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Multicentred randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support in individuals with metabolic, musculoskeletal and mental health conditions: protocol for the e-coachER trial
Get PDFIntroduction Physical activity is recommended for improving health among people with common chronic conditions such as obesity, diabetes, hypertension, osteoarthritis and low mood. One approach to promote physical activity is via primary care exercise referral schemes (ERS). However, there is limited support for the effectiveness of ERS for increasing long-term physical activity and additional interventions are needed to help patients overcome barriers to ERS uptake and adherence.
This study aims to determine whether augmenting usual ERS with web-based behavioural support, based on the LifeGuide platform, will increase long-term physical activity for patients with chronic physical and mental health conditions, and is cost-effective.
Methods and analysis A multicentre parallel two-group randomised controlled trial with 1:1 individual allocation to usual ERS alone (control) or usual ERS plus web-based behavioural support (intervention) with parallel economic and mixed methods process evaluations. Participants are low active adults with obesity, diabetes, hypertension, osteoarthritis or a history of depression, referred to an ERS from primary care in the UK.
The primary outcome measure is the number of minutes of moderate-to-vigorous physical activity (MVPA) in ≥10 min bouts measured by accelerometer over 1 week at 12 months.
We plan to recruit 413 participants, with 88% power at a two-sided alpha of 5%, assuming 20% attrition, to demonstrate a between-group difference of 36–39 min of MVPA per week at 12 months. An improvement of this magnitude represents an important change in physical activity, particularly for inactive participants with chronic conditions.
Ethics and dissemination Approved by North West Preston NHS Research Ethics Committee (15/NW/0347). Dissemination will include publication of findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals.
Results will be disseminated to ERS services, primary healthcare providers and trial participants
Banning the tackle in school rugby: Let's put it into context.
Get PDFProponents and critics of tackle rugby agree that the tackle is the most injurious aspect of the game.[1,2] Nonetheless, fierce debate regarding serious injury aetiology, harm minimization and maximizing health benefit in rugby has emerged.[3,4] I write as an academic and former Physical Education (PE) teacher who supports neither banning nor teaching tackle rugby in schools
Effects of controlled dehydration on sleep quality and quantity: A polysomnographic study in healthy young adults
Get PDFDehydration is associated with several alternations in body homeostasis involving both physiological and mental aspects. In addition some studies have reported a negative effect of dehydration on subjectively assessed sleep-related parameters. The aim of the current study was to examine for the first time the effect of controlled dehydration on sleep quality and quantity using the gold-standard method of polysomnography. Twelve healthy male volunteers participated in this study (23.4 ± 0.8 years). Participants performed an in-house full polysomnographic assessment in two different occasions taking place in random order: (i) in a dehydrated state; and (ii) in a euhydrated state. In the dehydration scenario, the participants were allowed to consume only 1.25 L of non-caffeinated fluids, while during the euhydrated state participants had to drink at least 3 L of non-caffeinated fluids during the last 24 hr before the polysomnographic study. Urine specific gravity was assessed by refractrometry on collection day in order to assess hydration status. Participants who did not fulfil the hydration criteria were rescheduled. All participants successfully completed the two polysomnographic studies without any complaints or adverse effects reported. No significant differences were found in any of the examined indices of sleep quality and quantity between the dehydration and euhydration scenarios (p > .05). This is the first study to show that controlled mild dehydration does not seem to affect sleep quality and quantity in young healthy adults. More research is necessary to further verify these conclusions and assess whether other parameters are involved in the manifestation of sleep disturbances
Endurance athletes’ current and preferred ways of getting psychological guidance
Get PDFThis study examined how people who participate in endurance events currently get guidance on psychological aspects of their events and their preferred ways for receiving guidance from researchers and practitioners, so that psychologists can use these ways to disseminate research-derived knowledge. People in the United Kingdom (N = 574) who participated competitively or non-competitively in running (5 km and greater), road cycling (time trials, road races, or sportives), or triathlon events completed an online survey. The main questions addressed ways they have intentionally used to find psychological guidance, how they have got guidance without intentionally looking for it, and their preferences for receiving guidance. The most common ways of intentionally finding guidance were looking on websites (48.1% of participants), asking other athletes (46.7%), and asking coaches (32.5%). Athletes most commonly tried to find guidance on coping, motivation, and managing nerves. Posts on social media (51.3%), spoken word (48.0%), and magazines (45.9%) were common ways of unintentionally getting guidance, and athletes (68.1%) and coaches (45.9%) were most often the source of unintentionally received guidance. Websites (49.5%) and online videos (41.8%) were the most preferred ways to receive guidance, although researchers and practitioners working with coaches (35.5%) and event organisers (34.8%), and magazines (34.7%) were also preferable. Psychologists are encouraged to disseminate guidance to endurance athletes using websites, online videos, social media, magazines, and by working with coaches and event organisers. The data can also inform the design of intervention efficacy and effectiveness trials that deliver interventions in these ecologically valid and preferable formats
