Experiences participating in a telehealth exercise program among older adults with cancer: a qualitative study.

PURPOSE: Telehealth delivery of exercise programs has rapidly increased in recent years; yet, little is known regarding older cancer survivors' (OCS) experiences participating in telehealth exercise. The purpose of this study was to determine OCS barriers and facilitators to participation in telehealth-delivered exercise. METHODS: OCS who participated in a 12-week, one-on-one telehealth exercise program were recruited to participate in one of three focus groups. Focus groups were conducted virtually using a semi-structured interview guide. Focus groups were audio recorded, transcribed verbatim, and analyzed utilizing thematic analysis with Atlas.ti. RESULTS: Fourteen OCS (age range 65-79 years) participated in the focus groups, five (35.7%) of which had not completed a telehealth follow-up assessment. The most common cancer type was breast (n = 6, 42.9%), and all cancer stages were represented. Three overall themes were identified: having adequate space to exercise, meeting OCS physical and psychosocial needs, and OCS learning throughout the exercise program. Within these themes, five facilitators and two barriers were identified. Facilitators included the individualization of the exercise program, no travel, accountability, learning to exercise, and support from staff and family. The barriers identified were having limited space to exercise and a learning curve with technology. CONCLUSION: OCS viewed telehealth exercise positively. Identified barriers aligned with those in younger cancer survivors (≥18 years), indicating that OCS are able to engage with telehealth exercise programs alongside their younger counterparts. IMPLICATIONS FOR CANCER SURVIVORS: Telehealth exercise mitigates exercise barriers in OCS and should be used as a strategy to support exercise participation among cancer survivors, regardless of age.

Enjoyment Mediates Associations of the Physical and Family Environment With Adolescent Physical Activity: A Structural Equation Modeling Approach.

PURPOSE: The purpose of this study was to examine the direct effects and mediating effect of physical activity (PA) enjoyment on the associations of the physical environment and family environment with adolescent PA behavior. METHODS: Participants were US high school students who participated in the National Youth Physical Activity and Nutrition Study (N = 11,429; 49.4% female). The dependent variable was a latent variable from 3 survey items indicating adolescent PA behavior. One set of independent variables were items of the physical environment and a second set of independent variables were items of the family environment. A latent PA enjoyment mediating variable was constructed within a weighted structural equation model to examine the standardized direct and indirect effects (IEs) of the physical and family environment variables with adolescent PA controlling for demographic covariates. RESULTS: Significant PA enjoyment mediating effects on adolescent PA were observed for the physical environment variables (IE range = 0.015-0.040) and adult transportation (IE = 0.013, 95% confidence interval [CI]: 0.006-0.020). The strongest direct effects were the associations between the family environment variables of adult PA encouragement (ß = 0.11, 95% CI: 0.08-0.14), transportation (ß = 0.14, 95% CI: 0.10-0.17), and watching (ß = 0.12, 95% CI: 0.09-0.15) with adolescent PA. DISCUSSION: Stronger PA enjoyment mediating effects on adolescent PA were observed for variables of the physical environment compared to the family environment but the strongest direct effects on adolescent PA were observed for family environment variables. Interventions that provide equipment, improve neighborhood safety, and educate parents on how to support PA may both indirectly and directly improve adolescent PA.

Understanding the dimensions of sport-injury related growth: A DELPHI method approach.

Despite the multitude of adverse physical and psychosocial consequences of sports injury, evidence also highlights the potential for positive benefits in the injury aftermath. The purpose of this study is to address this gap by exploring the dimensions of personal growth following a severe sports injury. A 3-rounds e-Delphi method was utilized to develop a consensual understanding of the dimensions of sport-injury related growth. A panel of 24 psychology of sport injury experts participated in the process. The final list of items obtained was subjected to conventional content analysis to identify general themes. The process led to the development of a 5-dimension model capable of describing athletes' experiences of personal growth following a severe sports-related injury: personal strength, improved social life, health benefits, sport benefits, and social support and recognition. The domains of sport-injury related growth identified here are consistent with growth-domains identified in previous personal growth literature. However, they also highlight the importance of contextualizing the experience of growth. We have captured key elements of sport-injury related growth, domains that can be used as the basis for further psychometric testing and for further interventions to increase adjustment and well-being during the rehabilitation process.

School-based physical activity interventions and physical activity enjoyment: A meta-analysis.

The purpose of this meta-analysis was to examine the effectiveness of school-based physical activity interventions on increasing students' physical activity enjoyment. An internet search with several databases using the keywords "Adolescents", "Children", "Enjoyment", "Physical Activity", and "Schools" was performed yielding over 200 published studies. Studies were eliminated based on the lack of experimental manipulation (i.e., non-intervention studies), no assessment of physical activity enjoyment as an outcome variable, a lack of a control or comparison group, and no reporting of the effect estimate's variability (i.e., standard deviation, standard error, etc.). This procedure resulted in 10 studies being examined in the meta-analysis. Data were analyzed in the state of Utah, USA in 2017. The Hartung-Knapp-Sidak-Jonkman method for a random effects meta-analysis was employed with studies being weighted by inverse variance. The pooled Standardized Mean Difference=0.38 (95% C.I. [0.10-0.65], p=0.011). Cochran's Q test showed statistical significance (p<0.001) and the I2=76.6%, suggesting large heterogeneity across the 10 studies. Egger's regression model yielded an intercept coefficient that was statistically significant (bias=3.28, 95% C.I. [0.21-6.36], p=0.039), indicating the presence of small-study effects. This meta-analysis provides evidence that school-based physical activity interventions can be effective in increasing physical activity enjoyment in children and adolescents. However, the magnitude of the pooled effect was small-to-moderate and there was evidence for publication bias and large between-study heterogeneity.

A systematic review of the biomarker S100B: implications for sport-related concussion management.

OBJECTIVE: Elevated levels of the astroglial protein S100B have been shown to predict sport-related concussion. However, S100B levels within an athlete can vary depending on the type of physical activity (PA) engaged in and the methodologic approach used to measure them. Thus, appropriate reference values in the diagnosis of concussed athletes remain undefined. The purpose of our systematic literature review was to provide an overview of the current literature examining S100B measurement in the context of PA. The overall goal is to improve the use of the biomarker S100B in the context of sport-related concussion management. DATA SOURCES: PubMed, SciVerse Scopus, SPORTDiscus, CINAHL, and Cochrane. STUDY SELECTION: We selected articles that contained (1) research studies focusing exclusively on humans in which (2) either PA was used as an intervention or the test participants or athletes were involved in PA and (3) S100B was measured as a dependent variable. DATA EXTRACTION: We identified 24 articles. Study variations included the mode of PA used as an intervention, sample types, sample-processing procedures, and analytic techniques. DATA SYNTHESIS: Given the nonuniformity of the analytical methods used and the data samples collected, as well as differences in the types of PA investigated, we were not able to determine a single consistent reference value of S100B in the context of PA. Thus, a clear distinction between a concussed athlete and a healthy athlete based solely on the existing S100B cutoff value of 0.1 µg/L remains unclear. However, because of its high sensitivity and excellent negative predictive value, S100B measurement seems to have the potential to be a diagnostic adjunct for concussion in sports settings. We recommend that the interpretation of S100B values be based on congruent study designs to ensure measurement reliability and validity.

The impact of increased blood lactate on serum S100B and prolactin concentrations in male adult athletes.

S100B is an astroglial protein that is increased in the peripheral bloodstream after traumatic brain injury (TBI). Elevated serum levels of S100B have been shown to be predictive of mild TBI. Furthermore, physical activity (PA) can affect S100B levels. Interestingly, increased serum S100B concentrations have been detected in athletes without apparent TBI. Such increases could be attributed to tissue hypoperfusion reflected by blood lactate concentrations [BLa(-)] and/or increased serotonergic activity reflected by prolactin (PRL). The impact of increased blood lactates on peripheral S100B levels per se are yet unknown. The purpose of our study was to investigate if increased blood lactate induced by sodium lactate infusion, without the "side effects" of PA, resulted in changes in serum S100B and PRL. Twelve male adults were given a sodium lactate infusion for a period of 24 min by a perfusor with an infusion rate of 0.01 mL kg(-1) min(-1), increased every 3 min. The main outcome measures showed no increase in serum S100B (p > 0.05). Prolactin increased significantly (p < 0.05) after [BLa(-)] exceeded a concentration of 4 mmol L(-1). Furthermore, the expected values of blood lactate achieved peak values ranging from 11 to 15 mmol L(-1). We conclude that neither increased blood lactate nor serum PRL play an exclusive role in the regulation of S100B. Nevertheless, PA should be surveyed in medical history and critically assessed in determining the severity of TBI, especially in sports. Further studies are needed to clarify the impact of PA on the biomarker S100B.