The beliefs of third-level healthcare students towards low-back pain

Objectives. Beliefs held by healthcare providers are part of the complex recovery of a patient with low-back pain (LBP).The aim of this study was to investigate the attitudes and beliefs of Irish university healthcare students towards LBP. Methods. Physiotherapy ( = 107), medicine ( = 63), nursing, and midwifery ( = 101) students completed the survey. Demographic data, LBP related beliefs [Back Beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire physical subsection (FABQPA)] were collected. Results. Two hundred and seventy-one students responded (response rate 29%). Student physiotherapists had significantly lower FABQ ( < 0.001) scores than medical (95% CI [−5.492, −1.406]) and nursing students (95% CI [−7.718, −22.307]). Physiotherapy students had significantly higher BBQ scores ( < 0.0001) than medical (95% CI [1.490, 5.406]) and nursing students (95% CI [6.098, 11.283]). Beliefs of physiotherapy and medical students were significantly better among fourthyear year than first-year students ( < 0.0001) but were not significantly different for nursing students ( = 0.820 for FABQ and = 0.810 for BBQ). Conclusions. Physiotherapy students had more positive beliefs towards LBP thanmedical and nursing students. Physiotherapy and medical students’ beliefs towards LBP significantly improved over the course of their studies

Prevention and adherence in rheumatic and musculoskeletal disease

Rheumatic and Musculoskeletal Diseases (RMDs) are chronic conditions that affect a substantial number of people. RMDs are significantly related to co-morbidity. Therefore, focusing on prevention in RMDs is of importance to promote and maintain health. Prevention includes primary-, secondary-, tertiary-, and clinical prevention. Primary prevention aims to prevent the onset of disease before the disease process begins, secondary prevention includes detecting and reducing disease and risk factors at the earliest possible point, and tertiary prevention aims to limit the influence of a recognized or verified disease and to address or reduce further development or worsening of the disease, including physical and psychosocial disability. Clinical prevention attempts to integrate prevention into the disease management to limit disease progression and prevent complications and relapse. This chapter will focus on the evidence for prevention and highlight how innovations and trends can contribute by using digital technologies as an example

Sleep and physical activity: a survey of people with inflammatory arthritis and their engagement by health professionals in rheumatology in Ireland

Purpose: Sleep is important in maintaining the body’s circadian rhythm and in maintaining health. Aim was to investigate sleep and physical activity among people who have Inflammatory Arthritis and their engagement with Health Professionals. Materials and Methods: Members from a national charitable organisation for patients with arthritis and a national rheumatology health professionals society were invited to participate in separate cross-sectional surveys hosted on SurveyMonkey(R)TM. Results: Ninety (90) people responded and report an average of 5.7 (SD 1.46) hours sleep per night. A majority (61%) report their sleep quality as bad, with 31% taking medications at least once a week to help sleep. There was a statistically significant association between longer years with symptoms, taking medication at least once a week and limited in their activities, when rating their sleep quality as bad. Twenty eight (65%) health professional’s responded with 53% discussing sleep with their patients. Conclusions: People with inflammatory arthritis report low sleep with those having symptoms longer, taking medications regularly and having limitations with their activities, reporting poorer sleep quality. Only half of health professionals discuss sleep. More research is needed in investigating poor sleep quality, disturbances and physical activity in order to promote health and well-being in this population

"It might hurt, but still it's good': People with rheumatoid arthritis beliefs and expectations about physical activity interventions

Many people who have rheumatoid arthritis report low levels of physical activity. We conducted 17 interviews with people who have rheumatoid arthritis to gain insight into how they view physical activity and to explore how their levels of activity may be increased. Interviews were transcribed verbatim and analysed using thematic analysis. Four main themes were generated: being active, barriers and facilitators, information and advice, and supporting physical activity. A lack of information about being active fostered negative emotions limiting physical activity participation. Improved provision of physical activity advice is warranted to promote physical activity in people who have rheumatoid arthritis

Relationship between, self-efficacy, beliefs, and physical activity in inflammatory arthritis

Abstract Background: The benefits of physical activity (PA) in inflammatory arthritis (IA) patients are well-established. However, levels of PA in the IA population are suboptimal and the psychological determinants of PA are poorly understood. Objective: The study aimed to examine the self-reported PA levels and psychological determinants of PA for the IA population. Methods: A cross-sectional study of people with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) was conducted to explore the association between demographic and psychological variables such as self-efficacy and belief about PA, and levels of PA and energy expenditure (EE). PA was recorded using the Yale Physical Activity Survey (YPAS). Results: A total of 102 participants were included in the study. Participants reported low levels of PA [mean standard deviation (SD), 24.3 18.2]. Beliefs about PA, but not self-efficacy, correlated with levels of self-report PA over the past week (r Z 0.25, p Z 0.01), over the past month (r Z 0.21, p Z 0.04), and EE (r Z 0.31, p Z 0.01). Conclusion: People with IA have decreased levels of PA. Beliefs about PA are associated with levels of self-report PA and EE in this population. These data provide a useful signpost for guiding and designing interventions to improve PA levels in IA populations by altering beliefs about PA

Community-based intervention to promote physical activity in rheumatoid arthritis (CIPPA-RA): a study protocol for a pilot randomised control trial

Rheumatoid arthritis (RA) is a chronic, inflammatory condition which may cause pain, stiffness and fatigue. People who have RA have reduced levels of physical activity due to these symptoms. Interventions targeting physical activity behaviour in this population have had limited efficacy. This paper describes a protocol for a pilot randomised controlled trial (RCT) of a theory-based intervention delivered in a community setting designed to promote physical activity in people who have RA. The aim of the pilot study is to assess the impact of the intervention on moderate-intensity physical activity in people with RA. The objectives are to obtain reliable estimates regarding recruitment rates; participant retention, protocol adherence and generate potential effect size estimates to inform sample size calculations for a main trial on physical activity participation. Semi-structured interviews will be conducted with a selected sample of participants to explore their experiences. Participants will be recruited from direct referrals from the rheumatology clinics in a public hospital. Participants meeting inclusion criteria will be randomised into a 6 week physical activity intervention (four sessions delivered over a 6-week period by a trained physiotherapist) or a control group (physical activity information leaflet). Results of the pilot study will provide data to determine if a larger RCT is feasible. Qualitative data will inform intervention design and delivery. The findings will be disseminated to health professionals, in peer-reviewed journals and conference presentations

Stakeholder Perceptions of the Acceptability of Peer‑Mediated Intervention for Minimally Speaking Preschoolers on the Autism Spectrum

Peer mediated intervention (PMI) is an evidence-based approach to supporting social and communication development for  children on the autism spectrum. For PMI to be integrated into everyday practice, it needs to be acceptable to stakeholders.  This article engaged with autistic individuals, early childhood educators, parents, and speech and language pathologists on  the prospective acceptability of implementing PMI with minimally speaking preschoolers in inclusive preschool settings.  Focus groups and semi-structured interviews were conducted. The transcriptions were analyzed qualitatively using refexive thematic analysis. Stakeholders described PMI as an acceptable intervention approach for this population and provided  valuable insights to inform the development and implementation of PMIs. Attention needs to be paid to how to support  preschools to adopt a PMI-friendly philosophy </p

Does exercise impact on sleep for people who have rheumatoid arthritis? A systematic review

To systematically search for the availability of evidence for exercise impacting on sleep for people who have rheumatoid arthritis. Two reviewers independently searched seven electronic databases, identified and extracted relevant studies by applying eligibility criteria. Sources of bias were assessed independently by two reviewers using the Cochrane bias assessment tool for randomized controlled trials (RCTs) and Newcastle–Ottawa Quality Assessment Scale for non-RCTs. Data were synthesized using a level of evidence approach. Meta-analyses were deemed to be inappropriate due to the heterogeneity of study designs, measurement tools and interventions. Five studies were included: one RCT; two pilot RCTs and two samples of convenience. A total of 262 people with RA were included. Interventions used were difficult to assess due to the heterogeneity of study designs and the inclusion of two using different types of yoga as an intervention. Different sleep outcome measures were used thus, it was not feasible to pool results. Studies had a high risk of bias. This review could find no consistent or conclusive evidence on whether exercise impacts on sleep in people who have rheumatoid arthritis, therefore no firm conclusions can be made. However, there is some indication that exercise may have positive benefits on sleep in people who have rheumatoid arthritis. Further studies with improved study designs, using subjective and objective measures, are needed

Patient and clinician perspectives of online-delivered exercise programmes for chronic musculoskeletal conditions: a mixed-methods systematic review

Purpose:  To synthesize common or differing perceptions of patients’ and clinicians’ that influence  uptake of online-delivered exercise programmes (ODEPs) for chronic musculoskeletal (MSK) conditions. Methods: Eight databases were searched from inception to April 2023 for studies including (1) patients  with and/or clinicians delivering ODEPs for chronic MSK conditions, and (2) synchronous ODEPs, where  information is exchanged simultaneously (mode A); asynchronous ODEPs, with at least one synchronous  feature (mode B); or no ODEPs, documenting past experiences and/or likelihood of participating in an  ODEP (mode C). Critical Appraisal Skills Programme checklists were used to assess study quality.  Perceptions of patients’ and clinicians’ influencing uptake of ODEPs were extracted. Quantitative and  qualitative data were synthesised and integrated. Results:  Twenty-one studies were included (twelve quantitative, seven qualitative, and two  mixed-methods) investigating the perceptions of 1275 patients and 534 clinicians on ODEP mode A  (n=7), mode B (n=8), and mode C (n=6). Sixteen of the 23 identified perceptions related to satisfaction,  acceptability, usability, and effectiveness were common, with 70% of perceptions facilitating uptake  and 30% hindering uptake. Conclusions:  Findings highlight the need to promote targeted education for patients and clinicians  addressing interconnected perceptions, and to develop evidence-based perception-centred strategies  encouraging integrated care and guideline-based management of chronic MSK conditions.   IMPLICATIONS FOR REHABILITATION  • Almost 70% of perceptions related to satisfaction, acceptability, usability, and effectiveness that  influence the uptake of online-delivered exercise programmes for chronic musculoskeletal conditions  are shared by patients and clinicians. • Patient perceptions that differ from clinicians and that hinder uptake include the risk of misdiagnosis,  lack of social support, and advice from their clinic and/or clinician. • Clinician perceptions that differ from patients and that hinder uptake include risk of last-minute  appointment cancellations, the cost to set-up, and limitations of camera angles. • Implementation of online-delivered exercise programmes may be supported by targeted education  for patients and clinicians that addresses misinformed perceptions. </p

A randomised controlled trial of a Mediterranean dietary intervention for adults with rheumatoid arthritis (MEDRA): study protocol

Background: Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis affecting 0.5–1% of the adult population worldwide. While the primary line of treatment of RA includes pharmacological therapies, people living with the condition often seek non-pharmacological therapies such as diet and exercise in an attempt to attenuate their symptoms. Established, evidence-based dietary guidelines for RA are currently lacking. The MEDRA study aims to explore the effectiveness of implementing, via telehealth, a Mediterranean type diet. (MedDiet) compared to a standard healthy diet as per the Healthy Eating Guidelines (HEG) in Ireland in terms of differences in physical function and quality of life in adults with RA living in Ireland. Methods: The MEDRA study is a parallel, randomised controlled trial delivered through telehealth methods. Forty-four eligible participants who have RA will be randomly allocated to either a MedDiet or HEG group for a 12 weeks intervention period. Primary outcome measures include changes in physical function and quality of life, both of which will be measured using validated questionnaires at baseline, six and twelve weeks. Both intervention arms will attend a total five teleconsultations with a Registered Dietitian (RD). The MedDiet intervention arm focuses on recommendations from the traditional Mediterranean diet and HEG intervention arm will use the dietary recommendations as currently advised in Ireland. Discussion: This study will provide evidence as to whether dietary treatment of RA can improve physical function and quality of life in a small cohort of participants with RA. The results of the study will be disseminated at national scientific conferences and published in peer-reviewed journals. Ethics: This protocol has been approved by the Education and Health Sciences Research Ethics Committee at the University of Limerick (2020_09_05_EHS) and by the Health Service Executive Mid-Western Regional Hospital Research Ethics Committee (REC Ref 103/19). Trial registration: ClinicalTrials.gov NCT04262505. Trial registration date: April 2, 2020.</p