•Dropout form exercise interventions is not higher than in the control conditions.•Applying controlled motivation strategies predicts higher dropout.•Supervision by an expert in exercise prescription ...predicts lower dropout.•Applying autonomous motivation strategies predicts lower dropout.
. Exercise has established efficacy in people with anxiety and stress-related disorders. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of the evidence, with dropout rates varying across studies. We conducted a meta-analysis to investigate the prevalence and predictors of dropout rates among adults with anxiety and stress-related disorders participating in exercise RCT's.
. Two authors searched major electronic databases up to 07/2020. We included RCT's of exercise interventions in people with anxiety and stress-related disorders that reported dropout rates. A random effects meta-analysis and meta-regression were conducted.
. Fourteen RCT's involving 16 exercise interventions (n=369, mean age 20.7 to 67.7years; 38.4% male) were included. The trim-and-fill-adjusted prevalence of dropout across all studies was 22.4% (95%CI = 15.0% to 32.0%). Applying controlled motivation strategies (P<0.001) predicted higher dropout. Supervision during all sessions and by an expert in exercise prescription and applying autonomous motivation strategies predicted lower dropout (all P<0.001). Dropout was similar in exercise versus control conditions (OR = 0.84, 95%CI = 0.54 to 1.29, p = 0.42, I2 = 0%; N=16).
. Potentially important moderators of dropout, such as the severity of mental health symptoms and illness duration were insufficiently available.
. Exercise is well tolerated by people with anxiety and stress-related disorders and drop out in RCT's is comparable to control conditions. Thus, exercise is a feasible treatment, in particular when autonomous motivation strategies are included and when the intervention is delivered by healthcare professionals with expertise in exercise prescription.
This study in firefighters aims to explore correlations between physical activity (PA), sedentary levels, PTSD symptoms, psychological distress and well-being. We also compare PTSD symptoms, ...psychological distress and well-being in those who meet the 150 min of moderate-to-vigorous PA per week recommendation versus those who don't. Finally, we compare PA levels in those with PTSD versus without. Self-reported PA and sedentary levels Simple Physical Activity Questionnaire, Physical Activity Vitals Sign, PTSD symptoms (PTSD Checklist for DSM-5, PCL-5), psychological distress (Kessler-6, K-6) and well-being (WHO-5 Well-being index) were collected in 87 firefighters (77 men, age = 43.1 years; SD = 10.3). Spearman Rho correlations were used to explore associations and Mann-Whitney U tests to examine differences between subgroups. Time spent exercising correlated with PTSD symptoms (ρ = −0.220; p = 0.041). Those with significant PTSD symptoms spent less time exercising (U = 102.5; p = 0.018) and more time sedentary (U = 375; p = 0.027). Physically inactive firefighters scored 5.4 points higher on the PCL-5, 1.5 points more on the K-6, and 5.2 points less on the WHO-5. Participants with PTSD (n = 6) were more sedentary (U = 375.0; p = 0.027) and exercised less (U = 102.5; p = 0.018) compared to those without. Physical inactivity and sedentary behavior could be considered in prevention and treatment programs for psychological distress and PTSD in firefighters.
Although motor problems are highly prevalent in children with autism spectrum disorder (ASD), they remain underdiagnosed. Questionnaire-based screening for motor problems could optimize current ...clinical practice. This study aimed to examine the psychometric properties of the developmental coordination disorder questionnaire (DCDQ) to screen for co-occurring motor problems in individuals with ASD (n = 115; aged 5–15 years). Results indicated an excellent internal consistency; concurrent and discriminant validity with the Movement Assessment Battery for Children, second edition. Sensitivity was excellent, but specificity was lower. The positive and negative predictive values indicate that the DCDQ can be used to detect motor problems in children with ASD and can exclude the presence of developmental coordination disorder.
This study explored the association between intelligence and motor skills in children with ASD after controlling for Attention Deficit and Hyperactivity Disorder (ADHD) and the associations between ...motor impairment and intellectual disability (ID) in this population. In total, 120 children with ASD (3–16 years; 81.7% boys) completed a standardized intelligence test, the Movement Assessment Battery for Children and Beery–Buktenica Developmental Test of Visual-Motor Integration. Variance in performance IQ was associated with 20.8% of the variance in motor skills while significant associations were found between comorbid ID and motor impairment (ɸ = 0.304). Manual Dexterity and Balance are moderately influenced by performance IQ in children with ASD. Furthermore, presence of ID is also moderately associated with motor impairment in this population.
•Evidence on the anxiolytic effects of exercise in anxiety and related disorders has grown in recent years.•Exercise has a small effect on reducing anxiety symptoms in anxiety and related ...disorders.•Although the current meta-analytic evidence has less statistical heterogeneity than previously reported, future research still needs to elucidate the moderate levels of heterogeneity in detail.
Exercise as a treatment option for people with mental disorders is a field of growing interest. The increased number of published randomized controlled trials (RCTs) evaluating the effects of exercise in the treatment of anxiety and related disorders in recent years calls for an update of the available meta-analytic evidence. Electronic databases (PubMed, CINAHL, PSYCArticles, and Embase) were searched up to 17.2.2021, for RCTs evaluating the effects of exercise on anxiety and stress symptoms in adults with anxiety and related disorders. A random effects meta-analysis was conducted. A total of 13 RCTs comprising 731 adult participants (exercise n=376; control n=355) were included. Exercise had a small, bordering medium, but statistically significant effect on decreasing anxiety symptoms compared to control condition (standardized mean difference=-0.425, 95%CI -0.67 to -0.17; I2 = 47.9%) in people with anxiety and related disorders. Our meta-analysis updates the existing evidence supporting exercise as an efficacious intervention for anxiety and related disorders. Although the updated meta-analytic evidence is less heterogenous than previously reported, future research is still needed to explore the factors moderating the effects of exercise on outcome such as frequency, intensity, duration of the sessions, and type of exercise and qualification of the provider in more detail.
Background:
Physical inactivity is an important risk factor for chronic mental and physical health conditions in firefighters. It remains unclear why a substantial portion of firefighters do not meet ...the World Health Organization’s physical activity (PA) recommendations. In this cross-sectional study, we explored associations between motivational reasons for being physically active and time spent exercising, walking, and in incidental PA in firefighters. A secondary aim was to investigate differences in motivational reasons between physically active versus physically inactive firefighters.
Methods:
Eighty-seven participants (43.1 ± 10.3 years; 87.6% male) who were recruited via a nonprofit peer support network of fire rescue personnel in Flanders, Belgium, completed the Behavioral Regulation in Exercise Questionnaire 2 (BREQ-2), Simple Physical Activity Questionnaire (SIMPAQ), and the Physical Activity Vital Sign (PAVS) via an online survey.
Findings:
Firefighters who identified the benefits of exercising and/or those who found pleasure or a personal challenge in it exercised more. Those who did not meet the guideline of 150 min of moderate-to-vigorous physical activity per week had much less intrinsic motivation.
Conclusions/Implications for Practice:
This study demonstrates that autonomous motives for PA (i.e., because it is perceived to be consistent with intrinsic goals or outcomes and emanates from the self) are important for an active lifestyle in firefighters. Occupational health professionals can foster autonomous motivation in firefighters by focusing on the benefits of exercise, making sure there are a wide range of exercise options available, and supporting initiatives of firefighters within the fire station.
Mexico is among the countries with the highest estimated excess mortality rates due to the COVID–19 pandemic, with more than half of reported deaths occurring in adults younger than 65 years old. ...Although this behavior is presumably influenced by the young demographics and the high prevalence of metabolic diseases, the underlying mechanisms have not been determined.
The age–stratified case fatality rate (CFR) was estimated in a prospective cohort with 245 hospitalized COVID–19 cases, followed through time, for the period October 2020–September 2021. Cellular and inflammatory parameters were exhaustively investigated in blood samples by laboratory test, multiparametric flow cytometry and multiplex immunoassays.
The CFR was 35.51%, with 55.2% of deaths recorded in middle–aged adults. On admission, hematological cell differentiation, physiological stress and inflammation parameters, showed distinctive profiles of potential prognostic value in patients under 65 at 7 days follow–up.
Pre–existing metabolic conditions were identified as risk factors of poor outcomes. Chronic kidney disease (CKD), as single comorbidity or in combination with diabetes, had the highest risk for COVID–19 fatality. Of note, fatal outcomes in middle–aged patients were marked from admission by an inflammatory landscape and emergency myeloid hematopoiesis at the expense of functional lymphoid innate cells for antiviral immunosurveillance, including NK and dendritic cell subsets.
Comorbidities increased the development of imbalanced myeloid phenotype, rendering middle–aged individuals unable to effectively control SARS–CoV–2. A predictive signature of high–risk outcomes at day 7 of disease evolution as a tool for their early stratification in vulnerable populations is proposed.
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