"Conscious Nine Months": Exploring Regular Physical Activity amongst Pregnant Women-A Qualitative Study Protocol.

Despite a clear and convincing evidence base and strong recommendations for pregnant women to maintain regular moderate physical activity throughout pregnancy, many of them reduce or discontinue exercise altogether. This is due to pregnancy-related difficulties and barriers. The aim of this protocol is to describe a qualitative research methodology for a study exploring the experiences of women who managed to achieve the recommended levels of physical activity throughout their pregnancy by regularly participating in a specially designed "Conscious nine months" exercise programme. A qualitative descriptive design will be used, including semi-structured in-depth literature-based interviews, together with thematic analysis. Consolidated criteria for reporting qualitative research (COREQ) guidelines will be used. In-depth individual interviews (60-90 min) with exercise programme participants, used together with a thematic analysis process, will allow for a better understanding and exploration of what enabled the participants to achieve such high adherence to the overall exercise programme. The chosen methodology offers a structured way for researchers to explore the experiences and factors that influence the ability of pregnant women to be physically active, enabling research into how pregnant women can be supported to remain active during this special, often challenging time in life.

Knowledge, behaviours and attitudes towards Evidence-Based Practice amongst physiotherapists in Poland. A nationwide cross-sectional survey and focus group study protocol.

OBJECTIVES: Evidence-Based Practice, EBP, is recognised, along with team work and patient-centred care, as a core competency in contemporary healthcare. However, dissemination and implementation of EBP remains problematic and is dependent on various external and internal factors, from personal through institutional to systemic, factors, with specific characteristics for different professions, contexts and settings. Knowledge, behaviours, attitudes, as well as facilitators and barriers towards EBP amongst physiotherapists, have been widely explored worldwide, but never in Poland. This study is part of a nationwide project, including dissemination actions addressing EBP in physiotherapists registered in Poland. Our purpose is to explore the issues of knowledge, behaviours, experiences, and attitudes of physiotherapists in Poland towards EBP. Descriptive research studies are warranted before analytical investigations and dissemination activities are conducted. METHODS: We plan to conduct a quantitative, cross-sectional study-an online survey amongst the total population of physiotherapists registered in Poland to assess knowledge, behaviours and use of EBP (Study 1), and a qualitative study to allow physiotherapists to voice their opinions and to explore their experiences and attitudes towards EBP (Study 2). The EBP2 questionnaire, Polish validated translation, will be used for Study 1, in a web-based survey. A focus group approach will be applied for Study 2, with purposive sampling to achieve a representative picture of physiotherapists with respect to setting, specialty, seniority, educational degrees, and age. We will follow an inductive approach, using topics rather than questions. RESULTS: We will present the results of the studies separately, as typically presented in relevant study types: Study 1 will be reported addressing the domains and items of the EBP2, in relation to the independent variables, and Study 2 will be discussed using the themes and illustrative quotes analyses. DISCUSSION: We are aware that significant non-response, spin and Hawthorne effect may potentially bias our findings.

The effects of a physical exercise program on fetal well-being and intrauterine safety.

OBJECTIVES: The aim of this study was to evaluate the effects of a supervised physical exercise program on fetal well-being and intrauterine safety. Physical activity is recommended for healthy pregnant women. However, constant evaluation of fetal condition and development is recommended to ensure the safety of the exercise program. MATERIAL AND METHODS: Randomized control trial study design. Sixty-six healthy pregnant women (age 24-35) with singleton gestation were randomly assigned to either an exercise group (EG, n = 34) or a non-active control group (CG, n = 32). The exercise program included 81 sessions (moderate intensity, 3 times per week, 50-60 min/session from weeks 13 to weeks 40/41 of pregnancy). Fetal well-being was assessed in weeks 32 and 37 of pregnancy. The cerebroplacental ratio (CPR) was calculated to evaluate the safety of the exercise program for the fetus. RESULTS: The differences in the CPR ratio measurements between EG and CG groups in week 37 (p < 0.05) were observed. The increase in the CPR ratio was also shown in week 37 of pregnancy in comparison to week 32 (p < 0.01). Moreover, maternal heart rate was significantly lower in the exercise group as measured at 37 weeks (p < 0.05). CONCLUSIONS: The results of this study confirm that regular and supervised exercise program throughout pregnancy does not affect fetal well-being and is safe for the fetus. Additionally, regular physical activity improves maternal physical fitness and cardiac efficiency which might aid at preparing pregnant women for natural labor.

The end of being a straight child: an autoethnography of coping with adolescent idiopathic scoliosis.

PURPOSE: In the field of research on adolescent idiopathic scoliosis, the personal dimension is undervalued. Even the most comprehensive and current recommendations focus on biomedical issues and are entirely based on quantitative studies. Reports and narratives presenting people's preferences, values, views, and opinions, especially of those affected by this health condition, are not considered in those reports. This article's aim is to present personal experiences of scoliosis screening, diagnosis, and treatment, to contribute to the discussion. METHODS: This is an evocative narrative autoethnography study, which allows focusing on the personal story of the author's experiences of adolescent idiopathic scoliosis management, connecting it to the rehabilitation context. RESULTS: Experiences of non-person-centred rehabilitation resulted in stigmatisation, distress, and emotional upset, including anxiety and fear. In contrast, person-centred therapeutic relationship involved more positive outcomes of care, such as becoming an engaged co-responsible and active partner in rehabilitation. CONCLUSIONS: It is strongly suggested to promote biographical research into the personal experiences of all aspects of adolescent idiopathic scoliosis, to identify patients' preferences and values more clearly. Furthermore, screening, diagnosis and treatment processes should be reviewed in terms of person-centredness, to ensure they are responsive to young people's needs in the vulnerable time of puberty. IMPLICATIONS FOR REHABILITATION Adolescent idiopathic scoliosis, including the treatment, and even the diagnosis, may be stigmatising and may lead to emotional and psychosocial harms Adolescent idiopathic scoliosis screening, diagnosis and treatment processes need to be person-centred, recognising young people's needs for privacy and support in the vulnerable time of puberty Emotional support from therapists ought to be part of the professional relationship based upon being with another person An explication of experiences of living with adolescent idiopathic scoliosis should be considered as a legitimate contribution to the practical and scientific understanding of this health condition.

Screening for scoliosis - New recommendations, old dilemmas, no straight solutions.

This opinion review considers the prevailing question of whether to screen or not to screen for adolescent idiopathic scoliosis. New and improved standards of people-oriented care and person-centredness, as well as improved principles of preventive screening and guideline development, have been postulated and implemented in health care systems and cultures. Recommendations addressing screening for scoliosis differ substantially, in terms of their content, standards of development and screening principles. Some countries have discontinued issuing recommendations. In the last decade, a number of updated and new recommendations and statements have been released. Systematically developed guidelines and recommendations are confronted by consensus and opinion-based statements. The dilemmas and discrepancies prevail. The arguments concentrate on the issues of the need for early detection through screening in terms of the effectiveness of early treatment, on costs and cost-effectiveness issues, scientific and epidemiologic value of screenings, and the credibility of the sources of evidence. The problem matter is of global scale and applies to millions of people. It regards clinical and methodological dilemmas, but also the matter of vulnerable and fragile time of adolescence and, more generally, children's rights. The decisions need to integrate people's values and preferences - screening tests need to be acceptable to the population, and treatments need to be acceptable for patients. Therefore we present one more crucial, but underrepresented in the discussion, issue of understanding and implementation of the contemporary principles of person-centred care, standards of preventive screening, and guideline development, in the context of screening for scoliosis.

Mapping the evidence of experiences related to adolescent idiopathic scoliosis: a scoping review protocol.

INTRODUCTION: Adolescent idiopathic scoliosis, the diagnosis and management of this condition, may lead to poorer body image and diminished psychosocial functioning. Furthermore, treatment, especially bracing and surgery as well as screening, remain controversial and debated, with an unclear evidence base. Personal experiences in terms of issues such as person-centred care, shared decision making, and patient and public involvement, are contemporarily recognised as highly valued. Nonetheless, people's experiences related to adolescent idiopathic scoliosis is an issue underrepresented in current systematic reviews and systematically developed recommendations. There appears a substantial imbalance between a vast amount of biomedical research reports, and sporadic biopsychosocial publications in this field. The objective of this planned scoping review is to explore and map the available evidence from various sources to address a broad question of what is known about experiences of all those touched, directly and indirectly, by the problem of adolescent idiopathic scoliosis. METHODS AND ANALYSIS: We based our protocol on the Joanna Briggs Institute's scoping review method, including the Population - Concept - Context framework, to formulate the objectives, research questions, eligibility criteria and conduct characteristics of the study. We will consider any primary study designs, research synthesis reports, as well as narrative reviews and opinion pieces. We will not restrict eligible publications to English language. Search and selection processes will include academic and grey literature searches using multiple electronic databases, search engines and websites, hand searches, and contacting the authors. We will use a customised data charting table and present a narrative synthesis of the results. ETHICS AND DISSEMINATION: Scoping review is a secondary study, aiming at synthesising data from publicly available publications, hence it does not require ethical approval. We will submit the report to a peer-reviewed journal and disseminate it among professionals involved in scoliosis management, guideline and recommendation development, and policymaking.

Biomechanical Analysis of Successful and Unsuccessful Snatch Lifts in Elite Female Weightlifters.

The aim of this study was to identify biomechanical factors affecting successful and unsuccessful snatch attempts in elite female weightlifters during the 2013 World Weightlifting Championships. Fourteen female competitors took part in this study. Their successful and unsuccessful snatch lifts with the same load were recorded with 2 camcorders (50 Hz), and selected points were digitized manually on to the body and the barbell using the Ariel Performance Analysis System. The kinetic and kinematic barbell movement as well as the athlete's body movement variables during the liftoff phase were examined. The results of this study show statistical differences (p ≤ 0.05) between successful and unsuccessful attempts in relation to the angle values in the knee and hip joints in preparation for the aerial phase position. Similarly, the center of gravity velocity was significantly higher in successful attempts during the catch phase. Thus, coaches should pay particular attention to the accuracy of the execution in preparation for the aerial phase position and to the velocity of the center of gravity of the competitors during the catch phase.

The Effectiveness of Regular Exercise Programs in the Prevention of Gestational Diabetes Mellitus-A Systematic Review.

IMPORTANCE: Physical activity is recognized as one of the most important tools in the management of gestational diabetes mellitus (GDM). OBJECTIVE: The aim of this review was to compare and analyze regular prenatal exercise programs and examine their effectiveness in the prevention of GDM. EVIDENCE ACQUISITION: The following databases were used: Academic Search Complete, Health Source-Consumer Edition, Health Source-Nursing/Academic Edition, Master File Premier, MEDLINE, and SportDiscus with full text. The inclusion criteria were as follows: a randomized study, regular training program throughout pregnancy, and supervised by a prenatal activity specialist. RESULTS: The 10 articles selected for the review were divided into 2 groups. The first group comprised 2 studies presenting successful interventions in the prevention of GDM, whereas the second group included 8 articles with no statistically significant effects of the training programs in GDM prevention. Beginning an exercise program at early stages of the pregnancy and high adherence were common features of the effective programs. CONCLUSIONS: When designing and carrying out the program, the beginning of the intervention and adherence should be considered. To increase adherence, the program should be attractive and it should meet the participants' needs. CONCLUSIONS AND RELEVANCE: This review might be used for identifying factors deciding whether an exercise program is an effective intervention to prevent the development of GDM. Moreover, it might also prove useful in the preparation of future guidelines for designing and implementing regular exercise programs effective in preventing GDM in pregnant women by gynecologists, obstetricians, midwives, trainers, and prenatal specialists.