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- Heiland, Emerald G, et al.
(författare)
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ABBaH: Activity Breaks for Brain Health : A Protocol for a Randomized Crossover Trial
- 2020
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media S.A.. - 1662-5161. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Extended periods of sitting may have detrimental effects on brain health. However, the effects of breaking up prolonged sedentary periods with frequent, short physical activity bouts on mechanisms to improve brain health remain unclear. Therefore, this study aims to investigate the immediate effects of uninterrupted sitting and frequent, short bouts of physical activity on cerebral blood flow and cognitive function in the prefrontal cortex in middle-aged adults. Methods: This is a protocol article to describe a randomized crossover study. We will collect data from 13 healthy adults, aged between 40 and 60 years old, with a body mass index <35 kg/m(2). Participants will be required to come into the laboratory on three occasions, sit for 3 h, and perform a different type of break for 3 min every 30 min at each visit in a random order, being either: (1) a social break; (2) brisk walk on a treadmill; or (3) simple resistance activities. Before and after each experimental condition, cerebral blood flow (primary outcome) will be measured using functional near-infrared spectroscopy (fNIRS), with short-separation channels, and working memory (1-, 2-, and 3-back on the computer) will be assessed. The following additional secondary outcomes will be collected: psychological factors (questionnaires); arterial stiffness; salivary cortisol levels; and blood glucose levels. Conclusion: The results from this randomized crossover study will determine the effects of uninterrupted sitting and frequent, short bouts of physical activity on cerebral blood flow and cognitive performance. Publication of this study protocol emphasizes the importance of registration and publication of protocols in the field of sedentary behavior research.
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- Heiland, Emerald G, et al.
(författare)
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Frequent, Short Physical Activity Breaks Reduce Prefrontal Cortex Activation but Preserve Working Memory in Middle-Aged Adults : ABBaH Study.
- 2021
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media S.A.. - 1662-5161. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Prolonged sitting is increasingly common and may possibly be unfavorable for cognitive function and mood. In this randomized crossover study, the effects of frequent, short physical activity breaks during prolonged sitting on cognitive task-related activation of the prefrontal cortex were investigated. The effects on working memory, psychological factors, and blood glucose were also examined, and whether arterial stiffness moderated prefrontal cortex activation. Thirteen subjects (mean age 50.5 years; eight men) underwent three 3-h sitting conditions, interrupted every 30-min by a different 3-min break on separate, randomized-ordered days: seated social interactions (SOCIAL), walking (WALK), or simple resistance activities (SRA). Arterial stiffness was assessed at baseline. Before and after each 3-h condition, psychological factors (stress, mood, sleepiness, and alertness) were assessed through questionnaires and functional near-infrared spectroscopy (fNIRS) was used to measure changes in prefrontal oxygenated hemoglobin (Oxy-Hb), indicative of cortical activation, while performing working memory tasks [1- (baseline), 2-, and 3-back]. Blood glucose levels were continuously measured throughout the conditions. Results revealed no significant changes in Oxy-Hb during the 2-back compared with the 1-back test in any condition, and no time-by-condition interactions. During the 3-back test, there was a significant decrease in Oxy-Hb compared with the 1-back after the WALK condition in the right prefrontal cortex, but there were no time-by-condition interactions, although 3-back reaction time improved only in the WALK condition. Mood and alertness improved after the WALK condition, which was significantly different from the SOCIAL condition. Arterial stiffness moderated the effects, such that changes in Oxy-Hb were significantly different between WALK and SOCIAL conditions only among those with low arterial stiffness. Blood glucose during the interventions did not differ between conditions. Thus, breaking up prolonged sitting with frequent, short physical activity breaks may reduce right prefrontal cortex activation, with improvements in some aspects of working memory, mood, and alertness. Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT04137211.
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- Lannin, Natasha A., et al.
(författare)
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Public perspectives on acquired brain injury rehabilitation and components of care : A Citizens’ Jury
- 2021
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Ingår i: Health Expectations. - : John Wiley & Sons. - 1369-6513 .- 1369-7625. ; 24:2, s. 352-362
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Tidskriftsartikel (refereegranskat)abstract
- Background: Brain injury rehabilitation is an expensive and long-term endeavour. Very little published information or debate has underpinned policy for service delivery in Australia. Within the context of finite health budgets and the challenges associated with providing optimal care to persons with brain injuries, members of the public were asked ‘What considerations are important to include in a model of care of brain injury rehabilitation?’.Methods: Qualitative study using the Citizen Jury method of participatory research. Twelve adult jurors from the community and seven witnesses participated including a health services funding model expert, peak body representative with lived experience of brain injury, carer of a person with a brain injury, and brain injury rehabilitation specialists. Witnesses were cross-examined by jurors over two days.Results: Key themes related to the need for a model of rehabilitation to: be consumer-focused and supporting the retention of hope; be long-term; provide equitable access to services irrespective of funding source; be inclusive of family; provide advocacy; raise public awareness; and be delivered by experts in a suitable environment. A set of eight recommendations were made.Conclusion: Instigating the recommendations made requires careful consideration of the need for new models of care with flexible services; family involvement; recruitment and retention of highly skilled staff; and providing consumer-focused services that prepare individuals and their carers for the long term.Patient and public contribution: As jury members, the public deliberated information provided by expert witnesses (including a person with a head injury) and wrote the key recommendations.
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- Meretoja, Atte, et al.
(författare)
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Stroke doctors : Who are we? A World Stroke Organization survey
- 2017
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Ingår i: International Journal of Stroke. - : SAGE Publications. - 1747-4949 .- 1747-4930. ; 12:8, s. 858-868
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Tidskriftsartikel (refereegranskat)abstract
- Background Specialist training provides skilled workforce for service delivery. Stroke medicine has evolved rapidly in the past years. No prior information exists on background or training of stroke doctors globally. Aims To describe the specialties that represent stroke doctors, their training requirements, and the scientific organizations ensuring continuous medical education. Methods The World Stroke Organization conducted an expert survey between June and November 2014 using e-mailed questionnaires. All Organization for Economic Co-operation and Development countries with >1 million population and other countries with >50 million population were included ( n = 49, total 5.6 billion inhabitants, 85% of global strokes). Two stroke experts from each selected country were surveyed, discrepancies resolved, and further information on identified stroke-specific curricula sought. Results We received responses from 48 (98%) countries. Of ischemic stroke patients, 64% were reportedly treated by neurologists, ranging from 5% in Ireland to 95% in the Netherlands. Per thousand annual strokes there were average six neurologists, ranging from 0.3 in Ethiopia to 33 in Israel. Of intracerebral hemorrhage patients, 29% were reportedly treated by neurosurgeons, ranging from 5% in Sweden to 79% in Japan, with three neurosurgeons per thousand strokes, ranging from 0.1 in Ethiopia to 24 in South Korea. Most countries had a stroke society (86%) while only 10 (21%) had a degree or subspecialty for stroke medicine. Conclusions Stroke doctor numbers, background specialties, and opportunities to specialize in stroke vary across the globe. Most countries have a scientific society to pursue advancement of stroke medicine, but few have stroke curricula.
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- Thurston, Charlotte, et al.
(författare)
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Mobile health to promote physical activity in people post stroke or transient ischemic attack : study protocol for a feasibility randomised controlled trial
- 2023
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Ingår i: BMC Neurology. - : BioMed Central (BMC). - 1471-2377. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical activity is essential to improve health and reduce the risk of recurrence of stroke or transient ischemic attack (TIA). Still, people post stroke or TIA are often physically inactive and the availability of physical activity promotion services are often limited. This study builds on an existing Australian telehealth-delivered programme (i-REBOUND– Let’s get moving) which provides support for home-based physical activity for people post stroke or TIA. The aim of this study is to test the feasibility, acceptability, and preliminary effects of a mobile Health (mHealth) version of the i-REBOUND programme for the promotion of physical activity in people post stroke or TIA living in Sweden.Methods: One hundred and twenty participants with stroke or TIA will be recruited via advertisement. A parallel-group feasibility randomised controlled trial design with a 1:1 allocation ratio to 1) i-REBOUND programme receiving physical exercise and support for sustained engagement in physical activity through behavioural change techniques, or 2) behavioural change techniques for physical activity. Both interventions will proceed for six months and be delivered digitally through a mobile app. The feasibility outcomes (i.e., reach, adherence, safety and fidelity) will be monitored throughout the study. Acceptability will be assessed using the Telehealth Usability Questionnaire and further explored through qualitative interviews with a subset of both study participants and the physiotherapists delivering the intervention. Clinical outcomes on preliminary effects of the intervention will include blood pressure, engagement in physical activity, self-perceived exercise self-efficacy, fatigue, depression, anxiety, stress and health-related quality of life and will be measured at baseline and at 3, 6 and 12 months after the baseline assessments.Discussion: We hypothesise that the mHealth delivery of the i-REBOUND programme will be feasible and acceptable in people post stroke/TIA living in rural and urban regions of Sweden. The results of this feasibility trial will inform the development of full-scale and appropriately powered trial to test the effects and costs of mHealth delivered physical activity for people after stroke or TIA.
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| 7. |
- van Wijck, Frederike, et al.
(författare)
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Improving life after stroke needs global efforts to implement evidence-based physical activity pathways.
- 2019
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Ingår i: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 14:5, s. 457-459
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Tidskriftsartikel (refereegranskat)abstract
- There is an urgent need to improve life after stroke across the world-especially in low-income countries-through methods that are effective, equitable and sustainable. This paper highlights physical activity (PA) as a prime candidate for implementation. PA reduces modifiable risk factors for first and recurrent stroke and improves function and activity during rehabilitation and following discharge. Preliminary evidence also indicates PA is cost-effective. This compelling evidence urgently needs to be translated into seamless pathways to enable stroke survivors across the world to engage in a more active lifestyle. Although more quality research is needed-particularly on how to optimize uptake and maintenance of PA-this should not delay implementation of high-quality evidence already available. This paper shares examples of best practice service models from low-, middle-, and high-income countries around the world. The authors call for a concerted effort to implement high-quality PA services to improve life after stroke for all.
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