The influence of dog ownership on objective measures of free-living physical activity and sedentary behaviour in community-dwelling older adults: a longitudinal case-controlled study.

BACKGROUND: There is some evidence to suggest that dog ownership may improve physical activity (PA) among older adults, but to date, studies examining this, have either depended on self-report or incomplete datasets due to the type of activity monitor used to record physical activity. Additionally, the effect of dog ownership on sedentary behaviour (SB) has not been explored. The aim of the current study was to address these issues by using activPAL monitors to evaluate the influence of dog ownership on health enhancing PA and SB in a longitudinal study of independently-mobile, community-dwelling older adults. METHODS: Study participants (43 pairs of dog owners and non-dog owners, matched on a range of demographic variables) wore an activPAL monitor continuously for three, one-week data collection periods over the course of a year. Participants also reported information about their own and their dog demographics, caring responsibilities, and completed a diary of wake times. Diary data was used to isolate waking times, and outcome measures of time spent walking, time spent walking at a moderate cadence (>100 steps/min), time spent standing, time spent sitting, number of sitting events (continuous periods of sitting), and the number of and of time spent sitting in prolonged events (>30 min). For each measure, a linear mixed effects model with dog ownership as a fixed effect, and a random effects structure of measurement point nested in participant nested in pair was used to assess the effect of dog ownership. RESULTS: Owning a dog indicated a large, potentially health improving, average effect of 22 min additional time spent walking, 95%CI (12, 34), and 2760 additional steps per day, 95%CI (1667, 3991), with this additional walking undertaken at a moderate intensity cadence. Dog owners had significantly fewer sitting events. However, there were no significant differences between the groups for either the total time spent sitting, or the number or duration of prolonged sedentary events. CONCLUSIONS: The scale of the influence of dog ownership on PA found in this study, indicates that future research regarding PA in older adults should assess and report dog ownership and/or dog walking status.

Cocreators' experiences and effectiveness of cocreated interventions in improving health behaviours of adults with non-communicable diseases: a systematic review protocol.

INTRODUCTION: Improved health behaviours and help-seeking behaviour reduce morbidity and mortality from non-communicable diseases (NCDs). Compliance with the recommendations of lifestyle changes for the management of NCDs has been challenging, as patients find it difficult to change and sustain lifestyle behaviours for a long period of time. Studies have reported that cocreated interventions are promising in addressing negative health behaviours and improving health outcomes in people with NCDs; however, no conclusive evidence exists. Therefore, this review aims to evaluate cocreators' experiences and the effectiveness of cocreated interventions in improving the health behaviours of individuals with NCDs. METHODS AND ANALYSIS: This review will follow the recommendations described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement for the synthesis of qualitative data. The following databases: Co-creation Database (https://zenodo.org/record/6773028%23.Y9h2sezP1pg), MEDLINE (via OVID), Cumulative Index to Nursing and Allied Health Literature (via EBSCO Host), EMBASE (via OVID), PsycINFO (via OVID), Scopus, Web of Science, Cochrane Library and grey literature will be searched. The identified studies will be independently screened by two reviewers to determine their eligibility. The review will target to include studies that investigated the experiences of cocreators and/or the effectiveness of cocreated interventions on the health behaviour and/or health outcomes of adults with NCDs. Two independent reviewers will also appraise the quality of the included studies, as well as data extraction. A narrative synthesis will be used to summarise the findings. Thematic synthesis and meta-analysis will be conducted for the qualitative and quantitative data, respectively. The qualitative and quantitative findings will be integrated using the parallel result convergent synthesis. ETHICS AND DISSEMINATION: Ethics approval is not applicable because the review will only use data from the published studies. The findings will be disseminated through publication in peer-reviewed journals and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42023391746.

The effects of spinal manipulative therapy on lower limb neurodynamic test outcomes in adults: a systematic review.

Objective: Spinal Manipulative Therapy (SMT) is a routinely applied treatment modality for various musculoskeletal conditions, including low back pain. The precise mechanisms by which SMT elicits its effects are largely unknown, but recent research supports a multi-system explanation recognizing both biomechanical and neurophysiological mechanisms. Although the evaluation of changes in clinical presentation is complex, objective neurophysiological measures of sensitivity to movement (e.g. neurodynamic tests) can be a valuable clinical indicator in evaluating the effects of SMT. This review aimed to synthesize current literature investigating the effects of SMT on lower limb neurodynamics.Method: Eight electronic databases were systematically searched for randomized controlled trials (RCT) that applied SMT (against any control) and evaluated lower limb neurodynamics (Passive Straight Leg Raise or Slump Test). Selection and data extraction were conducted by one researcher, reviewed by a second author. Risk of bias (RoB) was assessed using the Cochrane Back Review Group criteria.Results: Eight RCTs were included, one with high RoB. SMT produced a clinically meaningful (≥6°) difference in five of these studies compared with inert control, hamstring stretching, and as an adjunct to conventional physiotherapy, but not compared with standard care, as an adjunct to home exercise and advice, or when comparing different SMT techniques. Findings compared to sham were mixed. When reported, effects tentatively lasted up to 6 weeks post-intervention.Conclusion: Limited evidence suggests SMT-improved range of motion and was more effective than some other interventions. Future research, using standardized Neurodynamic tests, should explore technique types and evaluate longer-term effects.Level of Evidence: 1a.

Living a burdensome and demanding life: A qualitative systematic review of the patients experiences of peripheral arterial disease.

BACKGROUND: Peripheral arterial disease (PAD) has a significant negative impact on the quality of life of individuals. Understanding the experiences of people living with PAD will be useful in developing comprehensive patient-centred secondary prevention therapies for this population. AIM: The aim of this study is to identify first-hand accounts of patients' experiences of living with PAD. METHODS: Six databases (CINALH, PsyclNFO, MEDLINE, AMED, EMBASE, Social citation index/Science citation index via Web of Science (WOS)) and reference lists of identified studies were searched until September 2017 (updated February 2018). Qualitative studies reporting patients' account of living with PAD were eligible for inclusion. A framework thematic synthesis was implemented. RESULTS: Fourteen studies with 360 participants were included. Pain and walking limitation were recurrent among the varied symptom descriptions. Patients' ignorance and trivialisation of symptoms contributed to delays in diagnosis. Inadequate engagement in disease understanding and treatment decisions meant patients had poor attitudes towards walking treatments and unrealistic expectations about surgery. Depending on symptom progression, patients battle with walking impairment, powerlessness, and loss of independence which were a source of burden to them. Lack of disease understanding is central through patients' journey with PAD and, although they subsequently began adaptation to long term living with PAD, many worried about their future. CONCLUSIONS: Disease understanding is vital across the illness trajectory in patients with PAD. Although certain experiences are common throughout patient journey, some might be unique to a particular stage (e.g. unrealistic expectation about surgery, or rationale of walking in spite of pain in a supervised exercise program). Given that PAD is an overarching construct ranging from the mildest form of intermittent claudication to severe critical limb ischemia with ulceration and gangrene, consideration of important patient constructs specific to each stage of the disease may enhance treatment success. Systematic review registration CRD42017070417.

Patient education interventions to improve physical activity in patients with intermittent claudication: a protocol for a systematic mixed-studies review.

INTRODUCTION: Peripheral arterial disease (PAD) and intermittent claudication (IC) decrease an individual's capacity to engage in physical activity (PA) with potentially negative effects on PA behaviour. Strategies to improve PA among this population may provide a range of positive health benefits. We present a protocol to assess the components of patient education interventions that improve PA capacity and PA behaviour in patients with PAD and IC. METHODS AND ANALYSIS: Published peer-reviewed studies will be searched in the following databases: CINAHL, the Cochrane Library, OVID, ProQuest, AMED, MEDLINE, PsycINFO, Web of Science Core Collection and PEDro, to identify literature investigating the effect of patient education on PA of patients with PAD and IC, or studies that investigated patients' perceptions or experience with these interventions. Two authors will independently perform screening for study eligibility, result synthesis and then appraise study quality. For interventions without follow-up, primary outcome measures will include change in PA capacity, or change in free-living PA behaviour; where there was a follow-up postintervention, the primary outcome will be rate of adherence to PA behaviour improvement. A three-phase sequential explanatory synthesis of mixed studies will be employed to answer the research questions. Homogenous quantitative data will be analysed using a random-effects model of meta-analysis with results presented as relative risk for dichotomous outcomes and as weighted or standardised means for continuous outcomes. Qualitative data will be analysed using thematic synthesis. This review protocol is reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines. TRIAL REGISTRATION NUMBER: CRD42015027314.

Step accumulation per minute epoch is not the same as cadence for free-living adults.

PURPOSE: The term cadence has been used interchangeably to describe both the rate of stepping and the number of steps in a minute epoch. This is only strictly true if walking is continuous within that epoch. This study directly compared these two outcomes in minute epochs of data from free-living adults to assess the scale of any difference between them. METHODS: A convenience sample of healthy adults wore an activPAL activity monitor for 7 d. The event record output of the activPAL, providing the start time and duration of each stride to the nearest 0.1 s, was used to calculate step accumulation (number of steps), duration of walking, and cadence (number of steps/duration of walking) for each minute of measurement. RESULTS: Data from 117 individuals (78 females; mean age, 46 ± 16 yr; mean body mass index, 24.9 ± 3.7 kg·m-2) were analyzed. Twenty-one percent of minutes (n = 310d-1) contained walking. The distribution (most minutes fewer than 40 steps per minute) and mean (34 ± 9 steps per minute) of step accumulation were very different from that of cadence (most minutes between 60 and 100 steps per minute; mean, 76 ± 6 steps per minute). Only 12% of minutes with stepping were walked continuously, whereas 69% of minutes with stepping contained less than 30 s of walking. This is key to the difference between step accumulation and cadence, and means that cadence cannot be reconstructed from step accumulation without also knowing the duration that was walked. CONCLUSION: Step accumulation, the number of steps in a fixed period, and cadence, the rate of stepping while walking, are not interchangeable outcome measures. It is vitally important that unambiguous terminology is used to describe the rate of stepping so that the outcomes of studies can be correctly interpreted.

Daily and hourly frequency of the sit to stand movement in older adults: a comparison of day hospital, rehabilitation ward and community living groups.

BACKGROUND AND AIMS: The sit to stand (STS) movement is commonly performed in daily life, and can be used as an indicator of activity. This study aimed to quantify the usual frequency and distribution of the STS movement performed by older adults in both home and rehabilitation settings. METHODS: Three groups of older adults were recruited; healthy older adults living in the community, older adults living in the community attending rehabilitation services at a day hospital, and frail older patients in a rehabilitation ward. Participants wore an activity monitor, which reported posture continuously for a week. The number of STS movements was the primary outcome measure, and mean values of daily STS frequency were reported. The pattern of activity was investigated using median values of STS hourly rate. RESULTS: Healthy older adults living in the community performed significantly more STS movements per day (n=20; 71±25) than either older adults attending a day hospital (n=20; 57±23) or frail older patients in a rehabilitation ward (n=30; 36±16). For all participants, the hourly rate of STS movements ranged from zero to 48, although the median hourly rate was two (healthy older adults) and one (both rehabilitation groups). CONCLUSION: Measurement of the number of STS movements performed over the course of a week in three groups of older adults, demonstrated significant differences in daily number of STS movements and in the hourly pattern between the groups. Activity patterns can provide additional information on clinically relevant aspects of physical activity and function to daily averages.