Browsing by Person "Coulter, Elaine H."

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Access and use of clinical services and disease modifying therapies by people with progressive Multiple Sclerosis in the United Kingdom
(CMSC, 2017-08-30) Campbell, Evan; Coulter, Elaine H.; Mattison, Paul; McFadyen, Angus; Miller, Linda; Paul, Lorna
Background: According to current UK guidelines everyone with progressive MS should have access to an MS Specialist but levels of access and use of clinical services is unknown. Objective: To investigate access to MS Specialists, use of clinical services and Disease Modifying Therapies (DMT) by people with progressive MS in the United Kingdom. Methods: A UK wide, online survey was conducted via the UK MS Register. Inclusion criteria: age over 18 years, primary or secondary progressive MS and a member of the UK MS Register. Participants were asked about access to MS Specialists; recent clinical service use; receipt of regular review and current and previous DMT use. Participant demographics; quality of life and disease impact measures were supplied from the UK MS Register. Results: In total 1298 participants responded: 5% were currently taking DMT; 23% had previously taken DMT; and 95% reported access to an MS Specialist. Most utilised services were: MS Doctor/Nurse (50%), General Practitioner (45%), and Physiotherapist (40%). Seventy-four percent received a regular review although 37% received theirs less than annually. Current DMT use was associated with better quality of life but past DMT use was associated with poorer quality of life and higher impact of disease. Conclusion: Access to, and use of, MS Specialists was high. However a gap in service provision was highlighted in both receiving and frequency of regular reviews.
Characteristics of a Protocol to Collect Objective Physical Activity/Sedentary Behavior Data in a Large Study: Seniors USP (Understanding Sedentary Patterns)
(Human Kinetics, 2018-04-30) Dall, P. M.; Skelton, D. A.; Dontje, Manon L.; Coulter, Elaine H.; Stewart, Sally; Cox, Simon R.; Shaw, Richard J.; Čukić, Iva; Fitzsimons, C. F.; Greig, Carolyn; Granat, M. H.; Der, Geoff; Deary, Ian J.; Chastin, SFM
The Seniors USP (Understanding Sedentary Patterns) study measured sedentary behavior (activPAL3, 9-day wear) in older adults. The measurement protocol had three key characteristics: enabling 24-hour wear (monitor location, waterproofing), minimizing data loss (reducing monitor failure, staff training, communication), and quality assurance (removal by researcher, confidence about wear). Two monitors were not returned; 91% (n = 700) of returned monitors had seven valid days of data. Sources of data loss included monitor failure (n = 11), exclusion after quality assurance (n = 5), early removal for skin irritation (n = 8), or procedural errors (n = 10). Objective measurement of physical activity and sedentary behavior in large studies requires decisional trade-offs between data quantity (collecting representative data) and utility (derived outcomes that reflect actual behavior).
The effectiveness of interventions targeting physical activity and/or sedentary behaviour in people with Multiple Sclerosis: A systematic review
(Taylor & Francis, 2018-10-05) Coulter, Elaine H.; Bond, Sarah; Dalgas, Ulrik; Paul, Lorna
Background: Remaining physically active is important to maintain functional ability and reduce the incidence of co-morbidities in people with Multiple Sclerosis. The aim of this review was to evaluate the effectiveness of interventions on physical activity or sedentary behaviour in people with Multiple Sclerosis. Methods: A systematic search was conducted in May 2018 of the following databases: Web of Science Core Collections, Embase and Medline. Included studies were randomised controlled trials involving people with Multiple Sclerosis who completed an intervention, compared to any comparator. Outcomes included subjective or objective measures of physical activity or sedentary behaviour. Quality assessment was performed using the Physiotherapy Evidence Database scale. Results: Twenty-five trials were included covering 1697 participants, the majority of which had mild-moderate disability (average Physiotherapy Evidence Database score 6.2±1.5). Experimental interventions included exercise prescription (n=5), behaviour change interventions (n=10), combined exercise and behaviour change techniques (n=7) and education (n=3). Generally, subjective but not objective physical activity improved in those with mild-moderate disability. Insufficient data existed on the effectiveness on sedentary behaviour. Conclusion: A discrepancy seems to exists between the effectiveness of physical activity interventions in people with Multiple Sclerosis depending on whether physical activity was assessed objectively or subjectively, with the latter indicating effects. Effects on sedentary behaviour remain to be elucidated.
High intensity interval training for people with multiple sclerosis: A systematic review.
(Elsevier, 2018-06-13) Campbell, Evan; Coulter, Elaine H.; Paul, Lorna
Aerobic high intensity interval training (HIIT) is safe in the general population and more efficient in improving fitness than continuous moderate intensity training. The body of literature examining HIIT in multiple sclerosis (MS) is expanding but to date a systematic review has not been conducted. The aim of this review was to investigate the efficacy and safety of HIIT in people with MS. A systematic search was carried out in September 2017 in EMBASE, MEDline, PEDro, CENTRAL and Web of Science Core collections using appropriate keywords and MeSH descriptors. Reference lists of relevant articles were also searched. Articles were eligible for inclusion if they were published in English, used HIIT, and included participants with MS. Quality was assessed using the PEDro scale. The following data were extracted using a standardised form: study design and characteristics, outcome measures, significant results, drop-outs, and adverse events. Seven studies (described by 11 articles) were identified: four randomised controlled trials, one randomised cross-over trial and two cohort studies. PEDro scores ranged from 3 to 8. Included participants (n = 249) were predominantly mildly disabled; one study included only people with progressive MS. Six studies used cycle ergometry and one used arm ergometry to deliver HIIT. One study reported six adverse events, four which could be attributed to the intervention. The other six reported that there were no adverse events. Six studies reported improvements in at least one outcome measure, however there were 60 different outcome measures in the seven studies. The most commonly measured domain was fitness, which improved in five of the six studies measuring aspects of fitness. The only trial not to report positive results included people with progressive and a more severe level of disability (Extended Disability Status Scale 6.0-8.0). HIIT appears to be safe and effective in increasing fitness in people with MS and low levels of disability. Further research is required to explore the effectiveness of HIIT in people with progressive MS and in those with higher levels of disability. [Abstract copyright: Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.]
The effectiveness of structured exercise in the south Asian population with type 2 diabetes: a systematic review
(Taylor & Francis, 2017-10-03) Albalawi, Hani; Coulter, Elaine H.; Ghouri, Nazim; Paul, Lorna
Objectives: The impact of exercise interventions on south Asians with type 2 diabetes (T2DM), who have a higher T2DM incidence rate compared to other ethnic groups, is inconclusive. This study aimed to systematically review the effect of exercise interventions in south Asians with T2DM. Method: Five electronic databases were searched up to April 2017 for controlled trials investigating the impact of exercise interventions on south Asian adults with T2DM. The Pedro scale was used to assess the quality of the included studies. Results: Eighteen trials examining the effect of aerobic, resistance, balance or combined exercise programs met the eligibility criteria. All types of exercise were associated with improvements in glycemic control, blood pressure, waist circumference, blood lipids, muscle strength, functional mobility, quality of life or neuropathy progression. The majority of included studies were of poor methodological quality. Few studies compared different types or dose of exercise. Conclusion: This review supports the benefits of exercise for south Asians with T2DM, although it was not possible to identify the most effective exercise prescription. Further studies of good methodological quality are required to determine the most effective dosage and type of exercise to manage T2DM in this population.
Validation of the activPAL3 activity monitor in people moderately affected by Multiple Sclerosis
(Elsevier, 2017-04-10) Coulter, Elaine H.; Miller, Linda; McCorkell, Sara; McGuire, Caroline; Algie, Kimberley; Freeman, Jenny; Weller, Belinda; Mattison, Paul; McConnachie, Alex; Wu, Olivia; Paul, Lorna
Background: Walking is the primary form of physical activity performed by people with Multiple Sclerosis (MS), therefore it is important to ensure the validity of tools employed to measure walking activity. The aim of this study was to assess the criterion validity of the activPAL3 activity monitor during overground walking in people with MS. Methods: Validity of the activPAL3 accelerometer was compared to video observation in 20 people moderately affected by MS. Participants walked 20-30m twice along a straight quiet corridor at a comfortable speed. Results: Inter-rater reliability of video observations was excellent (all intraclass correlations > 0.99). The mean difference (activPAL3- mean of raters) was -4.70 ± 9.09, -4.55 s ± 10.76 and 1.11 s ± 1.11 for steps taken, walking duration and upright duration respectively. These differences represented 8.7, 10.0 and 1.8% of the mean for each measure respectively. The activPAL3 tended to underestimate steps taken and walking duration in those who walked at cadences of ≤ 38 steps/minute by 60% and 47% respectively. Discussion: The activPAL3 is valid for measuring walking activity in people moderately affected by MS. It is accurate for upright duration regardless of cadence. In participants with slow walking cadences, outcomes of steps taken and walking duration should be interpreted with caution.