Testing Leash Walking Training as a Physical Activity Intervention for Older Adult Dog Owners: A Feasibility Study.

Dog walking is a physical activity (PA) with many health benefits for older adults. Dog behavior issues can be a barrier to dog walking. This study piloted leash manners training as a PA intervention for dog owners ages 60+ years. Fourteen dog owners (mean age = 65 years, female = 71%) enrolled in a leash manners training course. Process evaluation data were collected to determine feasibility and acceptability of the intervention and study procedures. Twelve of fourteen enrolled participants (86%) completed the course, and most were highly engaged with the program, as evidenced by high class attendance (92% of participants who completed the course attended ≥5 of 6 classes) and a majority (64%) reporting frequent skills practice at home. Further, most participants (73%) reported their leash walking skills improved. The PA assessment protocol (7 days of 24 h data collection using activPAL monitors) was well tolerated, with all participants who completed assessments at each time point (pre-program, post-program, 4-week follow-up) providing ≥6 valid days of data. In sum, the intervention approach and study procedures were feasible and acceptable in this sample of older adults. More research is needed to determine the effectiveness of leash manners training for increasing PA in this population.

Conceptualization of Participation: A Qualitative Synthesis of Brain Injury Stakeholder Perspectives.

Background: The return to participation in meaningful life roles for persons with acquired brain injury (pwABI) is a goal shared by pwABI, their families, clinicians, and researchers. Synthesizing how pwABI define participation will help to identify the aspects of participation important to pwABI and can inform a person-centered approach to participation outcome assessment. To-date, the qualitative synthesis approach has been used to explore facilitators and barriers of participation post-stroke, and views about participation among individuals with stroke in the UK. Objectives: This paper's objectives are to (1) conduct a scoping review of qualitative literature that defines and characterizes participation from the perspective of pwABI of any type, (2) synthesize how pwABI define and categorize participation, and (3) link the themes identified in the qualitative synthesis to the International Classification of Functioning, Disability, and Health (ICF) using standardized linking rules to enhance the comparability of our findings to other types of health information, including standardized outcome measures. Methods: We completed a scoping review of qualitative literature. Our search included PubMed, APA PsychInfo, CINAHL, and Embase databases and included articles that (1) had qualitative methodology, (2) had a sample ≥50% pwABI, (3) had aims or research questions related to the meaning, definition, perception, or broader experience of participation, and (4) were in English. Qualitative findings were synthesized using Thomas and Harden's methodology and resultant themes were linked to ICF codes. Results: The search identified 2,670 articles with 2,580 articles excluded during initial screening. The remaining 90 article abstracts were screened, and 6 articles met the full inclusion criteria for the qualitative synthesis. Four analytical themes emerged: (1) Essential Elements of Participation (2) How pwABI Approach Participation, (3) Where pwABI Participate, and (4) Outcomes of Participation. Each overarching theme included multiple descriptive themes. Conclusion: In this paper, we identified themes that illustrate key components of participation to pwABI. Our results provide insight into the complex perspectives about participation among pwABI and illustrate aspects of participation that should hold elevated importance for clinicians and researchers supporting participation of pwABI.

A meta-synthesis of individual, interpersonal, and systemic factors impacting resilience after traumatic brain injury.

PURPOSE/OBJECTIVE: Traumatic brain injuries (TBIs) are increasingly common and a major cause of death and long-term disability. Many individuals experience chronic stressors and adverse health outcomes, emphasizing the importance of cultivating resilience, (defined herein as individual, social, and systemic components engaged in response to the stressors that allow individuals to "bounce back," or move forward adaptively after TBI). Patients' perceptions of factors influencing resilience are critical to guide interventions that meet their needs. Here we offer the first metasynthesis of factors influencing resilience after TBI using a Social Ecological model framework. Research Methods/Design: We preregistered our metasynthesis on PROSPERO (CRD42021233975) and followed PRISMA guidelines. We searched 4 electronic databases for qualitative studies from inception up until June 2021. We included qualitative studies detailing perspectives of individuals with a history of moderate-severe TBI. We excluded case studies and systematic reviews. After removal of duplicates, we identified 124 articles for screening. We reviewed 49 articles for full text eligibility and included 38 studies. We extracted study characteristics and data (e.g., author interpretations and relevant quotes) relating to factors influencing resilience. RESULTS: We synthesized findings using a Social Ecological model framework to guide thematic analysis. Persons with TBI identified barriers and facilitators to resilience at individual (e.g., physical and cognitive challenges, coping behaviors), interpersonal, (e.g., stigma and isolation) and systemic (e.g., access to resources, rehabilitation support) levels. CONCLUSIONS/IMPLICATIONS: Considering multifaceted factors at individual, interpersonal and systemic levels in clinical, research, and policy-setting contexts is important for cultivating resilience and optimizing recovery after TBI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Non-ambulatory measures of lower extremity sensorimotor function are associated with walking function in Multiple Sclerosis.

BACKGROUND: Disease progression of multiple sclerosis (MS) is often monitored by ambulatory measures, but how non-ambulatory sensorimotor measures differentially associate to walking measures in MS subtypes is unknown. We determined whether there are characteristic differences between relapsing-remitting MS (RRMS), progressive MS (PMS), and non-MS controls in lower extremity sensorimotor function and clinical walking tasks and the sensorimotor associations with walking function in each group. METHODS: 18 RRMS, 13 PMS and 28 non-MS control participants were evaluated in their plantar cutaneous sensitivity (vibration perception threshold, Volts), proprioception during ankle joint position-matching (|∆°| in dorsiflexion), motor coordination (rapid foot-tap count/10 s), and walking function with three tests: Timed 25-foot walk (T25FW) at preferred and fast speeds (s), and timed-up-and-go (TUG, s). RESULTS: Foot-tapping (p = 0.039, Mean difference (MD)= 5.65 taps) and plantar cutaneous sensation (p = 0.026, MD= -10.30 V) differed between the MS subtypes. For the RRMS group faster walking was related to better proprioceptive function (preferred T25FW: p = 0.019, Root mean square error (RMSE)=1.94; fast T25FW: p = 0.004, RMSE=1.65; TUG: p = 0.001, RMSE=2.12) and foot-tap performance (preferred T25FW: p = 0.033, RMSE = 2.74; fast T25FW: p = 0.010, RMSE=2.02). These associations were not observed in the PMS group. CONCLUSIONS: Foot-tap performance and plantar cutaneous sensitivity but not ankle proprioception differed between MS subtypes. Lower walking performance was associated with lower foot-tapping and plantar cutaneous sensitivity in the RRMS but not the PMS group. This result suggests a change in the relationship of lower extremity sensorimotor function to walking performance in the PMS subtype.

Sensorimotor function in progressive multiple sclerosis.

BACKGROUND: A sensitive test reflecting subtle sensorimotor changes throughout disease progression independent of mobility impairment is currently lacking in progressive multiple sclerosis. OBJECTIVES: We examined non-ambulatory measures of upper and lower extremity sensorimotor function that may reveal differences between relapsing-remitting and progressive forms of multiple sclerosis. METHODS: Cutaneous sensitivity, proprioception, central motor function and mobility were assessed in 32 relapsing-remitting and 31 progressive multiple sclerosis patients and 30 non-multiple sclerosis controls. RESULTS: Cutaneous sensation differed between relapsing-remitting and progressive multiple sclerosis at the foot and to a lesser extent the hand. Proprioception function in the upper but not the lower extremity differed between relapsing-remitting and progressive multiple sclerosis, but was different for both upper and lower extremities between multiple sclerosis patients and non-multiple sclerosis controls. Foot-tap but not hand-tap speed was slower in progressive compared to relapsing-remitting multiple sclerosis, suggestive of greater central motor function impairment in the lower extremity in progressive multiple sclerosis. In addition, the non-ambulatory sensorimotor measures were more sensitive in detecting differences between relapsing-remitting and progressive multiple sclerosis than mobility assessed with the 25-foot walk test. CONCLUSION: This study provides novel information about changes in sensorimotor function in progressive compared with relapsing-remitting forms of multiple sclerosis, and in particular the importance of assessing both upper and lower extremity function. Importantly, our findings showed loss of proprioceptive function in multiple sclerosis but also in progressive compared to relapsing-remitting multiple sclerosis.

Rapid foot-tapping but not hand-tapping ability is different between relapsing-remitting and progressive multiple sclerosis.

BACKGROUND: Rapid tapping tests have been shown to be reliable measures of upper motor neuron disease, and effectively examine motor function differences between multiple sclerosis (MS) and non-MS controls (CON), and between relapsing-remitting and progressive MS subtypes. To successfully perform rapid repetitive movements such as tapping, a person must be able to consistently turn on and off motor units to switch between the up and down movement phases. However, it is not clear which specific movement phase that occurs during tapping is different between MS subtypes. The objective of this study was to quantify and characterize performance differences during rapid hand- and foot-tapping tests between relapsing-remitting (RRMS) and progressive (PMS) forms of MS, as well as how both subtypes differ from non-MS controls. METHODS: Participants in this study included 30 non-MS controls, 32 RRMS, and 31 PMS. Participants wore inertial sensors on all hands and feet and were instructed to tap as fast as possible for 10 s. Angular velocity from the gyroscope was used to quantify inter-tap interval (ms), coefficient of variation of inter-tap interval (COV), and up- and down-movement characteristics (duration (ms), COV, peak angular velocity (rad/s)). Differences between groups were examined with ANOVA and independent t-tests. Inter-tap interval was examined for its ability to distinguish between RRMS and PMS by a binary logistic regression analysis. Up-down movement characteristics were further evaluated for within-group directional differences (up- vs. down-phase movement components) with paired-sample t-tests. RESULTS: Inter-tap interval for both hand- and foot-tapping differed between controls and MS, but only foot tapping was different between RRMS and PMS (RRMS = 286.7 ± 83.0 ms; PMS = 379.5 ± 170.9 ms; mean difference (d) = -92.8 ms). Logistic regression analysis showed foot-tap interval but not hand-tap interval has the potential to distinguish between RRMS and PMS (Area under the ROC = 0.71). Both up- and down-movement duration differences were consistent with the results for inter-tap interval, but up-movement duration showed larger mean group differences than down-movement differences. No significant group differences in overall inter-tap interval COV were detected for either hand- or foot-tapping; however, up-movement foot-tapping variation (CON = 18.7 ± 6.1; RRMS = 25.5 ± 11.2; PMS = 23.3 ± 8.6; CON vs RRMS d = -6.8; CON vs PMS d = -4.7), but not down-movement variation was different between controls and MS. Up- and down-peak angular velocity during foot-tapping were different between controls and PMS (CON Up = 1.4 ± 0.5 rad/s; PMS Up = 1.0 ± 0.4 rad/s; Up d = 0.4 rad/s; CON Down= 1.5 ± 0.6 rad/s; PMS Down = 1.2 ± 0.5 rad/s; Down d = 0.3 rad/s), and up-movement peak angular velocity differences showed larger mean group differences than the down-movement peak angular velocity between controls and PMS. CONCLUSION: Foot-tapping differs between MS disease subtypes and has greater potential than hand-tapping to distinguish between subtypes. Performance in the up-movement showed larger group differences than the down-movement, suggesting that the anti-gravity up-movement during tapping may be more important diagnostically. Future studies should be conducted on the nature of the physiological mechanisms underlying impairments in anti-gravity movements in people with MS.

Examining How Dog 'Acquisition' Affects Physical Activity and Psychosocial Well-Being: Findings from the BuddyStudy Pilot Trial.

Dog owners are more physically active than non-dog owners, but evidence of a causal relationship between dog acquisition and increased physical activity is lacking. Such evidence could inform programs and policies that encourage responsible dog ownership. Randomized controlled trials are the 'gold standard' for determining causation, but they are prohibited in this area due to ethical concerns. In the BuddyStudy, we tested the feasibility of using dog fostering as a proxy for dog acquisition, which would allow ethical random assignment. In this single-arm trial, 11 participants fostered a rescue dog for six weeks. Physical activity and psychosocial data were collected at baseline, 6, and 12 weeks. At 6 weeks, mean change in steps/day was 1192.1 ± 2457.8. Mean changes on the Center for Epidemiologic Studies Depression Scale and the Perceived Stress Scale were -4.9 ± 8.7 and -0.8 ± 5.5, respectively. More than half of participants (55%) reported meeting someone new in their neighborhood because of their foster dog. Eight participants (73%) adopted their foster dog after the 6-week foster period; some maintained improvements in physical activity and well-being at 12 weeks. Given the demonstrated feasibility and preliminary findings of the BuddyStudy, a randomized trial of immediate versus delayed dog fostering is warranted.