Realcare: recovery after lung resection: study design and preliminary results

Physical activity is considered beneficial for recovery of physical fitness, symptoms of fatigue and distress, and quality of life following lung resection. However, till now there is insufficient insight in the recovery and relevance of physical activity in this process as most studies so far rely on subjective information from questionnaires to capture level of physical activity.\ud Our results show that on average patients experience a complete recovery of health status at six months post surgery to pre-surgery levels. Next to that, higher levels of daily activity were associated with better health status. \ud Interestingly, part of NSCLC patients deploy below-average physical activity. \ud A next step would be to investigate whether ambulant monitoring of both symptoms and daily activity optimizes recovery of health status after lung resection

Rest Rust ! Physical active for active and healthy ageing

The aim of this paper is to give an insight on how physical activity can be defined, parameterized and measured in older adults and on different options to deal with citizen physical activity promotion at European level. Three relevant aspects are highlighted: When talking about physical activity, two different aspects are often unfairly mixed up: "physical activity" and "physical capacity". Physical activity, is referred to as the level of physical activity someone is actually performing in daily life.Physical capacity is referred to as the maximum physical activity a person can perform.Both physical activity and physical capacity can be expressed in different dimensions such as time, frequency, or type of activity with the consequence that there are many tools and techniques available. In order to support people to choose an appropriate instrument in their everyday practice a list of 9 criteria that are considered important is defined.Older adults score differently across the various physical dimensions, so strategies to promote physical activity should consider individual differences, in order to adapt for these variations

Rest rust! physical active for active and healthy ageing

The aim of this paper is to give an insight on how physical activity can be defined, parameterized and measured in older adults and on different options to deal with citizen physical activity promotion at European level. Three relevant aspects are highlighted: 1. When talking about physical activity, two different aspects are often unfairly mixed up: “physical activity” and “physical capacity”. • Physical activity, is referred to as the level of physical activity someone is actually performing in daily life. • Physical capacity is referred to as the maximum physical activity a person can perform. 2. Both physical activity and physical capacity can be expressed in different dimensions such as time, frequency, or type of activity with the consequence that there are many tools and techniques available. In order to support people to choose an appropriate instrument in their everyday practice a list of 9 criteria that are considered important is defined. 3. Older adults score differently across the various physical dimensions, so strategies to promote physical activity should consider individual differences, in order to adapt for these variations

Developing a pragmatic evaluation of ICTs for older adults with cognitive impairment at scale: the IN LIFE experience

Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impact on users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment this requires evaluation that can accommodate different levels of cognitive impairment, alongside input from family and formal caregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions for the Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six national pilot sites to examine a number of variables including impact on the users, user acceptance of the individual services and the overall platform, plus the economic case for the IN LIFE platform. The results confirmed the interest and need among older adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT). Relative to the baseline, quality of life improved and cognition stabilized, however, there was an overall reluctance to pay for the platform. The findings provide insights into existing barriers and challenges for adoption of ICT for older people living with cognitive impairment

The effectiveness of exercise-based telemedicine on pain, physical activity and quality of life in the treatment of chronic pain: A systematic review

Introduction The aim of this study was to systematically review the evidence on the effectiveness of exercise-based telemedicine in chronic pain. Methods We searched the Cochrane, PubMed, MEDLINE, EMBASE, CINAHL and PEDRO databases from 2000 to 2015 for randomised controlled trials, comparing exercise-based telemedicine intervention to no intervention or usual care in adults with chronic pain. Primary outcome data were pooled using random effect meta-analysis. Primary outcomes were pain, physical activity (PA), limitations in activities of daily living (ADL) and quality of life (QoL). Secondary outcomes were barriers, facilitators and usability of telemedicine. Results Sixteen studies were included. Meta-analyses were performed in three subgroups of studies with comparable control conditions. Telemedicine versus no intervention showed significantly lower pain scores (MD -0.57, 95% CI -0.81; -0.34), but not for telemedicine versus usual care (MD -0.08, 95% CI -0.41; 0.26) or in addition to usual care (MD -0.25, 95% CI -1.50; 1.00). Telemedicine compared to no intervention showed non-significant effects for PA (MD 19.93 min/week, 95% CI -5.20; 45.06) and significantly diminished ADL limitations (SMD -0.20, 95% CI -0.29; -0.12). No differences were found for telemedicine in addition to usual care for PA or for ADL (SMD 0.16, 95% CI -0.66; 0.34). Telemedicine versus usual care showed no differences for ADL (SMD 0.08, 95% CI -0.37; 0.53). No differences were found for telemedicine compared to the three control groups for QoL. Limited information was found on the secondary outcomes. Conclusions Exercise-based telemedicine interventions do not seem to have added value to usual care. As substitution of usual care, telemedicine might be applicable but due to limited quality of the evidence, further exploration is needed for the rapidly developing field of telemedicin

The implementation, actual use and user experience of an online home exercise program that fits the needs of older adults with mild cognitive impairments

As the population ages, the number of people in our communities suffering with mild cognitive impairment (MCI) will increase. Individuals with MCI may benefit from e-health interventions for exercise promotion, but there is a need for such an e-health program that fits the needs of older adults with MCI. The objective of this study was to evaluate the implementation, actual use and user-experience of a home-based exercise program developed for older adults with MCI. Questionnaires were filled in about the implementation strategy, actual use and user-experience (usefulness, usability and satisfaction). Fifty-seven older adults and eight formal caregivers participated in the study. Mean duration of the sessions was 18 minutes (+/-15). The user-experience of the older adults was higher than that of the formal caregivers. Formal caregivers mainly offered the program at the home care organization, but some older adults indicated that they were willing to try it at home. In conclusion, the online exercise program is feasible and potentially beneficial for older adults when taking into account the e-health literacy of older adults and attitude towards e-health of formal caregivers in the implementation strategy

Physical behavior and associations with health outcomes in operable NSCLC patients: A prospective study

Objectives: Our objectives were to 1) characterize daily physical behavior of operable non-small cell lung cancer (NSCLC) patients, from preoperative to six months postoperative using accelerometry, and explore if physical behavior preoperative or one month postoperative is associated with better health outcomes at six months postoperative. Methods: A prospective study with 23 patients (13 female) diagnosed with primary NSCLC and scheduled for curative lung resection was performed. Outcome measures were assessed two weeks preoperative, and one, three and six months postoperative, and included accelerometer-derived physical behavior measures and the following health outcomes: six minute walking distance (6MWD), questionnaires concerning health-related quality of life (HRQOL), fatigue and distress. Results: On group average, physical behavior showed significant changes over time. Physical behavior worsened following surgery, but improved between one and six months postoperative, almost reaching preoperative levels. However, physical behavior showed high variability between patients in both amount as well as change over time. More time in moderate-to-vigorous physical activity in bouts of 10 min or longer in the first month postoperative was significantly associated with better 6MWD, HRQOL, distress, and fatigue at six months postoperative. Conclusion: As expected, curative lung resection impacts physical behavior. Patients who were more active in the first month following surgery reported better health outcome six months postoperative. The large variability in activity patterns over time observed between patients, suggests that physical behavior ‘profiling’ through detailed monitoring of physical behavior could facilitate tailored goal setting in interventions that target change in physical behavior