Adolescents' experience with sports-related pain and injury: A systematic review of qualitative research

Objective: The aim of this review is to synthesise qualitative studies examining adolescents’ experience with pain and injury arising from sports participation. Methods: This review was registered on Open Science Framework prior to data extraction. A systematic search of PubMed, Embase, and SPORTDiscus was conducted. Studies were appraised using the CASP (critical appraisal skills programme) checklist. Data was synthesised using a meta aggregation. Study selection criteria: Inclusion criteria included studies related to adolescents aged 14–19yrs with sports related pain/injury, employed a qualitative design, full text publications in English. Results: Sixteen studies of 216 participants were included. Studies investigated severe knee injuries, concussion, or other musculoskeletal injuries. Synthesised findings show that, regardless of injury type, adolescents experience a mix of positive (motivation to rehab and return to sport, optimism) and negative emotions (fear of reinjury, isolation, depressive responses) throughout recovery. Common coping strategies were to ignore symptoms, modify activity levels, or seek support. Conclusion: Sports-related pain and injury has a multifaceted effect on the adolescent athlete. There is a pervasive fear of re-injury and social isolation, but the desire to return to sports is facilitated through motivation and support. Peer motivation effects the willingness of the adolescent to persist with rehabilitation

Synthalin::a lost lesson for glucagon suppression in diabetes therapeutics

Objectives Within mammalian pancreatic islets, there are two major endocrine cell types, beta-cells which secrete insulin and alpha-cells which secrete glucagon. Whereas, insulin acts to lower circulating glucose, glucagon counters this by increasing circulating glucose via the mobilisation of glycogen. Synthalin A (Syn A) was the subject of much research in the 1920s and 1930s as a potential pancreatic alpha-cell toxin to block glucagon secretion. However, with the discovery of insulin and its lifesaving use in patients with diabetes, research on Syn-A was discontinued. Key findings This short review looks back on early studies performed with Syn A in animals and humans with diabetes. These are relevant today because both type 1 and type 2 diabetes are now recognised as states of not only insulin deficiency but also glucagon excess. Summary Lessons learned from this largely forgotten portfolio of work and therapeutic strategy aimed at limiting the number or function of islet alpha-cells might be worthy of reconsideration

The Association of Physical Activity Fragmentation with Physical Function in Older Adults: Analysis from the SITLESS Study

The distribution of physical activity bouts through the day may provide useful information for assessing the impacts of interventions on aspects such as physical function. This study aimed to investigate the associations between physical activity fragmentation, tested using different minimum physical activity bout lengths, with physical function in older adults. The SITLESS project recruited 1360 community-dwelling participants from four European countries (≥65 years old). Physical activity fragmentation was represented as the active-to-sedentary transition probability (ASTP), the reciprocal of the average physical activity bout duration measured using ActiGraph wGT3X+ accelerometers. Four minimum bout lengths were utilised to calculate the ASTP: ≥10-s, ≥60-s, ≥120-s and ≥300-s. Physical function was assessed using the 2-min walk test (2MWT) and the composite score from the Short Physical Performance Battery (SPPB) test. Linear regression analyses, after adjusting for relevant covariates, were used to assess cross-sectional associations. After adjustment for relevant covariates, lower ASTP using ≥10-s bouts were associated with longer 2MWT distances and higher SPPB scores. Lower ASTP using ≥120-s bouts and ≥300-s bouts were associated with longer 2MWT distances but not the SPPB. Less fragmented physical activity patterns appeared to be associated with better physical function in community-dwelling older adult

The effect of chair-based exercise on physical function in older adults: a systematic review and meta-analysis

Physical activity is an important determinant of health in later life. The public health restrictions in response to COVID-19 have interrupted habitual physical activity behaviours in older adults. In response, numerous exercise programmes have been developed for older adults, many involving chair-based exercise. The aim of this systematic review was to synthesise the effects of chair-based exercise on the health of older adults. Ovid Medline, EMBASE, CINAHL, AMED, PyscInfo and SPORTDiscus databases were searched from inception to 1 April 2020. Chair-based exercise programmes in adults ≥50 years, lasting for at least 2 weeks and measuring the impact on physical function were included. Risk of bias of included studies were assessed using Cochrane risk of bias tool v2. Intervention content was described using TiDieR Criteria. Where sufficient studies (≥3 studies) reported data on an outcome, a random effects meta-analysis was performed. In total, 25 studies were included, with 19 studies in the meta-analyses. Seventeen studies had a low risk of bias and five had a high risk of bias. In this systematic review including 1388 participants, results demonstrated that chair-based exercise programmes improve upper extremity (handgrip strength: MD = 2.10; 95%CI = 0.76, 3.43 and 30 s arm curl test: MD = 2.82; 95%CI = 1.34, 4.31) and lower extremity function (30 s chair stand: MD 2.25; 95%CI = 0.64, 3.86). The findings suggest that chair-based exercises are effective and should be promoted as simple and easily implemented activities to maintain and develop strength for older adults

PREP Plus combined postrehabilitation programme to support upper limb recovery in community-dwelling stroke survivors: protocol for a mixed-methods, cluster-assigned feasibility study

Introduction Poor recovery of the upper limb following a stroke has been recognised as a significant problem in the UK. Although there is good evidence that early, intense rehabilitation can lead to upper limb recovery, often this is not maintained, with less than 50% of people regaining the ability to use their upper limb for independent function at 6 months. Upper limb recovery potential is reported for many years poststroke, yet current long-term provision is insufficient.Methods and analysis 60 participants will be recruited into this feasibility study, with 30 allocated to a Post Rehabilitation Enablement Programme (PREP) alone and 30 allocated to a combined programme, PREP Plus, consisting of PREP and the Graded Repetitive Arm Supplementary Programme (GRASP). We will aim to complete four iterative waves. Within each wave, the intervention design will be refined, based on participant feedback. Within each wave, there will be one cluster unit (one intervention group ;PREP Plus) and one control group ;PREP alone)). A total of five PREP sites within Northern Ireland Health and Social Care Trusts will be used for this study. PREP Plus will have a home exercise component along with exercises logs and a behaviour contract. Qualitative and quantitative measures will evaluate the acceptability and feasibility to determine how feasible it is to embed the intervention into practice, as well as to determine the feasibility of a larger, mixed-methods, randomised controlled trial to assess intervention efficacy. Clinical endpoints will also be explored.Ethics and dissemination This study has been approved by the Health and Social Care Research Ethics Committee A, IRAS project ID (278620). Participants will provide informed consent prior to participating in the study. Information outlining the purpose of the study, what data will be collected and how the data will be managed will be provided. Results will be published in peer-reviewed journals and any published data will be available on the university data repository. The project management group will advise on different avenues for dissemination to ensure it reaches appropriate audiences.Trial registration number NCT05090163

Changes in dietary fat intake and associations with mental health in a UK public sample during the COVID-19 pandemic

Background: Consumption of unhealthy foods may have changed during the COVID-19 pandemic. This study explored how dietary fat intake was impacted in a sample of the UK public who were social distancing during the COVID-19 pandemic. Methods: Data were collected from a UK COVID-19 online survey. Fat intake was measured using the Dietary Instrument for Nutrition Education questionnaire. Anxiety and depressive symptoms were assessed using Becks’ Anxiety and Depression Inventories, while the short-form Warwick-Edinburgh Mental Well-being Scale assessed mental well-being. Differences between individuals who increased versus decreased fat intake were explored using chi-square or independent sample t-tests. Association between fat intake and mental health was explored using adjusted linear regression models. Results: Eight hundred and eighty-seven adults were included. Approximately, 34% recorded medium-to-high levels of fat consumption during social distancing. Around 48% reported decreased fat intake during social distancing compared to usual levels, while 41.3% documented increased fat intake. Fat intake was not significantly associated (P > 0.05) with any measures of mental health. Conclusions: A higher proportion of a sample of UK adults social distancing during the COVID-19 pandemic recorded decreased fat intake when compared to levels prior to social distancing. There appeared to be no associations between fat intake and mental health