ABSTRACT

Background

Exercise referral schemes (ERSs) can increase physical activity participation and improve health outcomes associated with chronic disease. The success of these programs relies heavily on the active involvement of health care professionals to make referrals. In this study, we explore the barriers and facilitators that influence health care professionals’ promotion of physical activity and ERSs in New South Wales (NSW), Australia.

Methods

Participants were recruited through Live Life Get Active, an existing, free ERS and health promotion charity. Semistructured interviews were conducted with 8 health care professionals. Data were analyzed using deductive and exploratory thematic analysis.

Results

Participants described their attitudes toward physical activity promotion via ERSs and barriers and facilitators to recommending physical activity programs. All participants described the importance of tailoring physical activity recommendations to their patients’ health needs, lifestyles, and preferences. While participants understood the value of ERSs, they faced consultation time constraints, limited awareness of available programs, and the need to prioritize alternative treatments for health conditions. However, participants reported their own and patients’ positive experiences with physical activity, good physical activity literacy, and a clear understanding of the potential advantages for patients were catalysts for referrals. A streamlined referral process to free programs with social components was preferred.

Conclusion

Identified barriers to health care professionals promoting ERSs highlight the need for increased knowledge of available ERSs and physical activity programs and improved referral pathways. The findings support a focus on increasing professionals’ knowledge about exercise and reducing the gap between knowledge and action by increasing ease of exercise referral.

ABSTRACT

Background

Adults with Down syndrome (DS) have more cardiovascular disease risk factors but lower arterial stiffness than adults without DS. We investigated differences in cardiovascular disease risk factors and whether risk factors predict arterial stiffness in adults with and without DS.

Methods

Forty adults with DS and 50 without DS participated in this study. We measured body mass index (BMI), waist circumference (WC), blood pressure (BP), moderate to vigorous physical activity (MVPA) with accelerometry, and arterial stiffness with carotid-femoral pulse wave velocity (CF-PWV).

Results

Adults with DS had higher WC, BMI, and MVPA, and lower CF-PWV than those without DS (P ≤ 0.004). No significant differences were found between groups for age (P = 0.187), weight (P = 0.336), BP (P = 0.335), and total risk factors (P = 0.463). Age (P < 0.001, R² change = 0.33), DS (P < 0.001, R² change = 0.17), and WC (P = 0.003, R² change = 0.06) contributed to the prediction model for CF-PWV (R² = 0.56, P < 0.001) for the entire sample of adults with and without DS. Only age predicted CF-PWV in adults with DS (P < 0.001; R² = 0.36), whereas age (P < 0.001, R² change = 0.52) and BMI (P = 0.002, R² change = 0.11) predicted CF-PWV (R² = 0.63, P < 0.001) in adults without DS.

Conclusion

Adults with and without DS had similar average numbers of cardiovascular disease risk factors; however, adults with DS had a greater percentage of risk factors for obesity than adults without DS. Age may contribute to arterial stiffness in adults with and without DS. Increased levels of obesity do not appear to be associated with arterial health in adults with DS.

ABSTRACT

Background

A subset of adult patients with heart failure symptoms and normal left ventricular systolic function have primary left ventricular diastolic dysfunction with elevated filling pressure. Noninvasive diastolic stress testing (NDST) has been used in adults to reveal left ventricular diastolic dysfunction during exercise. Given limited data in young individuals, we assessed the feasibility and reliability of NDST in a diverse sample of 10- to 21-year-olds.

Methods

Twenty-two participants with a normal cardiac evaluation from our Le Bonheur Children’s Hospital Heart Institute outpatient center were recruited for the study protocol. After consent and screening, 1 study participant was ineligible (obesity), leaving 21 patients. Baseline echocardiograms were performed at rest and as part of a graduated exercise stress test at 10, 20, and 30 W using a semirecumbent cycle ergometer. Conventional exercise data, baseline echocardiogram data, and left ventricular diastolic parameters were obtained. Left ventricular diastolic parameters were measured during each exercise stage and at 5- and 10-minute recovery. Two blinded readers (pediatric cardiologists) reviewed the echocardiograms to determine interobserver variability.

Results

Mean age and body mass index were 15.3 ± 3 years and 21.2 ± 3.1 kg^·m⁻², respectively. There was 81% agreement between readers with a Cohen κ coefficient of 0.44 (moderate agreement). The mitral E/e′ remained normal during exercise and recovery.

Conclusion

NDST is a feasible and reliable technique in a diverse sample in the 10- to 21-year-old age range.

BACKGROUND

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that affects the body’s ability to produce insulin, leading to hyperglycemia (1). Managing blood glucose levels is crucial for individuals with T1DM to prevent hypoglycemia, hyperglycemia, and other related complications. There are multiple benefits of exercise in patients with T1DM, including increased insulin sensitivity, improved glucose uptake by muscles, and counteracting after-meal hyperglycemia. Exercise in these patients also helps control weight, lowers blood pressure, improves cholesterol levels, and strengthens muscles and bones. To optimize blood glucose control during exercise, athletes with T1DM must be aware of factors

Cardiovascular Disease Risk Factors and Arterial Health in Adults With Down Syndrome

Brantley K. BallengerPhD, ACSM-CEP,

Stanley P. BrownPhD,

Bo FernhallPhD,

Robert W. MotlPhD, and

Stamatis AgiovlasitisPhD, ACSM-CEP

Farewell, but Not Goodbye

Health Care Professionals’ Promotion of Exercise Referral Schemes in New South Wales

ABSTRACT

Background

Methods

Results

Conclusion

Cardiovascular Disease Risk Factors and Arterial Health in Adults With Down Syndrome

ABSTRACT

Background

Methods

Results

Conclusion

Feasibility of Noninvasive Diastolic Stress Testing in the 10- to 21-Year-Old Age Group

ABSTRACT

Background

Methods

Results

Conclusion

Enrolling Patients With Claudication into Supervised Exercise Therapy: A Single-Center Experience

INTRODUCTION

Management of Type 1 Diabetes in an Elite Endurance Athlete

BACKGROUND

Cardiovascular Disease Risk Factors and Arterial Health in Adults With Down Syndrome

Health Care Professionals’ Promotion of Exercise Referral Schemes in New South Wales

Enrolling Patients With Claudication into Supervised Exercise Therapy: A Single-Center Experience

Farewell, but Not Goodbye

Feasibility of Noninvasive Diastolic Stress Testing in the 10- to 21-Year-Old Age Group