Promoting participatory research in chronicity: The ESPRIMO biopsychosocial intervention for young adults with multiple sclerosis.

Background: Co-creation allows to develop tailored interventions in chronicity and to increase patients' engagement. Considering the interacting nature of physical, psychological, and social domains in multiple sclerosis (MS), a biopsychosocial approach to care is crucial. Aims: This paper aims to present (i) an example of a co-creation process in the context of chronic diseases (ii) preferences and perspectives of young adults with multiple sclerosis (YawMS; aged 18-45) and healthcare professionals (HCPs) on the relevance, objectives, and modalities of a biopsychosocial intervention (named ESPRIMO) and on strategies/barriers to participation. Methods: A participatory mixed-method approach in three consecutive steps was implemented: online surveys with YawMS (n = 121) and HCPs (n = 43), online focus groups (FGs) with YawMS, consultation with an advisory board (AB) composed by YawMS, HCPs and researchers. For the survey, descriptive statistics and inductive content analysis have been used for quantitative and qualitative analysis, respectively. FGs and AB were used to deepen the understanding of the survey's results. Results: An integrated intervention is extremely relevant according to the perspectives of the main stakeholders. Helping disease acceptance, providing stress management strategies, and supporting emotional expression emerged as the most relevant psychological objectives according to participants. Having tangible benefits, being tailored, and fostering interpersonal relationships emerged as the main preferred characteristics of physical activity. Preferences emerged on the modalities and timing of the intervention, with a venue unrelated to the disease strongly supported. Both HCPs and YawMS highlighted as the most valuable advantages of conducting the intervention online the increased accessibility, while the main limit was the restriction to social interaction (recognized as already limited during the COVID-19 pandemic). Accessibility and lack of time resulted as the main barriers to participation. Conclusion: The co-creation process gave valuable information on preferences and perspectives of main stakeholders on objectives, modalities, and strategies to improve participation which has been used in the design of the ESPRIMO biopsychosocial intervention. Those results might inform future intervention development in the field of chronicity. The current paper outlined a co-creation methodology which might be replicated in future research on other conditions of vulnerability.

Physical Activities at Distance: Feasibility and Acceptability of Online Remote Exercise Intervention in Older Adults

Introduction. During the COVID-19 pandemic, comprehensive social distancing policies, such as prohibiting agglomerations, travel restrictions, and staying-at-home recommendations, were adopted by several countries. Due to these lockdown measures, older adults decreased daily physical activity levels, consequently increasing sedentary behavior. This pilot feasibility study aimed to explore the feasibility of implementation (i.e., adherence, safety) and acceptability (i.e., satisfaction, intent to continue use, perceived appropriateness) of an online face-to-face supervised exercise intervention in a sample of older adults.Material and Methods. Seven older adults (mean age: 68 ± 5 years;38% females) completed the study. The exercise program was composed of two 45-min sessions per week for five consecutive weeks. Participants followed a remote exercise program in Zoom©. After each training session, both participants and the fitness trainer completed a questionnaire designed to investigate the acceptability and feasibility of the exercise program.Results. Six out of seven participants (i.e., 86%) attended 100% of the workouts. No experience of fall/injury occurred during the training. All the participants agreed or strongly agreed to have the competence to perform the proposed exercise (range 100-42.9%), and this perception increased at the end of the intervention.Conclusions. Our results suggest that an online physical exercise program using web technology seems to be feasible and acceptable to independent older adults. The program does not require specific equipment, shows a high adherence level, and seems safe. Moreover, both the participants and the fitness trainer reported a high level of satisfaction with the activity.

Adapted physical activity in subjects and athletes recovering from covid-19: a position statement of the Società Italiana Scienze Motorie e Sportive.

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic illness that is impacting the cardiovascular, pulmonary, musculoskeletal, and cognitive function of a large spectrum of the worldwide population. The available pharmacological countermeasures of these long-term effects of COVID-19 are minimal, while myriads of non-specific non-pharmacological treatments are emerging in the literature. In this complicated scenario, particular emphasis should be dedicated to specific exercise interventions tailored for subjects and athletes recovering from COVID-19. Specific guidelines on adapted physical activity in this critical population are unavailable so far, therefore, in this position statement of the Società Italiana di Scienze Motorie e Sportive (SISMeS) the members of the steering committee of the research group Attività Motoria Adattata, Alimentazione, Salute e Fitness have indicated the adapted physical activity approaches to counteract the long-term effects of the COVID-19, both in good health people and athletes.

Exercising at the time of the COVID-19 pandemic: acute physiological, perceptual and performance responses of wearing face masks during sports activity.

BACKGROUND: The COVID-19 pandemic requires the adoption of strict preventive measures, such as wearing a protective face mask, but few studies investigated its impact during exercise. We investigated the effects of wearing a protective face mask while exercising at different intensities and verified whether differences between two types of protective face masks exist. METHODS: Twenty subjects performed 4-min running at 8 km•h-1 and at 10 km•h-1, 8 x 90-m Intermittent running bouts and the Yo-Yo Intermittent Recovery Test Level-1, while wearing either a surgical mask, a sports-reusable mask or no mask. Physiological responses (HR, [La], SpO2), overall and breathlessness perceived exertion and YYIRT1-distance were assessed. RESULTS: Breathlessness RPE was greater with surgical than without mask at the end of the run at 8 km•h-1 (+7.18 [3.21, 11.50]) and with both surgical and sports-reusable mask than without mask at the end of the run at 10 km•h-1 (+8.09 [4.09, 12.60] and +8.21 [4.53, 12.70]) and intermittent exercise (+11.10 [6.41, 16.10] and +10.50 [6.18, 15.30]). Overall RPE was greater with surgical than without mask at the end of the run at 8 (+3.71 [1.15, 6.91]) and 10 km•h-1 (+5.29 [2.26, 8.85]). Furthermore, YYIRT1 performance was lower with surgical (-150 m [44, 240]) and sports-reusable mask (-201 m [108, 286]) than without mask. CONCLUSIONS: Regardless of exercise intensity and mask type, wearing a protective face mask mostly affects perceptual responses, also causing a performance reduction during maximal exercise. These findings must be considered when prescribing/practicing exercise while wearing a protective face mask.

Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italy.

Importance: The management of mother-infant dyads during the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic constitutes a major issue for neonatologists. In mothers with SARS-CoV-2 infection, current recommendations suggest either to separate the dyad or encourage protected rooming-in under appropriate precautions. No data are available regarding the risk of mother-to-infant transmission of SARS-CoV-2 during rooming-in. Objective: To evaluate the risk of postnatal transmission of SARS-CoV-2 from infected mothers to their neonates following rooming-in and breastfeeding. Design, Setting, and Participants: A prospective, multicenter study enrolling mother-infant dyads from March 19 to May 2, 2020, followed up for 20 days of life (range, 18-22 days), was performed. The study was conducted at 6 coronavirus disease 2019 maternity centers in Lombardy, Northern Italy. Participants included 62 neonates born to 61 mothers with SARS-CoV-2 infection who were eligible for rooming-in practice based on the clinical condition of the mother and infants whose results of nasopharyngeal swabs were negative at birth. Exposures: Mothers with SARS-CoV-2 infection were encouraged to practice rooming-in and breastfeeding under a standardized protocol to minimize the risk of viral transmission. Main Outcomes and Measures: Clinical characteristics and real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 on neonatal nasopharyngeal swabs at 0, 7, and 20 days of life. Results: Of the 62 neonates enrolled (25 boys), born to 61 mothers (median age, 32 years; interquartile range, 28-36 years), only 1 infant (1.6%; 95% CI, 0%-8.7%) was diagnosed as having SARS-CoV-2 infection at postbirth checks. In that case, rooming-in was interrupted on day 5 of life because of severe worsening of the mother's clinical condition. The neonate became positive for the virus on day 7 of life and developed transient mild dyspnea. Ninety-five percent of the neonates enrolled were breastfed. Conclusions and Relevance: The findings of this cohort study provide evidence-based information on the management of mother-infant dyads in case of SARS-CoV-2 maternal infection suggesting that rooming-in and breastfeeding can be practiced in women who are able to care for their infants.

Safety procedures for exercise testing in the scenario of COVID-19: a position statement of the Società Italiana Scienze Motorie e Sportive.

Recent data on coronavirus disease 2019 (COVID-19) pandemic showed that the virus is mostly conveyed by respiratory droplets that are produced at high intensity especially when an infected subject coughs or sneezes. Therefore, elevated volume ventilations, usually reached during physical efforts and exercise, are a potential source of contamination. On the other hand, the lockdown period which has lasted for nearly 2 months and is actually involving several countries worldwide, obliged a large part of human population to sedentary behaviors, drastically reducing their physical activity level, and reducing their cardiopulmonary fitness. Therefore, cardiopulmonary exercise testing could be beneficial, so that a safe and well-weighted return to pre-lockdown active lifestyle can be efficiently planned. However, specific guidelines on exercise testing safety procedures in the era of COVID-19 are unavailable so far. This article is aimed to provide an overview of safety procedures for exercise testing during and after COVID-19 worldwide pandemic.

SARS-CoV-2 infection and neonates: a review of evidence and unresolved questions.

SARS-CoV-2 infection in the neonatal period poses previously unmet challenges to obstetricians and neonatologists, but several key questions are yet to be answered. Few cases of presumed in utero vertical transmission of the virus from infected mothers to fetuses have been reported, but stronger evidence is needed, from larger datasets with multiple biospecimens rigorously analyzed. Whether acquired before or after birth, SARS-CoV-2 infection in neonates can be symptomatic, but our comprehension of neonatal immune response and the subsequent clinical characteristics of COVID-19 in early life are incomplete. Finally, the pandemic challenged several dogmas regarding the management of mother-infant dyads, and again more robust data are needed to support the formulation of evidence-based guidelines. Here, we briefly summarize existing evidence and key unresolved questions about SARS-CoV-2 infection and COVID-19 in the neonatal period.