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Introduction
Hip and knee osteoarthritis are associated with functional limitations, pain and restrictions in quality of life and the ability to work. Furthermore, with growing prevalence, osteoarthritis is increasingly causing (in)direct costs. Guidelines recommend exercise therapy and education as primary treatment strategies. Available options for treatment based on physical activity promotion and lifestyle change are often insufficiently provided and used. In addition, the quality of current exercise programmes often does not meet the changing care needs of older people with comorbidities and exercise adherence is a challenge beyond personal physiotherapy. The main objective of this study is to investigate the short- and long-term (cost-)effectiveness of the SmArt-E programme in people with hip and/or knee osteoarthritis in terms of pain and physical functioning compared to usual care.
Methods
This study is designed as a multicentre randomized controlled trial with a target sample size of 330 patients. The intervention is based on the e-Exercise intervention from the Netherlands, consists of a training and education programme and is conducted as a blended care intervention over 12 months. We use an app to support independent training and the development of self-management skills. The primary and secondary hypotheses are that participants in the SmArt-E intervention will have less pain (numerical rating scale) and better physical functioning (Hip Disability and Osteoarthritis Outcome Score, Knee Injury and Osteoarthritis Outcome Score) compared to participants in the usual care group after 12 and 3 months. Other secondary outcomes are based on domains of the Osteoarthritis Research Society International (OARSI). The study will be accompanied by a process evaluation.
Discussion
After a positive evaluation, SmArt-E can be offered in usual care, flexibly addressing different care situations. The desired sustainability and the support of the participants’ behavioural change are initiated via the app through audio-visual contact with their physiotherapists. Furthermore, the app supports the repetition and consolidation of learned training and educational content. For people with osteoarthritis, the new form of care with proven effectiveness can lead to a reduction in underuse and misuse of care as well as contribute to a reduction in (in)direct costs.
Trial registration
German Clinical Trials Register, DRKS00028477. Registered on August 10, 2022.
This study explores the intriguing relationship between personality traits, self-rated fitness (SRF), and physical activity (PA) variables among German university students (N = 4244) and sheds light on the impact of personality on adherence to PA guidelines. Employing an online cross-sectional study, the short-form of the Big Five Inventory-2 assessed five domains of personality traits (Extraversion, Negative Emotionality, Agreeableness, conscientiousness, and Open-Mindedness). PA, including sitting time, was assessed using the International Physical Activity Questionnaire (short-form). SRF and muscle-strengthening activities (MSA) were assessed with one item each. Multiple linear and logistic regression analyses examined associations of individual personality trait domains and all domains combined with SFR, PA variables, and adherence to PA guidelines, controlling for sociodemographic, behavioral, and (mental) health covariates. Most reliably, Extraversion and Conscientiousness revealed positive associations with PA variables, while Negative Emotionality yielded inverse relationships with PA variables. For instance, each unit increase in Extraversion corresponded to an additional 17 min of weekly MSA. On the contrary, daily sitting time was unrelated to personality. Of note, high Open-Mindedness was associated with lower odds for adhering to current PA guidelines. The findings have implications for developing targeted interventions that promote a physically active lifestyle and support students’ well-being and academic success.
University students frequently engage in unhealthy behaviors. However, there is a lack of studies examining a wide range of their lifestyle characteristics by sex and academic level of study. This cross-sectional survey of students enrolled in BSc, MSc, or PhD programs at one university in Germany (N = 3389) assessed physical activity (PA), sedentary behavior (SB), nutrition, sleep quality, and alcohol, tobacco, and other drug (ATOD) use by sex and academic level and was conducted with EvaSys version 8.0. Chi-squared tests compared categorical variables by sex, and binary logistic regression analyses adjusted for sex with Bonferroni adjustments evaluated differences across academic level. Although 91% of students achieved the aerobic PA guidelines, only 30% achieved the muscle strengthening exercises (MSE) guidelines, and 44% had high SB. Likewise, <10% met the fruit and vegetable consumption (FVC) recommendations, >40% of students experienced impaired sleep, and >30% had hazardous alcohol consumption. Less than 20% of the sample achieved the guideline/recommendation of all three PA, MSE and SB. Some behaviors exhibited significant sex and academic level differences. The identified at-risk groups included males (lower FVC), females (eating more during stress), and BSc students (poorer nutrition/sleep quality, more ATOD use). Given the above findings, multipronged strategies are needed with an overarching focus highlighting the health–academic achievement links. Behavioral interventions and environmental policies are required to raise awareness and promote student health.
Beach handball is a young discipline that is characterized by numerous high-intensity actions. By following up on previous work, the objective was to perform in-depth analyses evaluating external load (e.g., distance traveled, velocity, changes in direction, etc.) in beach handball players. In cross-sectional analyses, data of 69 players belonging to the German national or prospective team were analyzed during official tournaments using a local positioning system (10 Hz) and inertial measurement units (100 Hz). Statistical analyses comprised the comparison of the first and second set and the effects of age and sex (female adolescents vs. male adolescents vs. male adults) and playing position (goalkeepers, defenders, wings, specialists, and pivots) on external load measures. We found evidence for reduced external workload during the second set of the matches (p = 0.005, ηp2 = 0.09), as indicated by a significantly lower player load per minute and number of changes in direction. Age/sex (p < 0.001, ηp2 = 0.22) and playing position (p < 0.001, ηp2 = 0.29) also had significant effects on external load. The present data comprehensively describe and analyze important external load measures in a sample of high-performing beach handball players, providing valuable information to practitioners and coaches aiming at improving athletic performance in this new sport.
Studien haben wiederholt auf eine hohe Beschwerdelast Studierender hingewiesen und Hochschulen veranlasst, sich zunehmend im studentischen Gesundheitsmanagement zu engagieren, das darauf abzielt, gesundheitsfördernde Strukturen zu entwickeln sowie individuelle Ressourcen im Setting Hochschule zu fördern. Die körperliche Aktivität und mentale Gesundheit Studierender stellen hierfür Ansatzpunkte dar. International zeigen sich eindeutige Zusammenhänge zwischen dem Bewegungsverhalten Studierender und der psychischen Gesundheit, jedoch liegen bisher nur wenige nationale Erhebungen vor, was die Übertragbarkeit auf die deutsche Hochschullandschaft einschränkt. Dieser Beitrag untersucht, wie in dieser Zielgruppe die aktuellen Bewegungsempfehlungen, bestehend aus den Kategorien ausdauerorientierte körperliche Aktivitäten, Sitzzeiten und muskelkräftigende Aktivitäten, mit verschiedenen Indikatoren mentaler Gesundheit zusammenhängen.
Im Sommersemester 2019 nahmen 4.244 Studierende an einer hochschulweiten Umfrage teil. Neben dem Bewegungsverhalten wurden das Stresserleben erhoben und Screenings auf Kernelemente einer depressiven und angstbezogenen Störung sowie auf eine psychische Belastung durchgeführt. Positive Aspekte mentaler Gesundheit wurden über eine Skala zur Beurteilung studentischen Engagements erfasst. Als Assoziationsmaß wurden adjustierte Odds Ratios unter Berücksichtigung soziodemografischer und behavioraler Störvariablen berechnet.
Sämtliche Kriterien der Bewegungsempfehlungen werden von 9,6% der Studierenden erreicht. 48% der Befragten weisen ein hohes Stresserleben auf und 29% gelten als psychisch belastet. Das Befolgen aller Kriterien der Bewegungsempfehlungen ist mit signifikant geringeren Chancen für psychische Belastungsindikatoren assoziiert, wobei der stärkste Zusammenhang für depressive Symptome gefunden wurde. Studentisches Engagement war nicht signifikant mit dem Erreichen der Bewegungsempfehlungen assoziiert.
Die Ergebnisse bestätigen die hohe psychische Belastung Studierender und deuten das Optimierungspotenzial aus Sicht der Bewegungsförderung an. Hochschulen sollten die Studienbedingungen und das Gesundheitsverhalten der Studierenden systematisch und fortlaufend analysieren, um geeignete verhaltens- und verhältnisorientierte Maßnahmen wie bewegungsorientierte Lehre, Campusentwicklung und Ausbau des Hochschulsportangebots abzuleiten und zu evaluieren.