS. RESULTS: After RT, the PFS score increased from initial levels in CS only without changes in sleepiness, depression, or physical activity. Hb decreased in CS only [mean (SD): pre, 15 (1.1); post, 14.5 (1.1) g/dl; P = 0.04]. Endurance decreased in CS [mean (SD): pre, 519 (340) s; post, 388 (203) s; P = 0.04] and increased in controls [mean (SD: pre, 616 (387) s; post, 753 (553) s; P = 0.03]. Only endurance was associated with PFS in CS (r = -0.55, P = 0.05). DISCUSSION: Muscle endurance is impaired after RT and may contribute to CRF in CS.