Behavioural change for Parkinson's Disease: A randomised controlled feasibility study to promote physical activity and exercise adherence among people with Parkinson's: study protocol.

Background: Parkinson's is a common progressive neurological condition characterized by motor and non-motor deficits. Physical activity and exercise can improve health, but many people with Parkinson's (PwP) have trouble reaching the recommended dosage. Our recent literature review found improvements in exercise adherence with behavioural change interventions, but it remains unclear which are most effective. Further qualitative research and patient and public involvement has informed a novel behavioural change intervention to be tested alongside an existing exercise program. Objective: To examine the feasibility of behavioural change techniques delivered alongside an exercise programme to improve physical activity, function, and self-efficacy in PwP (and study procedures) to inform a future pilot RCT trial. Methods: A parallel-arm single blinded randomised feasibility study. Twenty participants with Parkinson's (Hoehn and Yahr stage 1-3) will be recruited from a physiotherapy primary-care waiting list. Following written consent, and baseline assessment, the participants will be randomly allocated to the intervention (n=10) or the control group (n=10). Both groups will receive usual care, which includes a weekly program of a multidisciplinary education, a supervised exercise class and a prescribed home exercise program. The intervention group will receive additional behavioural change techniques, targeting behaviour regulation, belief about capabilities and social influences. Class and home exercise adherence, behavioural component uptake and adherence, and negative events will be recorded. Outcomes will include enrolment and maintenance rates, physical function, falls, physical activity, and exercise self-efficacy measured pre- and post- the 12-week program (in-person). Surveys will be used to compare experiences and satisfaction between groups. Exit interviews will be completed with the intervention group only, exploring their experience of the behavioural change techniques. Discussion: The results will help inform a future pilot RCT, based on the intervention acceptability, consent rate, maintenance, and protocol integrity. Trial Registration: ClincialTrials.gov NCT06192628.

Exercise adherence for patients with trismus after head and neck cancer treatment.

BACKGROUND: Head and neck cancer treatment often leads to trismus, a condition characterized by limited mouth opening. Exercise-based therapy is the most common intervention but there are no clear guidelines as to the optimal exercise regimen. Restorabite™ is a portable and force-regulated trismus device designed to enhance exercise adherence. This study explores the adherence to exercises using Restorabite™ in head and neck cancer patients with trismus and identifies facilitators and barriers to exercise therapy. MATERIALS AND METHODS: Mixed-methods, prospective cohort study undertaken at a quaternary oncology hospital, in Sydney Australia involving participants diagnosed with head and neck cancer diagnosed with trismus (maximal incisal opening under 35 mm). Patients underwent a 10-week individualized trismus program using Restorabite™ with weekly speech pathology reviews. Exercise adherence was tracked through categorized descriptors. Data were collected prospectively at baseline, during 10 weeks of therapy with Restorabite™, and at 6- and 12-month post-trismus exercise. Participants described facilitators of trismus therapy, and barriers to completing the prescribed exercises. Clinical documentation of these responses was then analyzed using content analysis. RESULTS: One-hundred and thirty-five participants were recruited. During the intervention 69% (n = 93) exercised as recommended, 24% (n = 32) exercised less, and 7% (n = 10) exercised more than recommended. At 6 months post-intervention, 55.5% (n = 75) exercised as recommended, 38.5% (n = 52) exercised less, and 4% (n = 6) exercised more. At 12 months, 36% (n = 49) exercised as recommended, 48% (n = 62) exercised less, and 11% (n = 15) exercised more. MIO increased from a mean of 18.6 mm at baseline, to 30.1 mm at the end of the 10-week intervention. This was maintained at 6 and 12 months (31.7 and 32.1 mm, respectively). Adherence to the exercise program was associated with greater improvement in maximum interincisal opening (p < 0.001). Facilitators of adherence included intrinsic motivation, device portability, perceived functional change, and external support tools. Barriers included cancer treatment toxicities, competing priorities, and health challenges. Positive outcomes included functional improvements, while negative outcomes included increased pain. CONCLUSIONS: Seventy-six percent of patients prescribed Restorabite™ performed trismus exercises at or more than the recommended frequency. Facilitators and barriers identified provide insights into factors influencing adherence. Future research should involve comparative studies that compare the adherence and effectiveness of different exercise programs.

Successful Aging of Korean Older Adults Engaging in Sports Regularly: Health Beliefs, Exercise Adherence Intention, and Health Promotion Behavior.

The population of older adults is increasing more rapidly in Korea than in any other country, making successful aging a salient need in Korean society. For successful aging, older adults must engage in sports activities regularly. This study determined the relationships among health beliefs, exercise adherence intention, health promotion behavior, and successful aging among older adults who engage in sports activities regularly. The participants were 287 adults aged 65 years or older who live in Korea and exercise regularly. Data were collected through a survey and analyzed using descriptive statistics, correlation analysis, and structural equation modeling. The integrated model lacked explanatory power in terms of goodness of fit, but the alternative model had sufficient explanatory power. The alternative model showed that health beliefs, exercise adherence intention, and health promotion behavior are significantly related and that health promotion behavior positively predicts successful aging. It also showed that health beliefs affect successful aging through the mediation of exercise adherence intention and health promotion behavior. This study is meaningful because it verifies the structural and theoretical relationships among health beliefs, exercise adherence intention, health promotion behavior, and successful aging. As a result, it provides information that can improve the welfare of older adults in Korean society.

The relationship between exercise commitment and college students' exercise adherence: The chained mediating role of exercise atmosphere and exercise self-efficacy.

OBJECTIVE: This study aims to explore the mechanisms underlying exercise commitment, exercise atmosphere, exercise self-efficacy, and exercise adherence among college students, as well as the impact of gender differences on these mechanisms. METHODS: Using a stratified cluster sampling method, 984 college students (aged 19.74 ± 1.25 years) from six universities in Anhui, Shandong, and Shaanxi provinces were randomly selected, with 403 male students and 581 female students. They had completed the Exercise Commitment Scale (ECC), Physical Exercise Atmosphere Scale (PEAS), Exercise Self-Efficacy Scale (ESES), and Exercise Adherence Scale (EPS). The study variables were analyzed in sequence for reliability and validity, correlation analysis, regression analysis, structural equation model testing, and bias-corrected percentile Bootstrap testing using SPSS 23.0 software and Hayes' (2013) Process plug-in. RESULTS: Exercise commitment significantly positively predicted exercise adherence (ß = 0.796, p < 0.01), exercise commitment significantly positively predicted exercise environment and exercise self-efficacy (ß = 0.645, p < 0.01, ß = 0.356, p < 0.01), exercise environment significantly positively predicted exercise self-efficacy and exercise adherence (ß = 0.344, p < 0.01, ß = 0.144, p < 0.01), and exercise self-efficacy significantly positively predicted exercise adherence (ß = 0.934, p < 0.01). The mediating role of exercise environment in the relationship between exercise commitment and exercise adherence does not exist in male college students, while it exists in female college students. CONCLUSIONS: Exercise atmosphere and exercise self-efficacy play a mediating role between exercise commitment and exercise adherence, with a total mediating effect value of 0.796. This study indicates that exercise commitment not only directly predicts exercise adherence, but also indirectly predicts exercise adherence through the chained mediating effects of exercise atmosphere and exercise self-efficacy. The above-mentioned mediating effect exists in female college students, while some mediating effects do not exist in male college students, thus gender has a significant impact on this mediating effect.

Empowering Movement: Enhancing Young Adults' Physical Activity through Self-Determination Theory and Acceptance and Commitment Therapy-Based Intervention.

OBJECTIVE: This study aims to investigate the effectiveness of a combined Self-Determination Theory (SDT) and Acceptance and Commitment Therapy (ACT) intervention, the "Running Minds" program, in promoting physical activity (PA) among young adults. METHODS: The intervention, consisting of eight sessions, targeted motivational and psychological barriers to PA. It intertwined SDT's core components (autonomy, competence, relatedness) with ACT's emphasis on mindfulness and value-driven actions. This study used a qualitative approach, collecting data through semi-structured interviews with twelve participants aged 20-35, conducted post-intervention. RESULTS: Our reflexive thematic analysis of the interviews revealed five key themes: alignment with personal values, rewarding experience of the sessions, fulfillment of social connectedness, enhancement of both intrinsic and extrinsic motivation, and observable behavioral changes. These findings highlight the importance of aligning exercise with personal values and the role of supportive social environments in sustaining PA. CONCLUSIONS: The integration of SDT and ACT in the "Running Minds" program appears to be a viable approach for enhancing motivation and adherence to PA among young adults. This study offers valuable insights for future PA interventions, underscoring the need for strategies that consider psychological and social dimensions. Limitations and Future Research: Despite the promising results, limitations include potential recall bias and the short duration of the study. Further research, especially focusing on more diverse groups and employing longitudinal designs, is recommended to broaden and substantiate these findings.

A Qualitative Study Identifying Barriers and Enablers to Exercise Adherence in People with Chronic Low Back Pain. "It's a personal journey".

Exercise leads to clinically meaningful pain reductions in people with chronic low back pain and is recommended as a first line treatment. The benefits of exercise for chronic low back pain decrease over time with a lack of long-term exercise adherence as a potential reason for this decreasing effect. We aimed to identify the barriers and enablers to exercise adherence from the perspective of people with chronic low back pain. This qualitative study was underpinned by a constructivist epistemology and used a critical realist ontological perspective. Adults (18-65 years) with chronic low back pain who had exercised since the onset of their back pain were recruited to participate in focus groups and individual interviews. Audio data were transcribed and then analysed in 2 stages 1) inductive coding using reflexive thematic analysis, followed by 2) deductive analysis through mapping codes onto the Theoretical Domains Framework. Five enablers and 3 barriers were identified across 6 of the 14 Theoretical Domain Framework domains. Exercise identity and confidence in deciding to self-manage pain were enablers, whereas beliefs about the consequences of exercise, exercise context, and relationships could function as either barriers or enablers. These barriers and enablers were complex and fluid, with participants reporting conflicting barriers and enablers that varied, depending on context. These findings improve our understanding of the barriers and enablers to exercise adherence from the individual perspective of people with chronic low back pain and can be utilised for more effective exercise treatment in this population. PERSPECTIVE: This article presents the barriers and enablers to exercise adherence from the perspective of people with chronic low back pain. These perspectives may aid to individualise and optimise exercise treatment, improve its long-term adherence and therefore its effectiveness for chronic low back pain.

Use of a Home-Based, Commercial Exercise Platform to Remotely Monitor Aerobic Exercise Adherence and Intensity in People With Parkinson Disease.

OBJECTIVE: Physical therapists are well-positioned to prescribe exercise outside of a clinical setting to promote positive health behaviors in people with Parkinson disease (PD). Traditionally, a barrier to precise exercise prescription has been reliance on participant self-reported exercise adherence and intensity. Home-based, commercially available exercise platforms offer an opportunity to remotely monitor exercise behavior and facilitate adherence based on objective performance metrics. The primary aim of this project was to characterize the feasibility and processes of remote aerobic exercise data monitoring from a home-based, commercially available platform in individuals participating in the 12-month Cyclical Lower Extremity Exercise for PD II (CYCLE-II) randomized clinical trial. Secondary aims focused on using exercise behavior to classify the cohort into exercise archetypes and describing a shared decision-making process to facilitate exercise adherence. METHODS: Data from each exercise session were extracted, visualized, and filtered to ensure ride integrity. Weekly exercise frequency was used to determine exercise archetypes: Adherent (2-4 exercise sessions per week), Over-adherent (>4 exercise sessions per week), and Under-adherent (<2 exercise sessions per week). RESULTS: A total of 123 people with PD completed 22,000+ exercise sessions. Analysis of exercise frequency indicated that 79% of participants were adherent; 8% were over-adherent; and 13% were under-adherent. Three case reports illustrate how shared decision-making with the use of exercise performance data points guided exercise prescription. CONCLUSIONS: The number of exercise sessions and completeness of the data indicate that people with PD were able to utilize a commercial, home-based exercise platform to successfully engage in long-term aerobic exercise. Physical therapists can use objective data as a part of a shared decision-making process to facilitate exercise adherence. IMPACT: Commercially available exercise platforms offer a unique approach for physical therapists to monitor exercise behavior outside of a clinical setting. The methods used in this project can serve as a roadmap to utilizing data from consumer-based platforms.

The influence of control beliefs on the cardiovascular fitness of college students: the chain mediating effect of subjective exercise experience and exercise adherence.

PURPOSE: Lack of adequate physical exercise is the main reason for the frequent occurrence of health problems among Chinese college students. The purpose of this study is to explore the effects of control beliefs on cardiovascular fitness among college students and the mediating role of subjective exercise experience and exercise adherence in it. METHODS: The Control Belief Scale, the Subjective Exercise Experience Scale (SEES), and the Exercise Adherence Scale were used to investigate 1854 freshmen and sophomores in Nantong and Suzhou, China. Cardiovascular fitness data for college students from the National Student Physical Health Standard and SPSS 23.0 statistical analysis software were used to carry out statistics and analyses on the questionnaires. Correlation analysis, regression analysis, and mediation models were used to assess control beliefs, subjective exercise experiences, exercise adherence, and cardiovascular fitness. RESULTS: The control belief of college students was directly related to cardiovascular fitness (effect value: 0.121), the mediating effect through subjective exercise experience was not significant, indirectly related through the mediating effect of exercise adherence (effect value: 0.101), and indirectly related through the mediating effect of subjective exercise experience and exercise adherence (effect value: 0. 019). The positive prediction effect of control belief on cardiovascular fitness of college students was significant (ß = 0.267, P < 0.001), and the positive prediction effect of control belief on cardiovascular fitness of college students was still significant (ß = 0.121, P < 0.01) after adding the intermediary variables (subjective exercise experience and exercise adherence). CONCLUSIONS: The cardiovascular fitness of college students was not only directly affected by control beliefs but also affected by the chain mediating effect of subjective exercise experience and exercise adherence. Therefore, it is necessary to improve the control beliefs, subjective exercise experiences, and exercise adherence of college students to improve their cardiovascular fitness level and enhance their physical health.

A Content Analysis of African Americans' Experience of Engaging in Qigong Exercise Intervention in a Community Setting.

Introduction: Although an increasing number of African Americans 50 years of age and older practice qigong, a mind-body exercise, to manage their health conditions, little is known about their perceptions and experiences of engaging in and learning qigong exercise. This study aimed to explore the subjective perceptions of the health benefits, engagement, adherence, and learning of qigong exercise in African Americans 45-85 years of age as a foundation for promoting this approach for African Americans' physical and psychological health. Methods: Fifteen African Americans were enrolled in a 1-h qigong exercise program twice a week for 8 weeks (a total of 16 sessions) in the activity center of a local church. Participants were interviewed after the intervention to explore their perceptions of learning and practicing qigong exercise. Interviews were conducted in person, audio recorded, transcribed verbatim, and analyzed using content analysis. Results: Five themes emerged: (1) Perceived benefits of practicing qigong, (2) helpful strategies for qigong learning, (3) facilitators for home qigong practice, (4) motivators for qigong exercise adherence, and (5) recommending qigong to others. qigong exercise was perceived to be effective for balance, flexibility, muscle strength, sleep quality, emotion regulation, and stress management. Nearly 75% of participants reported home qigong practice at least twice a week. Conclusions: Middle-age and older African Americans' responses provide insights on health benefits associated with practicing qigong exercise, adherence, home practice, and learning, which may serve as the first step to promoting the use of qigong exercise in this population and may be adopted to similar exercise interventions with minority older adults in the future.

Perceptions of High-Intensity Interval Training Among People With Spinal Cord Injury: A Mixed-Methods Analysis.

This mixed-method project investigated how people with spinal cord injury perceive high-intensity interval training (HIIT). Using a recumbent hand cycle, 11 active men and 9 active women with spinal cord injury or related disease participated in a single HIIT and moderate-intensity continuous training (MICT) session. Following exercise, participants completed surveys assessing enjoyment, self-efficacy, and outcome expectations. Ten participants were randomly selected to participate in a semistructured interview to assess perceptions toward HIIT. Quantitative survey data revealed that participants trended toward enjoying HIIT over MICT (p = .06) with similar levels of self-efficacy and outcome expectations toward HIIT and MICT (p > .05). Qualitative data revealed that participants believed HIIT would enhance long-term physical and self-evaluative outcomes; several barriers emerged that could prevent widespread adoption among the general population with spinal cord injury. Results support HIIT as a viable exercise option, although research should begin exploring ways to remove HIIT-related barriers that people with spinal cord injury may encounter.

Effectiveness of telehealth in preventive care: a study protocol for a randomised controlled trial of tele-exercise programme involving older people with possible sarcopenia or at risk of fall.

BACKGROUND: Continuous loss of muscle mass and strength are the consequences of the ageing process, which increase the risk of falls among older people. Falls can lead to severe consequences such as bone fractures and hampered physical and psychological well-being. Regular exercise is the key to reversing muscle atrophy and relieving sarcopenia. However, the frailty of older people and the recent COVID-19 pandemic may affect their confidence to leave home to attend classes in the community. A feasible and effective alternative should be explored. METHODS: The primary objective is to evaluate the effectiveness of tele-exercise (TE) in relation to physical functioning and exercise adherence among community-dwelling older people at risk of falls in comparison with a community-based group (CB). The secondary objective includes evaluating older people's experience with tele-exercise, emphasizing their psychological welfare, social well-being, and acceptance of the telehealth approach. The design, conduct, and report follow the SPIRIT guidelines (Standard Protocol Items: recommended items to address in a Clinical Trial Protocol and Related Documents). Older people will be recruited from 10 local community centres in Hong Kong and randomly allocated into two groups. All participants will attend the exercise training 3 days per week for 3 months but the mode of delivery will differ, either online as the tele-exercise group (TE) or face-to-face as the community-based group (CB). The outcome measures include muscle strength, physical function, exercise adherence and dropout rate, psychological and social well-being will be assessed at the baseline, and the 3rd, 6th and 12th month. Some participants will be invited to attend focus group interviews to evaluate their overall experience of the tele-exercise training. DISCUSSION: Tele-exercise reduces the barriers to exercise, such as time constraints, inaccessibility to facilities, and the fear of frail older people leaving their homes. Promoting an online home-based exercise programme for older people can encourage them to engage in regular physical activity and increase their exercise adherence even when remaining at home. The use of telehealth can potentially result in savings in cost and time. The final findings will provide insights on delivering exercise via telehealth to older people and propose an exercise delivery and maintenance model for future practice. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( https://www.chictr.org.cn/hvshowprojectEN.html?id=219002&v=1.1 ), registration number: ChiCTR2200063370. Registered on 5 September 2022.

Long Term Effects of a Social Capital-Based Exercise Adherence Intervention for Breast Cancer Survivors With Moderate Fatigue: A Randomized Controlled Trial.

OBJECTIVES: This study reports on the long-term effects of the Better Life After Cancer: Energy, Strength, and Support (BLESS) program, a 12-week social capital-based exercise adherence program for breast cancer survivors (BCS), implemented using a randomized controlled trial design. The study investigated outcomes related to cancer-related fatigue (CRF), quality of life (QOL), physical activity, depression, anxiety, sleep quality, and social capital. METHODS: Participants who had moderate or greater CRF were randomly assigned to the intervention (n = 24), consisting of supervised and home-based exercise, or the control (n = 26), who received exercise leaflets. Generalized estimating equations models were fitted for the outcome variables. The assessment points were baseline (M1), immediately after completing the intervention at 12 weeks (M2), 1 month (M3), and 6 months post-intervention (M4). RESULTS: A significant reduction in the total CRF score was found for both groups. We observed a significant time by group effect at M2, indicating a reduction of behavioral/severity CRF scores and a higher increase of physical activity. Also, there was an increase in the QOL score of both groups at M2, M3, and M4, compared to M1. Both groups had reduced anxiety at M3 and M4 compared to M1. The time by group effect for depression, sleep quality and social capital was not statistically significant. CONCLUSION: This 12-week exercise adherence program improved behavioral/severity CRF and physical activity post-intervention. Both the experimental group and control group showed significant improvements in CRF, QOL, and anxiety domains compared to the baseline, which extended to 6 months post-intervention. TRIAL REGISTRATION: Korean Clinical Research Information Service (KCT0005763).

Adherence and perceptions of a home sports video gaming program in persons with spinal cord injuries: A pilot study.

OBJECTIVE: Sports video-gaming can facilitate increased activity levels in persons with limited exercise options. Understanding how persons with spinal cord injuries (SCI) participate in home-based video-gaming and its potential impact on maintaining or enhancing physical function remains largely unexplored. The purpose of this study was to evaluate adherence, perceptions, and potential physical effects of a home sports video-game program for persons with chronic SCI. PARTICIPANTS: Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia). DESIGN: This was a prospective study. Wii video-gaming systems that included four sports games were provided to participants for home use. Participants were instructed to play for 8 weeks 3-4 days/week. The video consoles recorded the time and number of sessions played. OUTCOME MEASURES: At baseline and at the conclusion of the program, measurements were made of upper extremity strength, perceived exertion, active heart rate, pain, balance, and a functional upper extremity (UE) test. The total time and number of sessions were compared to the prescribed game play as a measure of adherence. Scores from a self-reported survey were used to gauge participants' satisfaction and perceptions of their gaming experience. RESULTS: Overall mean gaming adherence was 85% during the first 4 weeks and 69% for the second 4 weeks. There were no significant changes in upper extremity strength, active heart rate, balance, pain, or functional UE test for either group. All of the participants rated video gaming as enjoyable and 85.7% perceived that it could be used as a form of exercise. CONCLUSION: The Wii sports home video-gaming intervention elicited overall high adherence rates and was well received by study participants indicating that it may have value as an adjunctive tool for increasing physical activity for individuals with SCI.

Strengthening oropharyngeal muscles as an approach to treat post-stroke obstructive sleep apnea: A feasibility randomised controlled trial.

This study aimed to determine the feasibility of a randomised controlled trial (RCT) evaluating oropharyngeal exercise (OPE) intervention as an alternative therapy for obstructive sleep apnea (OSA) in patients with stroke or transient ischaemic attack (TIA). Despite the high prevalence of OSA in this population, the standard therapy, continuous positive airway pressure (CPAP), is often poorly tolerated. Thirty stroke/TIA patients with OSA unable to tolerate CPAP were randomly assigned to an oropharyngeal exercise or sham exercise protocol. They performed exercises for 6 weeks, 5 days per week, 30 minutes twice per day. Feasibility was ascertained by the proportion of enrolled patients who completed more than 80% of the OPE regimen. Isometric tongue pressures, apnea-hypopnea index (AHI), oxygen desaturation index (ODI), daytime sleepiness, and quality of life (QOL) outcomes were collected at baseline, post-training (6-week follow-up), and retention (10-week follow-up) to document preliminary efficacy. Adherence to study exercises was excellent, with 83% of participants completing more than 80% of the exercises. The isometric tongue pressures were observed to improve in the oropharyngeal exercise group (compared with the sham group), along with a decrease in OSA severity (measured by the AHI and ODI), reduced daytime sleepiness, and enhanced quality of life outcomes following the exercise programme. Only the effects on posterior isometric tongue pressure and daytime sleepiness remained significantly different between groups at the retention session. In conclusion, an RCT evaluating the efficacy of oropharyngeal exercises on post-stroke/TIA OSA is feasible and our preliminary results suggest a clinically meaningful effect.

Examining Relationships between Cognitive Flexibility, Exercise Perceptions, and Cardiovascular Disease Risk Factors.

Adults do not engage in enough physical activity. Investigating cognitive and physiological factors related to improving this behavior-and reducing health risks-remains a public health priority. Our objective was to assess whether cognitive flexibility influenced perceptions and choice of exercise programs and whether flexibility was associated with cardiovascular disease (CVD) risk factors. Independent sample groups of college-aged adults (18-24 yrs) participated in two studies. Data were collected on individuals' degree of cognitive flexibility (both self-reported and objectively measured), perceptions and choice of exercise programs, and health status markers known to be associated with CVD (vascular function, muscular strength, and body composition). Vascular function was assessed with a near-infrared spectroscopy device, strength was defined as handgrip, and body composition was estimated via digital circumferences. Self-reported flexibility reliably predicted individuals' choice of exercise program and perceptions of effort required for success on an exercise program. The relationships among CVD risk factors and objectively measured cognitive flexibility were not significant, demonstrating that identifying a healthy individual's degree of performance-based cognitive flexibility does not predict health status. Furthermore, although greater self-reported trait flexibility (rigidity) is known to predict higher (lower) likelihood of physical activity, this finding should not be extrapolated to also assume that flexibility (rigidity), as measured by objective cognitive tests, is associated with reduced CVD risk in healthy adults. We posit a rationale for how understanding cognitive flexibility and rigidity can play an impactful role in improving adherence to exercise prescriptions targeted to reducing risks.

Exercise Intention and its Associated Factors Among Persons Post-Stroke: A Cross-Sectional Study.

Purpose: To investigate the level of exercise intention and its associated factors among persons post-stroke using the Theory of Planned Behavior. Patients and Methods: In this cross-sectional study, a total of 333 participants admitted to the neurology units of a tertiary care hospital in China with a confirmed diagnosis of stroke were recruited. A self-administered instrument based on the Theory of Planned Behavior was used to determine the exercise intention and its associated factors among persons post-stroke. Results: The results revealed that only 128 participants had exercise intention after discharge with a prevalence of 38.4%. Multivariable linear regression analysis revealed that monthly income, living situation, subjective norms, attitude, and perceived behavioral control were significant predictors of exercise intention of persons post-stroke. Perceived behavioral control and living situation were the most relevant factors of exercise intention. Conclusion: The level of exercise intention among persons post-stroke was found to be low. Perceived behavioral control and living situation were particularly important and contributed to exercise intention. Healthcare professionals' adequate guidance on exercise should be provided, with a focus on educating both patients and their family members, especially spouses, to promote exercise intention in persons post-stroke.

A Low Degree of Physical Exercise Adherence in College Students: Analyzing the Impact of Interpersonal Skills on Exercise Adherence in College Students.

Physical exercise adherence (PEA) is multifaceted and significantly influenced by elements such as physical prowess, personality traits, psychosocial traits, and demographics. At present, there are problems such as the low degree of PEA in college students. Studies have shown that exercise adherence (EA) can be improved by adjusting psychological factors. Social abilities are one of the important manifestations of mental health, so this study aims to explore the intrinsic influence mechanism of social abilities on college students' PEA. Shanghai Sports University consistently ranks first among Chinese institutions that specialize in sports in the list of the best Chinese institutions. Therefore, this study decided to survey Shanghai University students. Valid data were collected from 1278 students from 6 universities in Shanghai using a questionnaire survey method. The ordinary least square (OLS) regression analysis technique was utilized in the study. The study has shown that (1) boys have stronger social abilities than girls; (2) the exercise attitude and exercise persistence of junior students are better than those of freshmen and sophomores; (3) social abilities, emotion regulation strategies, exercise needs satisfaction, exercise attitude, and EA were significantly positively associated with each other. Emotion regulation strategies and exercise attitude had a negative predictive effect on PEA, and exercise needs satisfaction and social abilities had a significant predictive effect on exercise adherence. (4) Exercise needs satisfaction and exercise attitude were used as mediating variables to regulate the influence of college students' social abilities on EA.

Chemotherapy-related symptoms and exercise adherence in older patients with myeloid neoplasms.

PURPOSE: Exercise may ameliorate treatment-related symptoms, but older adults have lower exercise adherence compared to their younger counterparts due to treatment-related symptoms. METHODS: We recruited older patients with myeloid neoplasms receiving chemotherapy to a pilot study of a mobile health exercise intervention. Participants entered their steps and resistance data into the app daily, and symptom data twice a week, over an 8-12 week period. In this proof-of-concept analysis, we used a linear mixed-effects model to assess the association of symptoms from the previous week with exercise adherence in the current week among older adults with myeloid neoplasms. RESULTS: Mean age was 74.3 (SD = 5.0) years (N = 7). At baseline, patients on average walked 2564 daily steps (SD = 1816), which increased to 2967 (SD = 3448) post-intervention. Patients on average performed 3.5 (SD = 2.6) days of resistance training weekly, with mean duration of 21.5 min (SD = 11.6) and rated perceived exertion of 3.68 (SD = 1.78) on a 0-10 scale. Lower average steps in the current week was associated with greater interference with daily activities from pain (ß = - 203.13, p = 0.05), memory (ß = - 492.29, p = 0.09), numbness (ß = - 353.57, p = 0.07), and sadness (ß = - 403.03, p = 0.09) in the previous week. Similarly, lower average resistance minutes in the current week were associated with greater pain, sadness, and anxiety in the previous week. CONCLUSIONS: We found that greater pain, sadness, and anxiety were associated with lower exercise adherence. Symptom monitoring and management in older adults with myeloid neoplasms receiving chemotherapy can promote exercise adherence and in turn improve symptoms. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04035499. Registered 7/29/2019.