The purpose of this study was to determine the effect of commuter cycling on physical performance. Eighty-seven male and 35 female employees volunteered to cycle regularly to their work.
Sixty-one ...participants went commuter cycling for 1 yr (cycling group); the others cycled only in the second half year (control group). A maximal exercise test on a cycle ergometer was carried out at the start of the study, after 6 months, and after 1 yr to measure maximal external power (Wmax) and maximal oxygen uptake (VO2max).
After the first 6 months of commuter cycling, with a mean single trip distance of 8.5 km and a mean frequency of more than three times a week, a significant increase of 13% was found in the Wmax per kilogram body weight (Wmax x kg(-1)) in both sexes of the cycling group. The improvement in VO2max x kg(-1) was significant for the male participants (6%) but not for the female participants (-2%). At the end of the second half year, the control group also showed a mean gain in Wmax x kg(-1) of 13%. Their VO2max x kg(-1) declined in the first half year, but this was counteracted in the second half year. A dose-response relationship was found between two independent variables and the physical performance; the lower the physical performance at the start of the study and the higher the total amount of kilometers cycled, the higher the gain in Wmax. For subjects with a low initial fitness level, a single trip distance of only 3 km turned out to be enough to improve physical performance.
Commuter cycling can yield much the same improvement in physical performance as specific training programs.
The purpose of this study was to examine the effect of intermittent training in a hypobaric chamber on physical exercise at sea level. Over a 10 day period, 16 male triathletes trained for 2 h each ...day on a cycle ergometer placed in a hypobaric chamber. Training intensity was at 60%-70% of the heart rate reserve. There were 8 subjects who trained at a simulated altitude of 2,500 m, the other 8 trained at sea level. A year later, a cross-over study took place. Baseline measurements were made on a cycle ergometer at sea level, which included an incremental test until exhaustion and a Wingate Anaerobic Test. Altogether, 12 subjects completed the cross-over study. At 9 days after training in hypoxia, significant increases were seen in maximal power output (.W(max))(5.2%), anaerobic mean power (4.1%), and anaerobic peak power (3.8%). A non-significant increase in maximal oxygen uptake (.VO(2max)) of 1.9% was observed. At 9 days after training at sea level, no significant changes were seen in .W(max)(2.1%), .VO(2max) (2.0%), anaerobic mean power (0.2%) and anaerobic peak power (0.2%). When comparing the results of the two training regimes, the anaerobic mean power was the only variable that showed a significantly larger increase as a result of training at altitude. And, although the differences in percentage change between the two training protocols were not significant, they were substantial for as well as for anaerobic peak power. The results of this study indicate that intermittent hypobaric training can improve the anaerobic energy supplying system, and also, to a lesser extent, the aerobic system. It can be concluded that the overall results of the cross-over study showed predominantly improvements in the anaerobic metabolism at variance with the previous study of our own group, where the relative .VO(2max) and .W(max) increased by 7%.
Patients hospitalised with severe mental illness (SMI) have poor physical health. Recently, a multidisciplinary lifestyle enhancing treatment for inpatients with SMI (MULTI) was implemented after ...which improvements of physical health were observed in the longer term. As part of a comprehensive evaluation of MULTI, we aimed to additionally analyse changes in perceived psychosocial functioning and quality of life after 18 months of MULTI compared to treatment as usual (TAU). Furthermore, we explored whether increased physical activity mediated significant changes. In this observational study, we collected data on psychosocial functioning (HoNOS) and quality of life (EQ-5D and WHOQoL-Bref) within our cohort of inpatients with SMI. This was supplemented by repeated physical activity measurement (ActiGraph GT3X+). Data were analysed using linear multilevel regression, adjusting for baseline values of outcome and differences between groups. Patients receiving MULTI (n = 65) showed significantly improved functioning on sum score and subscales for impairment and social functioning compared to TAU (n = 47). Quality of life improved within MULTI but did not differ significantly from TAU. Changes in total activity did not mediate improvements in psychosocial functioning, suggesting that multiple components of MULTI contribute to these improvements. In addition to previously observed improvement of physical health, MULTI showed to be a feasible treatment to sustainably improve psychosocial functioning compared to TAU and increase the quality of life in inpatients with SMI.
•Evaluates a multidisciplinary lifestyle approach integrated into daily treatment.•Improved psychosocial functioning after 18 months compared to usual treatment.•Change in psychosocial functioning was not mediated by increased physical activity.•Quality of life improved but did not significantly differ from usual treatment.
Many women suffer from health problems after giving birth, which can lead to sick leave. About 30% of Dutch workers are on sick leave after maternity leave. Structural contact of supervisors with ...employees on maternity leave, supported by early medical advice of occupational physicians, may increase the chances of return-to-work after maternity leave. In addition, to understand the process of sick leave and return-to-work after childbirth it is important to gain insight into which factors hinder return-to-work after childbirth, as well, as which prognostic factors lead to the development of postpartum health complaints. In this paper, the design of the Mom@Work study is described.
The Mom@Work study is simultaneously a randomised controlled trial and a cohort study. Pregnant women working for at least 12 hours a week at one of the 15 participating companies are eligible to participate. The supervisors of these pregnant employees are randomised at 35 weeks pregnancy into the intervention group or control group. During maternity leave, supervisors in the intervention group contact their employee six weeks after delivery using a structured interview. When employees do not expect to return to their jobs at the end of their scheduled maternity leave due to health problems, the supervisor offers early support of the occupational physician. Supervisors in the control group have no structural contact with their employees during maternity leave. Measurements take place at 30 weeks pregnancy and at 6, 12, 24 and 52 weeks postpartum. In addition, cost data are collected. For the RCT, primary outcome measures are sick leave and return-to-work, and secondary outcome measures are costs, health, satisfaction with intervention and global feelings of recovery. Outcome measures for the cohort are pregnancy-related pelvic girdle pain, fatigue and depression. Finally, a number of prognostic factors for return-to-work and for the development of complaints will be measured.
The Mom@Work study will provide important information about return-to-work of employees after giving birth. Results will give insight in prognosis of postpartum sick leave and complaints. Also, the role of supervisors and occupational physicians in successful return-to-work after childbirth will be clarified.
Abstract
Economic evaluations of lifestyle interventions for people with mental illness are needed to inform policymakers and managers about implementing such interventions and corresponding reforms ...in routine mental healthcare. We aimed to evaluate changes in healthcare costs 18 months after the implementation of a multidisciplinary lifestyle-enhancing treatment for inpatients with severe mental illness (MULTI) versus treatment as usual (TAU). In a cohort study (n = 114; 65 MULTI, 49 TAU), we retrospectively retrieved cost data in Euros on all patient sessions, ward stay, medication use, and hospital referrals in the quarter year at the start of MULTI (Q1 2014) and after its evaluation (Q3 2015). We used linear regression analyses correcting for baseline values and differences between groups, calculated deterministic incremental cost-effectiveness ratios for previously shown changes in physical activity, metabolic health, psychosocial functioning, and additionally quality of life, and performed probabilistic sensitivity analyses including cost-effectiveness planes. Adjusted regression showed reduced total costs per patient per quarter year in favor of MULTI (B = –736.30, 95%CI: –2145.2 to 672.6). Corresponding probabilistic sensitivity analyses accounting for uncertainty surrounding the parameters showed statistically non-significant cost savings against health improvements for all health-related outcomes in MULTI compared to TAU. It is concluded that MULTI did not increase healthcare costs while improving health outcomes. This indicates that starting lifestyle interventions does not need to be hampered by costs. Potential societal and economic value may justify investment to support implementation and maintenance. Further research is needed to study this hypothesis.
To address major societal challenges and enhance cooperation in research across Europe, the European Commission has initiated and facilitated ‘joint programming’. Joint programming is a process by ...which Member States engage in defining, developing and implementing a common strategic research agenda, based on a shared vision of how to address major societal challenges that no Member State is capable of resolving independently. Setting up a Joint Programming Initiative (JPI) should also contribute to avoiding unnecessary overlap and repetition of research, and enable and enhance the development and use of standardised research methods, procedures and data management. The Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub (KH) is the first act of the European JPI ‘A Healthy Diet for a Healthy Life’. The objective of DEDIPAC is to contribute to improving understanding of the determinants of dietary, physical activity and sedentary behaviours. DEDIPAC KH is a multi-disciplinary consortium of 46 consortia and organisations supported by joint programming grants from 12 countries across Europe. The work is divided into three thematic areas: (I) assessment and harmonisation of methods for future research, surveillance and monitoring, and for evaluation of interventions and policies; (II) determinants of dietary, physical activity and sedentary behaviours across the life course and in vulnerable groups; and (III) evaluation and benchmarking of public health and policy interventions aimed at improving dietary, physical activity and sedentary behaviours. In the first three years, DEDIPAC KH will organise, develop, share and harmonise expertise, methods, measures, data and other infrastructure. This should further European research and improve the broad multi-disciplinary approach needed to study the interactions between multilevel determinants in influencing dietary, physical activity and sedentary behaviours. Insights will be translated into more effective interventions and policies for the promotion of healthier behaviours and more effective monitoring and evaluation of the impacts of such interventions.
The goal of this study was to investigate to what extent intermittent exposure to altitude in a hypobaric chamber can improve performance at sea-level. Over a 10-day period, elite male triathletes ...trained for 2 h each day on a cycle ergometer placed in a hypobaric chamber. Training intensity was 60-70% of the heart rate reserve. Eight subjects trained at a simulated altitude of 2.500 m (hypoxia group), the other eight remained at sea-level (sea-level group). Baseline measurements were done on a cycle ergometer at sea-level, which included an incremental test until exhaustion and a Wingate Anaerobic Test. Nine days after training in hypoxia, significant increases were seen in all important parameters of the maximal aerobic as well as the anaerobic test. A significant increase of 7.0% was seen in the mean maximal oxygen uptake per kilogram body weight (VO2max), and the mean maximal power output per kilogram body weight (Wmax) increased significantly by 7.4%. The mean values of both mean power per kilogram body weight and peak power per kilogram body weight increased significantly by 5.0%, and the time-to-peak decreased significantly by 37.7%. In the sea-level group, no significant changes were seen in the abovementioned parameters of both the maximal aerobic and the maximal anaerobic test at the second post-test. The results of this study indicate that intermittent hypobaric training can improve both the aerobic and the anaerobic energy-supply systems.
Background
ADappt is a Web‐based toolkit (www.ADappt.health) to support personalized communication and prediction in memory clinics. In the context of an iterative development process with ...professionals, patients, and care partners, we assessed feasibility, satisfaction, and usability of ADappt in the clinical workflow.
Method
We conducted a feasibility pilot in four Dutch memory clinics. Three neurologists, one geriatrician, two specialized nurses and two medical doctors (12±7y clinical experience) participated and recruited 21 patients (69±8yrs, 19%F) and 21 care partners (60±15yrs, 81%F). For professionals, ADappt‐modules comprised a 1) topic list, 2) shared decision‐making conversation guide, 3) overview of diagnostic tests, and 4) risk calculation tool. Prior to their visit, patients and care partners were informed about ADappt‐patient tools: 1) educational video‐animations, and 2) question prompt list. All participants completed questionnaires on feasibility, satisfaction, and usability after the first (n = 17) and/or the disclosure (n = 7) consultation. Professionals were interviewed afterward.
Result
Professionals reported good usability (68±14, range 50‐83, System Usability Scale, 0‐100) and high satisfaction (71±10, range 50‐85, scale 0‐100). They most often used the overview of diagnostic tests (67%) and reported this module as most helpful (3.8±0.4, range 3‐4, scale 1‐5). Patients and care partners were highly satisfied with the clinician‐patient consultations in general (81±14, range 50‐100, Patient Satisfaction Questionnaire, scale 0‐100). Of those who reported to know and have used the patient tools (54%), 97% would recommend them, whereby most used the question prompt list (84%) and a smaller proportion the video‐animations (64%). Recommendations from the interviews to improve feasibility include: 1) the development of more concrete instructions for professionals on how to use ADappt, and 2) a better alignment of patient tools with the patient journey and general information provided by that particular memory clinic.
Conclusion
Stakeholders reported good usability and high satisfaction regarding ADappt. Points of attention to foster feasibility in the clinical workflow are: 1) improved training for professionals and 2) improving the accessibility of patient tools. We take these matters into account while preparing for the next step: a prospective validation study in the memory clinic setting to study the influence of ADappt on patient satisfaction.
Objective To investigate the effectiveness of a worksite social and physical environment intervention on need for recovery (i.e., early symptoms of work-related mental and physical fatigue), physical ...activity and relaxation. Also, the effectiveness of the separate interventions was investigated. Methods In this 22 factorial design study, 412 office employees from a financial service provider participated. Participants were allocated to the combined social and physical intervention, to the social intervention only, to the physical intervention only or to the control group. The primary outcome measure was need for recovery. Secondary outcomes were work-related stress (i.e., exhaustion, detachment and relaxation), small breaks, physical activity (i.e., stair climbing, active commuting, sport activities, light/moderate/vigorous physical activity) and sedentary behavior. Outcomes were measured by questionnaires at baseline, 6 and 12 months follow-up. Multilevel analyses were performed to investigate the effects of the three interventions. Results In all intervention groups, a non-significant reduction was found in need for recovery. In the combined intervention (n = 92), exhaustion and vigorous physical activities decreased significantly, and small breaks at work and active commuting increased significantly compared to the control group. The social intervention (n = 118) showed a significant reduction in exhaustion, sedentary behavior at work and a significant increase in small breaks at work and leisure activities. In the physical intervention (n = 96), stair climbing at work and active commuting significantly increased, and sedentary behavior at work decreased significantly compared to the control group. Conclusion None of the interventions was effective in improving the need for recovery. It is recommended to implement the social and physical intervention among a population with higher baseline values of need for recovery. Furthermore, the intervention itself could be improved by increasing the intensity of the intervention (for example weekly GMI-sessions), providing physical activity opportunities and exercise schemes, and by more drastic environment interventions (restructuring entire department floor). Trial Registration Nederlands Trial Register NTR2553
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