Physiotherapy

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/6

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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 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.