Online resources as a source of information for exercise and physical activity in solid organ transplant recipients.

Introduction: Exercise training post-transplant has been shown to improve physical function and quality of life in solid organ transplant (SOT) recipients. Online resources in the form of websites and videos are commonly used to provide education and instruction on exercise and physical activity in SOT; however, the content and quality of these online resources has not been evaluated. Methods: The first 200 websites and videos identified on Google and YouTube using the English search term "exercise and physical activity in solid organ transplantation" were analyzed. Website and video content was evaluated based on 25 key components of exercise and physical activity in SOT as described in established exercise program recommendations. Website and video quality was determined using DISCERN, Global Quality Scale (GQS), and Patient Education Materials and Assessment Tool (PEMAT; threshold for which material is deemed understandable or actionable is >70%). Parametric and non-parametric tests were used to assess website and video characteristics, content, and quality metrics. Results: Forty-nine unique SOT websites (n = 15) and videos (n = 34) were identified, with the two most common categories being foundation/advocacy organizations and scientific resources. The average reading grade level of websites was 13 ± 3. Website and video content scores varied significantly (websites 11.3 ± 6.4; videos 8.4 ± 5.3). DISCERN total score and GQS score were low (median range for DISCERN 2.5-3.0; median for GQS 2.0 for both websites and videos, out of 5). PEMAT understandability and actionability scores were also low across websites and videos (mean range 57%-67% and 47%-65%, respectively). Foundation/advocacy websites had higher content and quality scores compared to scientific organizations and news/media articles. Conclusions: To our knowledge, this is the first comprehensive assessment of online content and quality of website and video resources on physical activity and exercise in adult SOT recipients. There were a limited number of online English patient-directed resources related to physical activity in SOT, most of which only partly captured items outlined in consensus exercise program recommendations and were of low quality and understandability and actionability. This work provides important insight to the English-speaking transplant community on the current state of online exercise health information and provides future direction for resource development.

Psychometric properties of life-space mobility measures in community-dwelling older adults: a systematic review protocol.

INTRODUCTION: Mobility is one of the most important contributors to healthy aging and is traditionally measured through performance-based tests. Measuring life-space mobility is a holistic way to measure the spaces individuals visited over a period of time versus what they are physically able to do. However, before a measure of life-space mobility can be widely used in research and clinical settings, it must have robust psychometric properties. The objective of this review is to summarize the psychometric properties of existing life-space mobility measures in community-dwelling older adults. INCLUSION CRITERIA: The construct is life-space mobility and the instruments are: The Nursing Home Life Space Diameter, the Life-Space Questionnaire, and the Life-Space Assessment. The population is community-dwelling older adults (age > 65). The outcome of the review includes all psychometric properties (reliability, validity, responsiveness) as well as feasibility and interpretability data. METHODS: Following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and JBI guidelines, a search strategy will be piloted and then translated to multiple databases. Two independent reviewers will conduct title/abstract screening, full-text screening, data extraction, and assess the methodological quality of the studies. A narrative synthesis will be compiled for all collected data. A meta-analysis will be conducted for each psychometric property if there are enough studies with sufficiently low heterogeneity. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019121855.

Intervention-related factors associated with physical activity maintenance among post-stroke patients: a protocol for a systematic review with meta-analysis and meta-regression.

OBJECTIVE: The aim of this review is to i) evaluate the effectiveness of current rehabilitation interventions in promoting short-, moderate-, and long-term physical activity maintenance among patients post-stroke, and ii) to investigate the intervention characteristics associated with the promotion of physical activity maintenance among patients post-stroke. INTRODUCTION: Physical activity and exercise can positively impact post-stroke recovery. However, few patients participate in the recommended levels of physical activity after a stroke. To design better post-stroke programs, the characteristics of current interventions that promote physical activity maintenance need to be identified. INCLUSION CRITERIA: Randomized controlled trials including adults (age ≥ 18) post-stroke, assessing physical activity via subjective or objective measures with a minimum three-month follow-up, and published in English will be considered for inclusion. METHODS: Literature searches will be conducted using MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials. The quality of the randomized controlled trials will be assessed using Cochrane's risk of bias tool. Interventions will be coded using the Behaviour Change Technique Taxonomy version 1. Standardized mean differences of physical activity levels between intervention and control groups will be calculated using study-specific measures and interpreted as small (<0.40), medium (0.40-0.70), or large (>0.70). Meta-analysis of effect sizes will be conducted for short- (three months), moderate- (six months), and long-term (≥12 months) follow-ups. Univariable and multivariable random effects meta-regression using intervention characteristics (setting, delivery method, delivery type, duration, outcome measure, and behavior change techniques) will be conducted to identify predictors of maintenance. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019131056.