Analysis of Madrid Primary Health-Care staff for the implementation of exercise prescription.

OBJECTIVE: To assess the self-perception of nurses and general practitioners (GPs) toward Physical Activity on Prescription (PAP) in Madrid Primary Health-Care (PHC). DESIGN: A survey-cohort study. SITE: Nurses and GPs of Madrid PHC System. PARTICIPANTS: A total of 319 GPs and 285 nurses' responders. MEASUREMENTS: Data were analyzed under a classification tree analysis by four predictor variables: (i) Health professional (Nurses/GPs); (ii) Exercise prescription collaboration with all health professionals: physicians, nurses, psychologists, physical therapists, sports medicine physicians, sports scientists, nutritionists, and teachers (Yes/No); (iii) PA promotion collaboration with Sports Scientists (Yes/No); and (iv) The stage of change of PHC staff to PA promotion (0-4 Likert scale). RESULTS: Regarding the predictor variable (i), responders without PA guidelines knowledge and positive attitude to collaborate with nurses in PA promotion are more GPs of female sex (nurses n=33 and GPs n=175) than male sex (nurses n=3 and GPs n=59) (p<.001). For the predictor variable (ii) only 9.30% of PHC staff with a positive attitude to collaborate with all health professionals in PA promotion and exercise prescription. For the predictor variable (iii) was shown low collaboration with sports physicians and sports scientists under a multidisciplinary PAP approach (26.50% responders). Finally, in the predictor variable (iv) Staff maintaining PAP for at least 6 months, self-considered active, and with PAP knowledge want to collaborate with Sports scientists (Yes=233; No=133). CONCLUSIONS: Nurses and GPs are conscious of health-related PA benefits despite the lack of PAP knowledge and lack of willingness to collaborate with other health personnel, exercise professionals, and community resources available.

Global Alliance for the Promotion of Physical Activity: the Hamburg Declaration.

Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the 'Hamburg Declaration'. This represented an international commitment to take all necessary actions to increase PA and improve the health of individuals to entire communities. Individuals and organisations are working together as the 'Global Alliance for the Promotion of Physical Activity' to drive long-term individual and population-wide behaviour change by collaborating with all stakeholders in the community: active hospitals, physical activity specialists, community services and healthcare providers, all achieving sustainable health goals for their patients/clients. The 'Hamburg Declaration' calls on national and international policymakers to take concrete action to promote daily PA and exercise at a population level and in healthcare settings.

Physical exercise training in the syllabus of Bachelor of Science in nursing degrees: an environmental scan.

Background: Scientific evidence regarding the effectiveness of physical activity (PA) in the prevention and treatment of chronic diseases is increasing. Healthcare systems are trying to increase exercise prescription treatments. However, it is not clear if health professionals are sufficiently trained. Aim: to analyze the contents related to PA and exercise in the prevention and treatment of chronic diseases in the syllabus of the Bachelor of Science in Nursing at all Spanish universities. Methods: A systematic environmental scan that included a web page search of curricular guide programs of all Spanish universities offering the Bachelor of Science in Nursing was undertaken for the 2017-2018 academic course. The assessment of the European Credit Transfer System (ECTS) about physical activity and/or exercise health-related benefits in the prevention or treatment of chronic diseases was performed by two experts in a peer-review process. ECTS of Practicum and Bachelor thesis were not included in the analysis. Results: In the mean, the Bachelor of Science in Nursing dedicated 5.82% (5.01% mandatory and 0.82% voluntary) of a total of 240 ECTS (ranging from 0 to 45 ECTS). The majority of contents were related to PA promotion; in contrast, contents related to exercise prescription are neglectable. Five Spanish universities do not offer any academic teaching to physical activity on prescription. Conclusions: A great disparity between universities was identified. In general, acquired knowledge seems scarce for PA promotion and exercise prescription in primary healthcare staff. Nurses would need additional physical activity on prescription training to improve PA promotion and exercise prescription knowledge as a coadjutant non-pharmacological treatment for non-communicable chronic diseases in Primary Healthcare settings.

Adherence Factors Related to Exercise Prescriptions in Healthcare Settings: A Review of the Scientific Literature.

Purpose: Physical activity on prescription (PAP) is being introduced in healthcare systems around the world. To apply a successful treatment is as important as to know if the patient is able to follow-up. In order to contribute to the development of effective PAP strategies, we have analyzed PAP-related adherence factors with a multi-dimensional approach. Methods PAP adherence factors in studies published in the WoS, Pubmed, and PsycInfo were reviewed, according to the WHO five dimensions adherence model. In a setting of prediction or adherence analysis of adults with high-risk factors or chronic diseases, the methods used to measure physical activity (PA), PAP treatments, PAP adherence, and mentioned theories related to human behavior change were analyzed. Results A total of 32 studies fulfilled our inclusion criteria. According to the WHO five dimensions adherence model, these total clustered adherence variables were observed: social/economic (n = 100), healthcare system/healthcare team (n = 18), condition-related (n = 61), therapy-related (n = 20), and patient-related (n = 47). PAP adherence has mainly been measured by adherence to measurement methods and by calculating attended versus total sessions scheduled. PA level was measured mainly by questionnaires and exercise referrals were the most frequent PAP resource in analyzed studies. Transtheoretical model of behavior change was the theory most referenced. Conclusion A lack of considering health system/healthcare-team factors and therapy-related factors has been identified, as most studies only analyze social/economic factors in non-pharmacological PAP adherence studies in healthcare settings. A multidimensional approach should be adopted to analyze PAP adherence in healthcare settings.

Physical activity as a tool to reduce disease-related work absenteeism in sedentary employees: A systematic review

BACKGROUND: Physical Activity (PA) programs have been suggested to lower absenteeism due to illness in sedentary employees. The aim of this review was to examine available scientific literature in order to study PA effects in workplace absenteeism taking the program design into consideration. METHODS: A search through 4 databases (Medline, Sportdiscus, Web of Science and Embase), from inception to December 2017, was conducted to identify control intervention and observational studies about PA and absenteeism published in either English or Spanish language using PRISMA procedures. RESULTS: A total of 10 published studies between 1981 and 2017 met the inclusion criteria. Evidence from the review suggested that PA is effective in reducing illness-related absence. Likelihood of being off from workplace reported with sedentary workers reach more probabilities when compared with exercisers. CONCLUSIONS: General PA is considered paramount in order to lower employees' absenteeism, which could be more related to vigorous training. However, there is a lack of rigorous and more specific studies about the issue. More focused on PA effect on absenteeism, adjusted by intervention variables, research would be desirable.

OBJETIVO: Se ha sugerido que los programas de actividad física (AF) podrían reducir el absentismo laboral por motivos de enfermedad en trabajadores sedentarios. Esta revisión tuvo como objetivo examinar la evidencia científica disponible para estudiar los efectos de la AF sobre el absentismo laboral teniendo en consideración el diseño del programa de AF. METODOS: Se realizó una búsqueda bibliográfica en 4 bases de datos (Medline, Sportdiscus, Web of Science y Embase) de ensayos clínicos y estudios observacionales publicados sobre AF y absentismo laboral, en inglés y en español, desde el inicio de indización hasta diciembre de 2017, utilizando la metodología PRISMA. RESULTADOS: Un total de 10 estudios publicados cumplieron con los criterios de elegibilidad establecidos. Las evidencias encontradas en la revisión sugieren que la AF es efectiva como medida para reducir el absentismo laboral por motivos de enfermedad. En general, los estudios señalaron que se observan mayores probabilidades de ausentarse del trabajo en trabajadores sedentarios que en los físicamente activos. CONCLUSIONES: La AF en general parece disminuir el absentismo laboral. En concreto, la AF vigorosa podría obtener mejores resultados que la realizada a intensidad moderada, aunque faltan estudios de intervención más rigurosos y específicos, con un mayor control sobre las variables de intervención.

[Physical activity as prevention and treatment resource of chronic diseases in the syllabus of Medicine and Sport Sciences at Spanish universities]. / La actividad física en el currículo universitario español de los grados de Medicina y Ciencias de la Actividad Física y del Deporte como recurso en la prevención y tratamiento de las enfermedades crónicas.

INTRODUCTION: Currently, there is scientific evidence about the benefits of physical exercise over human health. The aim of this study was to review the curricula of Medicine and Sport Sciences at Spanish universities, specifically regarding the contents related to physical exercise in the promotion, prevention and treatment of non-communicable chronic diseases (NCDs). MATERIAL AND METHODS: In a systematic way, all syllabus, programs and contents of the different subjects were reviewed for all Spanish universities which offer the Bachelors of Medicine and Sport Sciences. Total, compulsory and optional European Credit Transfer System (ECTS) were analyzed and added for each university. Practicum and Bachelor thesis were not considered. RESULTS: In the mean, Medicine studies dedicate 3.62% (2.38% mandatory and 1.20% optional) of the total 360 ECTS to these contents. In Sport Sciences studies, of the total 240 ECTS, 17.78% (9.87% mandatory and 7.92% optional) were identified as related to these areas of knowledge. Contents ranged from 36 to 4.5 ECTS in Medicine and from 48 to 28 ECTS in Sport Sciences. CONCLUSION: There is a great disparity between universities for both degrees among Spanish universities. Contents related to the efficient use of physical exercise for the prevention and treatment of non-communicable chronic diseases are scarce, especially in Medicine. Results indicate the need of increasing these contents in undergraduate studies and/or include them in Master or other programs.

INTRODUCCIÓN: la evidencia científica ha acreditado los beneficios que posee la actividad física sobre la salud. El objetivo de esta revisión fue analizar la formación curricular de los estudiantes de Medicina y de Ciencias de la Actividad Física y del Deporte (CAFYD) en las universidades españolas, en relación a la prevención y el tratamiento de enfermedades crónicas a través de la actividad y el ejercicio físico. MATERIAL Y MÉTODOS: de manera sistemática, se han revisado los planes de estudio de todas las universidades españolas que tienen capacidad legal para impartir de forma presencial los grados de Medicina y CAFYD, contabilizando el promedio de créditos ECTS (European Credit Transfer System) totales, obligatorios y optativos de las asignaturas que abordan la promoción, la prevención y el tratamiento de las enfermedades crónicas a través del ejercicio físico, excluyendo practicum y trabajos fin de grado (TGF). RESULTADOS: el grado de Medicina dedica un promedio del 3,62% (2,38% y 1,20% créditos obligatorios y optativos, respectivamente) (360 ECTS) y el grado de CAFYD un 17,78% (9,87% y 7,92%) (240 ECTS) a contenidos relacionados con la actividad física como herramienta en la prevención y tratamiento de las enfermedades crónicas no trasmisibles. El rango va de 36 a 4,5 ECTS en Medicina y de 48 a 28 ECTS en CAFYD. CONCLUSIÓN: se observa cierta disparidad entre los planes de estudio de las universidades españolas para los dos grados. Los créditos ECTS relacionados con actividad física y salud resultan escasos en el currículo de ambos grados, especialmente en Medicina. Los resultados indican la necesidad de aumentar estos contenidos en los estudios de grado y/o incluirlos en programas de postgrado.

[Sarcopenic obesity in elderly women: influence of I/D polymorphism of the angiotension converter enzyme]. / Obesidad sarcopénica en mujeres mayores: influencia del polimorfismo I/D de la enzima convertidora de angiotensina.

INTRODUCTION: Sarcopenic obesity (SO) is a term that refers to an increase of fat mass together with a decrease of muscle mass, which is suffered by a high percentage of elderly population. Physical activity seems to be a good strategy to prevent it getting worse. However, genetic factors related to the aging process and to elderly's physical fitness could have an influence on it. AIM: To determine if elderly women > 60 who practice physical activity regularly had differences in sarcopenic obesity according to the I/D polymorphism from the ACE (angiotensin converter enzyme) gen. METHODS: Cross-sectional study of 300 elderly women who have practiced physical exercise at least twice a week for the past two years. Anthropometric data, physical activity and sedentary behaviour questionnaire, sarcopenic obesity (determining the percentage of fat mass and total muscle mass by electrical impedance and grouping the quintiles of these values into four groups) and physical fitness assessment, as well as ACE gen genotype measured by oral mucosa sample, were evaluated. RESULTS: There were significant differences (p < 0.05) in sarcopenic obesity according to ACE I/D genotype (SO values: 2.18 ACE DD vs 2.48 ACE II + ACE ID). CONCLUSIONS: Women who were ACE DD presented lower risk of sarcopenic obesity than those in the ACE II and ACE ID groups.

Effect of whole-body vibration therapy on health-related physical fitness in children and adolescents with disabilities: a systematic review.

PURPOSE: To summarize the current literature regarding the effects of whole-body vibration (WBV) therapy on the health-related physical fitness of children and adolescents with disabilities. METHODS: A literature search using MEDLINE-PubMed, SPORT DISCUS, and EMBASE databases was conducted up to August 2013. A total of 22 articles were included in this review (eight randomized controlled trials, four non-randomized controlled trials, three case reports, and seven reviews). RESULTS: Most of the studies showed positive effects of WBV on health-related physical fitness in children and adolescents with disabilities. Overall, 10-20 minutes at least three times per week, for a minimum of 26 weeks, with high frequency (between 15 and 35 Hz) and low amplitude (no more than 4 mm of peak-to-peak displacement) might be an appropriate protocol to achieve improvement in body composition and muscular strength. CONCLUSIONS: Because no serious adverse events have been observed, WBV might be defined as a safe treatment to be applied in children and adolescents with disabling conditions. Further research is recommended to explore the minimum dose of exposure to WBV required to elicit an optimal response in children and adolescents for improving health-related physical fitness. These may be translated into a more specific WBV protocol.