A Qualitative Study of the Perspectives of Healthcare Professionals on Features of Digital Health Interventions to Support Physical Activity in Solid Organ Transplant Recipients.

Introduction: Digital health interventions may support physical activity among solid organ transplant recipients. These interventions should be designed with users in mind, including healthcare professionals who counsel transplant recipients on physical activity to ensure acceptance and to promote an optimal user experience. The purpose of this study was to explore the perspectives of health care providers on the features of digital health interventions that would be useful in the promotion, implementation, and maintenance of physical activity among solid organ transplant recipients. Methods: This qualitative, cross-sectional study used semistructured interviews that were conducted remotely, via videoconferencing software, with providers who worked with transplant recipients. Interviews were transcribed, and an iterative-inductive, thematic analysis was used to identify common themes. Data were coded using NVivo software. Findings: Thirteen providers participated in this study. Four main themes were identified: (a) physical activity and exercise features (eg, physical activity guidelines, and exercise instructions); (b) credibility; (c) self-management; and (d) user engagement. Potential barriers to using digital health interventions included staffing requirements, professional regulatory issues, cost, perceived low patient motivation to use, and lack of technological literacy or access. Discussion: Digital health interventions were perceived to be a potential adjunct to current physical activity counseling practices, and part of an innovative strategy to address identified barriers to physical activity participation in solid organ transplant recipients.

Changes in cognitive control and mood across repeated exercise sessions.

Acute exercise elicits benefits to cognition and mood. The consistency and accumulation of benefits across exercise sessions remains unclear. This exploratory study evaluated the reproducibility and accumulation of changes in cognitive control and mood across multiple exercise sessions. Thirty young healthy adults (18-35 years) were recruited to exercise (N = 14; age: 21.71 [SD = 1.64]; 57% female) or control (N = 16; age: 22.25 [SD = 3.68]; 56% female) groups. Participants attended six sessions over 2 weeks (EX = 20-min mod-intensity cycling; CO = 20-min reading). Cognitive control was assessed using a Flanker task (accuracy-adjusted response time, RTLISAS ) pre-/post-intervention. Mood was reported 5×/day on exercise and non-exercise days (pre, post, 11:30 am, 3 pm, and 8 pm) using the Bond-Lader VAS. Cognitive control and mood improved acutely (within session) following exercise compared with control (F(1, 592) = 6.11, p = .0137; F(1, 305.93) = 38.68, p < .0001; F(1, 307.06) = 13.69, p = .0003) and were consistent across sessions. Cognitive control also improved across sessions in both groups (F(5, 282.22) = 11.06, p < .0001). These results suggest that: (1) acute effects of exercise on cognition and mood are consistent across multiple sessions; (2) the Flanker task learning effects continue over many trials/sessions; and (3) accumulated mood effects require further investigation. Future studies should further explore the connection between acute exercise exposures and accumulated cognitive benefits.

Comparing the reliability of a trigonometric technique to goniometry and inclinometry in measuring ankle dorsiflexion.

OBJECTIVES: The purpose of this study was to compare the reliability of three previously used techniques for the measurement of ankle dorsiflexion ROM, open-chained goniometry, closed-chained goniometry, and inclinometry, to a novel trigonometric technique. METHODS: Twenty-one physiotherapy students used four techniques (open-chained goniometry, closed-chained goniometry, inclinometry, and trigonometry) to assess dorsiflexion range of motion in 24 healthy volunteers. All student raters underwent training to establish competence in the four techniques. Raters then measured dorsiflexion with a randomly assigned measuring technique four times over two sessions, one week apart. Data were analyzed using a technique by session analysis of variance, technique measurement variability being the primary index of reliability. Comparisons were also made between the measurements derived from the four techniques and those obtained from a computerized video analysis system. RESULTS: Analysis of the rater measurement variability around the technique means revealed significant differences between techniques with the least variation being found in the trigonometric technique. Significant differences were also found between the technique means but no differences between sessions were evident. The trigonometric technique produced mean ROMs closest in value to those derived from computer analysis. CONCLUSIONS: Application of the trigonometric technique resulted in the least variability in measurement across raters and consequently should be considered for use when changes in dorsiflexion ROM need to be reliably assessed.