Implementation of Physical Activity into routine Clinical pracTice in Rheumatic Musculoskeletal Disease: The IMPACT-RMD study protocol and rationale

Metsios, George S.; Fenton, Sally A. M.; Moe, Helene Rikke; Esch, M. van der; Zanten, Jet Veldhuijzen; Koutedakis, Yiannis; Vitalis, Panagiotis; Kennedy, Norelee; Brodin, Nina; Tzika, Aikaterini; Boström, Carina; Swinnen, Thijs Willem; Jester, Rebecca; Schneider, Karin Niedermann; Nikiphorou, Elena; Fragoulis, G.; Vlieland, T. P. M. Vliet; Ende, Cornelia van den; Kitas, George D.

doi:10.31138/mjr.30.4.231

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…To date, several studies have demonstrated that regular exercise in SSc patients can improve their disease symptoms, exercise capacity, physical function in daily life, and psychosocial status [ 31 , 32 ]. Thus, exercise is highly recommended [ 33 , 34 ]. In particular, aerobic and resistance exercise training programs were found to reduce cardiac risk factors and improve patients’ HRQL [ 25 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Morphology and Function after Exercise Training in People with Systemic Sclerosis: A Randomized Controlled Pilot Study

Anifanti

Teloudi

Mitropoulos

et al. 2023

Life

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Background: Vascular dysfunction and its concomitant multi-organ involvement, including cardiac involvement, affects prognosis in systemic sclerosis (SSc) patients. Regular exercise has demonstrated to be able to improve vascular function in SSc. However, the effects of an exercise program on the heart and specifically in right ventricular (RV) morphology and function in SSc have yet to be explored. The study aimed to examine whether a 3-month combined exercise program can affect RV morphology and function in SSc patients. Methods: Twenty-eight SSc patients were randomly allocated to either the exercise training (ET) or the control (CON) group. Baseline and follow-up assessments consisted of a cardiopulmonary exercise test along with both a conventional and a two-dimensional speckle tracking echocardiography (2DSTE) focused on RV morphology and function. Following the baseline assessments, Group ET participated in a supervised combined exercise program for 12 weeks, while group CON received their usual care. Results: The ET group demonstrated increases in peak oxygen consumption by 25.1% (p < 0.001), global RV free wall longitudinal systolic strain by 6.69% (p < 0.03), RV free wall longitudinal systolic strain of the basal segment by 13.5% (p < 0.001), and global RV four-chamber longitudinal systolic strain by 6.76% (p < 0.03) following the exercise program. No differences were observed in group CON. Conclusions: Combined exercise improved cardiorespiratory efficiency and indices of RV systolic function, as assessed by the 2DSTE, in SSc patients.

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Section: Discussionmentioning

confidence: 99%

Right Ventricular Morphology and Function after Exercise Training in People with Systemic Sclerosis: A Randomized Controlled Pilot Study

Anifanti

Teloudi

Mitropoulos

et al. 2023

Life

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“…(2) PTs need to be educated to tailor and instruct an exercise program and apply behaviour change techniques. Some first effort is made to downscale the lack of evidence-based education and training for health professionals working with rheumatic conditions [ 45 ]. Others [ 9 , 44 , 46 ] emphasise that interventions are needed for patients with axSpA including behaviour change techniques, that aim to deliver intrinsic motivation to overcome barriers to exercise [ 47 – 49 ] and to sustain an active lifestyle.…”

Section: Discussionmentioning

confidence: 99%

Lessons learned from a pilot implementation of physical activity recommendations in axial spondyloarthritis exercise group therapy

et al. 2022

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Background The Ankylosing Spondylitis Association of Switzerland (SVMB) aimed to implement physical activity recommendations (PAR) within their exercise groups (EGs). The PAR promote exercise in all fitness dimensions at the correct dose. To implement the PAR within EGs, they were translated into a new EG concept with five key activities: (a) training for supervising physiotherapists (PTs), (b) correctly dosed exercises in all fitness dimensions, (c) exercise counselling, (d) bi-annual fitness assessments, and (e) individual exercise training, in addition to EG. All these activities were realized in close coordination with SVMB management. Objectives To analyse the implementation success by evaluating adherence/fidelity, feasibility, and satisfaction at the patient, PTs, and organisational level. Methods The five key activities of the new EG concept were developed, executed, and assessed after 6 months. The primary outcomes for implementation success were adherence of patients to the recommended exercise behaviour, self-reported by electronic diary; fidelity of PTs to the new concept, self-reported by diary; SVMB organisational changes. Secondary outcomes were feasibility and satisfaction with the new EG concept at all three levels. The tertiary outcome, to evaluate the effectiveness of PAR, was patient fitness, assessed through fitness assessments. Results 30 patients with axSpA (ten women, mean age 58 ± 9 years) and four PTs (three women, mean age 46 ± 9 years) participated. The patients' self-reporting of adherence to the PAR was insufficient (43%), possibly due to technical problems with the electronic dairy. The PTs' fidelity to the new EG concept was satisfactory. On all levels, the new concept was generally perceived as feasible and useful for supporting personalised exercise.The frequency of exercise counselling and the fitness assessments was found by patients and PTs to be too high and rigid. Patients' cardiorespiratory fitness [ES 1.21 (95%CI 0.59, 1.89)] and core strength [ES 0.61 (95%CI 0.18, 1.06)] improved over the 6 months. Conclusions The pilot implementation of PAR showed acceptance and satisfaction to be sufficient, thus confirming the need for evidence-based EGs, provided by a patient organisation in order to support active PA behaviour. However, adaptations are necessary to increase its feasibility for nationwide implementation. Trial Registration: SNCTP, SNCTP000002880. Registered 31 May 2018, https://www.kofam.ch/en/snctp-portal/search/0/study/42491.

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“…Studies addressing phases 1–4 of the Behavioural Epidemiology Framework in the development of sedentary behaviour change interventions in inflammatory arthritis should consistently offer recommendations for translating research findings into practice [ 81 ]. For example, the use of comparative-effectiveness designs in research studies across phases 1–4, such as observational research, randomized controlled trials and systematic reviews, can inform health-care decisions by identifying the most effective intervention for an individual’s needs, abilities and motivations [ 82 ] (i.e.…”

Section: Phase 5: Translate Research Into Practicementioning

confidence: 99%

“…Engaging and working with key stakeholders within health-care systems and multidisciplinary teams is also vital to the dissemination, implementation, adoption and maintenance of sedentary behaviour change interventions in inflammatory arthritis [ 81 , 83 ]. Improving implementation intelligence in these areas can be achieved by organizing qualitative research and advisory groups, which can stimulate new research and thus feedback to earlier phases of the Behavioural Epidemiology Framework.…”

Section: Phase 5: Translate Research Into Practicementioning

confidence: 99%

The behavioural epidemiology of sedentary behaviour in inflammatory arthritis: where are we, and where do we need to go?

Fenton

O’Brien

Kitas

et al. 2022

Rheumatology Advances in Practice

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In the last decade, studies into sedentary behaviour in inflammatory arthritis have raised important questions regarding its role in this condition. Specifically, evidence is needed on whether sedentary behaviour might exacerbate adverse inflammatory arthritis outcomes, and whether reducing sedentary behaviour might offer an effective avenue for self-management in this population. Research exploring these important research questions is still very much in its infancy and lacks the direction and scientific rigour required to inform effective intervention design, delivery and evaluation. Behavioural epidemiology refers to research that aims explicitly to understand and influence health behaviour patterns to prevent disease and improve health. To this end, the Behavioural Epidemiology Framework specifies a focused approach to health behaviour research, which leads to the development of evidence-based interventions directed at specific populations. In this review, we introduce the Behavioural Epidemiology Framework in the context of research into sedentary behaviour in inflammatory arthritis and ask: where are we, and where do we need to go?

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Implementation of Physical Activity into routine Clinical pracTice in Rheumatic Musculoskeletal Disease: The IMPACT-RMD study protocol and rationale

Cited by 10 publications

References 24 publications

Right Ventricular Morphology and Function after Exercise Training in People with Systemic Sclerosis: A Randomized Controlled Pilot Study

Right Ventricular Morphology and Function after Exercise Training in People with Systemic Sclerosis: A Randomized Controlled Pilot Study

Lessons learned from a pilot implementation of physical activity recommendations in axial spondyloarthritis exercise group therapy

The behavioural epidemiology of sedentary behaviour in inflammatory arthritis: where are we, and where do we need to go?

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