Promotion of physical activity by health professionals in a sample of six public hospitals: A cross sectional study.

ISSUE ADDRESSED: Despite strong evidence of physical and mental health benefits from physical activity, participation is low. Physical activity promotion by health professionals can effectively increase physical activity participation. This study aimed to explore the frequency of physical activity promotion by health professionals in public hospitals with a focus on community-based structured exercise; and facilitators and barriers to such promotion. METHODS: We surveyed health professionals (n = 100) from physiotherapy, rheumatology and rehabilitation departments at six public hospitals in Sydney, Australia. RESULTS: Most common respondent characteristics were physiotherapist (84%), female (68%), aged 25-34 years (45%) and treating older adults (45%). Almost all health professionals (94%) considered themselves physical activity role-models. Half (53%) reported promoting physical activity frequently/often to their clients. Those working with children with a physical disability (23%) were more likely to promote physical activity (Relative Risk 1.69, 95% CI 1.13-2.51, p = .03), than those working with adults or older adults. Half the physiotherapists (52%) reported providing tailored advice about increasing physical activity frequently/often, but only 20% provided advice about structured physical activity. Barriers reported by physiotherapists were lack of time (51%) and client's access to transport (61%). CONCLUSION: Only half the health professionals surveyed offered tailored physical activity advice to clients, and advice on structured physical activity was less common. SO WHAT?: Some promotion of physical activity by health professionals is occurring in hospital settings but more work is needed to embed this within clinical care.

Study protocol for Running for health (Run4Health CP): a multicentre, assessor-blinded randomised controlled trial of 12 weeks of two times weekly Frame Running training versus usual care to improve cardiovascular health risk factors in children and youth with cerebral palsy.

INTRODUCTION: Children and youth with moderate-severe (Gross Motor Function Classification System (GMFCS) levels II-V) cerebral palsy (CP) participate less frequently in physical activities compared with peers without CP and have elevated risk of cardiorespiratory morbidity and mortality in adulthood. Frame Running (RaceRunning) is a new athletics discipline that is an accessible option for physical activity participation for people with moderate-severe CP. There is no high-quality evidence for the effect of Frame Running on cardiovascular disease in children and young people with CP. The primary aim of this study is to conduct a randomised controlled trial of the effect of 12 weeks of Frame Running training on risk factors for cardiovascular disease. METHODS AND NALYSIS: Sixty-two children and youth with CP (age 8-20 years) in GMFCS levels II-V will be recruited across four sites and randomised to receive either 12 weeks of Frame Running training two times weekly for 60 min, or usual care. Outcomes will be measured at baseline, immediately postintervention (primary endpoint) and 12 weeks later for retention of training effects. The primary outcome is cardiorespiratory fitness as measured by distance covered on Six Minute RaceRunner Test with 1 min heart rate recovery. Other outcomes include blood pressure, objectively measured physical activity, body mass index, waist circumference, percentage body fat, gross motor function capacity, community participation, feasibility, tolerability and safety. Adverse events will be monitored, and participants and their caregivers will be interviewed to discern their experiences of participation in Frame Running. ETHICS AND DISSEMINATION: The Children's Health Queensland Hospital and Health Service and the University of Queensland Human Research Ethics Committees have approved this study. Results will be disseminated in peer-reviewed journals and scientific conferences; through professional and athletic organisations; and to people with CP and their families. TRIAL REGISTRATION NUMBER: ACTRN12621000317897; Australian New Zealand Clinical Trials Registry number.

"People Associate Us with Movement so It's an Awesome Opportunity": Perspectives from Physiotherapists on Promoting Physical Activity, Exercise and Sport.

Insufficient physical activity (PA) is a critical public health issue especially in the context of COVID-related deconditioning. Health professionals are well placed to promote community-based PA but there is little supporting implementation research. We aimed to explore physiotherapists' knowledge, views, attitudes and experiences regarding the promotion of physical activity, exercise and sport within daily clinical practice in order to guide development of strategies to support implementation of PA promotion by physiotherapists, in particular those treating older people, and adults and children with a disability. We conducted interviews and focus groups with 39 physiotherapists. Two researchers coded transcripts with an iterative coding approach. Analysis returned five main themes: putting principles into practice; working with conflicting priorities; multiple client barriers; connections build confidence; and the battle for information. The physiotherapists accepted their legitimate role in PA promotion. Limited clinical and administrative time and acute treatment priorities often superseded PA promotion but the lack of updated information regarding suitable community-based PA opportunities and lack of trust in community providers were the biggest barriers. Strategies to enhance PA promotion by physiotherapists should address time and information constraints, and build partnership connections between health professionals and community-based PA providers.

Confidence amongst Multidisciplinary Professionals in Managing Paediatric Rheumatic Disease in Australia.

OBJECTIVE: Interprofessional collaboration is a crucial component of care for children with rheumatic disease. Interprofessional care, when delivered appropriately, prevents disability and improves long-term prognosis in this vulnerable group. METHODS: The aim of this survey was to explore allied health professionals' and nurses' confidence in treating paediatric rheumatology patients. RESULTS: Overall, 117 participants were recruited, 77.9% of participants reported being "not confident at all," "not confident," or "neutral" in treating children with rheumatic diseases (RD) despite 65.1% of participants reporting having treated >1 paediatric rheumatology case in the past month. Furthermore, 67.2% of participants felt their undergraduate education in paediatric rheumatology was inadequate. "Journals" or "texts books" were used by 49.3% of participants as their primary source of continuing professional development (CPD) and 39.3% of participants indicated that they did not undertake any CPD related to paediatric rheumatology. Small group and online education were perceived to be potentially of "great benefit" for CPD. CONCLUSION: This paper highlights allied health professionals' and nurses' perceived inadequacy of their undergraduate education in paediatric RD and their low confidence in recognising and treating RD. Undergraduate and postgraduate education opportunities focusing on interprofessional collaboration should be developed to address this workforce deficiency.

Fundamental movement skills, physical fitness and physical activity among Australian children with juvenile idiopathic arthritis.

AIM: To describe fundamental movement skills (FMS), physical fitness and level of physical activity among Australian children with juvenile idiopathic arthritis (JIA) and compare this with healthy peers. METHODS: Children aged 6-16 years with JIA were recruited from hospital rheumatology clinics and private rheumatology rooms in Sydney, Australia. All children attended an assessment day, where FMS were assessed by a senior paediatric physiotherapist, physical fitness was assessed using the multistage 20-metre shuttle run test, and physical activity and physical and psychosocial well-being were assessed with questionnaires. These results were compared with age- and gender-matched peers from the NSW Schools Physical Activity and Nutrition Survey and the Health of Young Victorians Study using logistic regression analysis. RESULTS: Twenty-eight children with JIA participated in this study. There were no differences in the proportion of children who had mastered FMS between children with JIA and their healthy peers (P > 0.05). However, there was a trend for children with JIA to have poorer physical fitness and be less physically active than healthy peers. Parents of children with JIA indicated more physical and psychosocial impairments among their children and themselves compared with parents of healthy children (P < 0.05). CONCLUSIONS: This is the first study in Australia to compare FMS, physical activity and fitness in children with JIA and their peers. While older children with JIA appear to have poorer physical fitness and physical activity levels than their peers, there is no difference in FMS.

Acapella vs. PEP mask therapy: a randomised trial in children with cystic fibrosis during respiratory exacerbation.

The Acapella is a positive pressure device designed to assist mucociliary clearance. This study investigated the effectiveness of the Acapella in comparison to PEP mask therapy. Twenty-three participants with cystic fibrosis (CF) with a median age of 12 years (range 7-18 years), who were admitted to hospital for a respiratory exacerbation were randomised to either the PEP mask or Acapella treatment group. Both groups completed two treatment sessions each day (10 sets of 10 breaths in sitting) over a 10-day period. Outcome measures were change in lung function (FEV1, FVC, FEF(25-75), and PEF) and exercise performance (modified 10-metre shuttle). In addition, total sputum production during treatment (wet weight) and patient satisfaction were assessed over the 10-day period. At the end of 10 days there were no statistically significant differences between the groups for any of the outcome measures. Participants were highly satisfied with both devices. The results suggest that there is no statistically significant difference between the Acapella device and the PEP mask for use in CF during an acute exacerbation. Larger studies are required to determine whether differences between PEP mask and Acapella noted in this trial are clinically worthwhile.