A feasibility study of the physiotherapy management of urinary incontinence in athletic women: trial protocol for the POsITIve study

BackgroundUrinary incontinence (UI) affects up to 40% of adult women within the UK, and pelvic floor muscle training can be effective as a treatment. The prevalence of UI is higher in athletic women than in their sedentary counterparts, but there is little research into reasons for this or into treatment within this population.The aim of this study is to investigate the feasibility of conducting a future randomised controlled trial of physiotherapeutic management of UI in athletic women.MethodsThis is a mixed methods study with three distinct but related phases.Phase 1: Semi-structured interviews with health care professionals in the community will explore current management practices of UI in women and particularly in female athletes in order to inform the control arm of a future study. It will also establish community health care professionals’ understanding of pelvic health physiotherapy.Phase 2: Athletic and regularly exercising women recruited directly from gyms and sports clubs will undergo a course of physiotherapy to manage UI. This will establish study recruitment, eligibility, consent, attendance, attrition, and data completion rates. It will provide information regarding appropriate clinical venues and outcome measures to use for this patient group.Phase 3: Semi-structured interviews with purposefully selected participants from phase 2 will investigate participant satisfaction with recruitment procedures, the intervention, outcome measures and the venues. Further, we will collect data regarding the use of a smartphone ‘app’ for adherence and monitoring of home exercises and participants’ beliefs around randomisation in a future study. We will explore the impact of UI on life and sport in more detail.DiscussionThis study will establish the ease and acceptability of recruiting athletic women directly from gyms and sports clubs and identify attrition rates. It will also explore the acceptability of the intervention, clinical venues and outcome measures. Data collected will be used to inform a future randomised controlled trial.Trial registrationNCT03986411 (clinicaltrials.gov). Registered on 14 June 201

Motive8!: feasibility of a text messaging intervention to promote physical activity in knee osteoarthritis

Aim: To develop and test the feasibility of using a SMS text messaging intervention to promote physical activity in patients with knee OA. Methods: 27 people (6 male, 21 female; aged 25-81 years) with knee osteoarthritis received 4 text messages per week, for 6 weeks. Telephone surveys were conducted at baseline and 6 weeks to measure physical activity levels and beliefs, including self-efficacy for exercise, barriers and benefits of exercise, social support and pain. Participants completed physical activity diaries. Process evaluation included participant perceptions of the intervention and 'real-time' data on intervention fidelity (automated collection of delivery and response data) and participant engagement (text response). Results: 648 messages were sent, 100% were accurately delivered. From baseline to 6 weeks, physical activity, self-efficacy for exercise, perceived benefits of exercise and social support significantly increased; reductions were observed in barriers to exercise and pain. Participants engaged with the intervention; 100% read the messages, 89% responded to texts requesting replies, 64% completed physical activity diaries with low attenuation (1.8% drop) by six weeks. Participants perceived messaging to be enjoyable (96%), personally relevant (85%), of appropriate frequency (100%) and duration (88%). Mobile phones, email and web were perceived to be most acceptable for health promotion compared with other forms of technology. Conclusions: People with knee osteoarthritis can engage meaningfully with an interactive mobile phone messaging intervention over a six-week period. Health communications promoting physical activity demonstrate potential for behaviour change and positive implications for perceptions of exercise and pain; this needs to be tested in a randomised trial. Data collected in 'real-time' can be used for process evaluation to demonstrate participant engagement and intervention fidelity

A cross-sectional study of retired Great British Olympians (Berlin 1936 - Sochi 2014):Olympic career injuries, joint health in later life, and reasons for retirement from Olympic sport

The relationship between Olympic career sport injury and the long-term musculoskeletal health of the elite athlete remains unclear. This study describes the lifetime prevalence of medical attention injuries that occurred during training and/or competition as part of the athlete’s Olympic career, reasons for retirement from Olympic sport, and the point prevalence of pain and osteoarthritis (OA) among retired Great Britain’s (GB) Olympians

Active8! Technology-based intervention to promote physical activity in hospital employees

Purpose: Increase physical activity in healthcare employees using health messaging, and compare email with mobile phone short-message service (SMS) as delivery channels. Design: Randomised controlled trial Setting: UK hospital workplace Subjects: 296 employees (19-67 years, 53% of study website visitors) Intervention: 12-week messaging intervention designed to increase physical activity and delivered via SMS (n=147) or email (n=149); content tailored using Theory of Planned Behaviour (TPB) and limited to 160 characters. Measures: Baseline, 6, 12 and 16 weeks. Online measures included TPB constructs; physical activity behaviour on the Global Physical Activity Questionnaire; health-related quality of life on the Short-Form 12. Analysis: General linear models for repeated measures. Results: Increase in duration (mean hours/day) of moderate work-related activity and moderate recreational activity from baseline to 16 weeks. Short-lived increase in frequency (days/week) of vigorous recreational activity from baseline to 6 weeks. Increase in duration and frequency of active travel from baseline to 16 weeks. Emails generated greater changes than SMS in active travel and moderate activity (work and recreational). Conclusion: Minimal physical activity promotion delivered by SMS or email can increase frequency and duration of active travel, and duration of moderate-intensity physical activity at work and for leisure, which is maintained up to one-month after messaging ends. Both channels were useful platforms for health communication; emails were particularly beneficial with hospital employees

Tectonic synthesis of the Olympic Mountains segment of the Cascadia wedge, using two-dimensional thermal and kinematic modeling of thermochronological ages

A fully coupled two-dimensional kinematic and thermal model of a steady state accretionary wedge, constrained by an extensive data set of fission track and (U-Th)/He ages for apatite and zircon, is here used to investigate the development of the Olympic Mountains segment of the Cascadia accretionary wedge. The model has two main free parameters: ε_(max), the maximum rate of erosion for a generic erosion function operating at the top of the wedge, and α, the distribution of sedimentary accretion into the wedge. The best fit values for ε_(max) and α and their confidence limits are determined through an iterative search of parameter space. This study represents the first time that such inversion methods have been used to quantify the thermal-kinematic evolution of an accretionary wedge. Our results suggest that horizontal transport plays an important role in the exhumation trajectories experienced by material passing through the Cascadia wedge. At a 95% confidence interval, 80 to 100% of the sedimentary sequence from the subducting Juan de Fuca Plate has been accreted at the front of the wedge offshore of the Olympics over the past 14 m.y. This frontally accreted material must then traverse the entire width of the wedge prior to its eventual exposure in the Olympic forearc high. Assessed in this two-dimensional framework, the fission track and (U-Th)/He age data sets from the Olympic Mountains are all best fit by ε_(max) of 0.9–1.0 mm yr^(−1), despite variation in the timescales relevant to the three chronometers. This result supports the hypothesis that the Olympic Mountains segment of the Cascadia accretionary wedge has been in a flux steady-state since ∼14 Ma. The demonstration of a flux balance across the Cascadia margin also suggests that margin-parallel transport has not had a significant role in driving uplift of the Olympic Mountains

Simple advice for a simple ankle sprain? The not so benign ankle injury

Editorial. No abstract available

Evaluation of occupational health checks for hospital employees

Purpose– The purpose of this paper is to ascertain which employees choose to access occupational health checks (OHCs), their perceptions of the usefulness of information received and whether they choose to act on tailored advice provided.Design/methodology/approach– In total, 253 hospital employees attended workplace OHC then completed online questionnaire survey.Findings– Participants included new cases (80 per cent) and those who had accessed the service previously (20 per cent), all age categories (23-69 years) and all occupational groups, although the vast majority were in office-based sedentary job roles, nursing or allied health professions (AHP) (78.3 per cent). Almost half were overweight or obese (46.7 per cent); many reported existing health problems or family history of chronic disease. Participants perceived OHC s to be convenient, informative and useful for raising their awareness of health issues, reassurance and monitoring, early identification of potential health problems and signposting to appropriate services. Participants reported post-check dietary changes (41 per cent) and increases in physical activity (30 per cent); smokers reported quitting or cutting down (44 per cent) and those exceeding alcohol limits reported cutting frequency or units of consumption (48 per cent). More than half those advised to visit their GP complied (53 per cent).Research limitations/implications– Future studies should investigate the efficacy of OHCs and whether reported lifestyle changes are sustained in the long-term.Originality/value– General health checks can be feasibly delivered in a multi-site hospital workplace setting with diverse appeal. Provision of tailored health information can help to raise health awareness and motivate health behaviour change or maintenance amongst hospital employees, including those reporting risk factors for chronic disease. Employees value the investment of healthcare organisations in the health and wellbeing of their workforce

Evaluation of occupational health checks for hospital employees

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