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Introduction: Head and neck cancer is considered a global public health problem, which arises in aesthetically and functionally critical areas. The practice of physical exercise has been considered one of the significant and effective non-pharmacological strategies to minimize the physical and psychological consequences. Objective: To analyze the evidence of physical activity interventions in the physical and psychological health of individuals with head and neck cancer. Method: A systematic review was conducted blindly and independently, from March to May 2021, according to the PRISMA guidelines. The search was performed in the following databases: PubMed Central®; Cochrane Library; Web of Science, Scopus, ScienceDirect. Results: Of the 515 selected studies, 15 were included in this systematic review with a total of 670 participants aged between 18 and 76 years old. The studies included aerobic exercises, endurance, mobility, stretching, strengthening, and yoga. Conclusion: Evidence proves that physical activity interventions performed with individuals with head and neck cancer may be beneficial in the treatment and physical/psychological health of this population. This study may help new researches considering the detailed information described previously regarding the interventions applied, in addition to discussing the most used instruments with this public and indicating the modalities that are being safely performed. It is suggested that more randomized trials be conducted to obtain more concise results. Introducción: El cáncer de cabeza y cuello es considerado un problema de salud pública a nivel mundial que se presenta en áreas estética y funcionalmente críticas. La práctica de ejercicio físico ha sido considerada una de las estrategias no farmacológicas significativas y eficaces para minimizar las consecuencias físicas y psíquicas. Objetivo: Analizar la evidencia de intervenciones de actividad física sobre la salud física y psicológica de individuos con cáncer de cabeza y cuello. Método: Revisión sistemática ciega e independiente de marzo a mayo de 2021, según las guías PRISMA. La búsqueda se realizó en las siguientes bases de datos: PubMed Central®; Biblioteca Cochrane; Web of Science, Scopus, ScienceDirect. Resultados: Entre los 515 estudios seleccionados, 15 fueron incluidos en esta revisión sistemática con un total de 670 participantes con edades entre 18 y 76 años. Los estudios incluyeron ejercicio aeróbico, resistencia, movilidad, estiramiento, fortalecimiento y yoga. Conclusión: La evidencia demuestra que las intervenciones de actividad física realizadas con individuos con cáncer de cabeza y cuello pueden ser beneficiosas en el tratamiento y la salud física/psicológica de esta población. Este estudio puede ayudar a futuras investigaciones considerando la información detallada descrita anteriormente sobre las intervenciones aplicadas, además de discutir los instrumentos más utilizados con esta audiencia e indicar las modalidades que se están realizando de forma segura. Se sugieren más ensayos aleatorios para obtener resultados más concisos. Introdução: O câncer de cabeça e pescoço é considerado um problema de saúde pública mundial, que surge em áreas cosmeticamente e funcionalmente críticas. A prática de exercício físico está sendo considerada uma das estratégias não farmacológicas significativas e eficazes a fim de minimizar as consequências físicas e psicológicas. Objetivo: Analisar as evidências de intervenções de atividade física na saúde física e psicológica de indivíduos com câncer de cabeça e pescoço. Método: Revisão sistemática de forma cega e independente, de março a maio de 2021, de acordo com as diretrizes PRISMA. A busca foi realizada nas seguintes bases de dados: PubMed Central®; Biblioteca Cochrane; Web of Science, Scopus, ScienceDirect. Resultados: Entre os 515 estudos selecionados, 15 foram incluídos nesta revisão sistemática com um total de 670 participantes com idade entre 18 e 76 anos. Os estudos incluíram exercícios aeróbicos, resistência, mobilidade, alongamento, fortalecimento e ioga. Conclusão: Evidências comprovam que intervenções de atividade física realizadas com indivíduos com câncer de cabeça e pescoço podem ser benéficas no tratamento e na saúde física/psicológica dessa população. Este estudo pode auxiliar em novas pesquisas considerando as informações detalhadas descritas anteriormente sobre as intervenções aplicadas, além de discutir os instrumentos mais utilizados com esse público e indicar as modalidades que estão sendo realizadas com segurança. Sugere-se a realização de mais ensaios randomizados para obter resultados mais concisos.

PURPOSE: Older patients with cancer are underrepresented in exercise-based trials. To engage older patients in physical activity (PA), it is necessary to consider age-related decline in health, comorbidities and practicalities. The study aim was to explore attitudes towards PA and exercise among older patients with cancer to inform future exercise-based interventions.METHOD: Individual interviews (N = 23) were conducted in patients ≥ 65 years with advanced lung, biliary tract and pancreatic cancer receiving palliative oncological treatment. Patients were recruited with a purposive sampling strategy. A semi-structured interview guide focusing on attitudes towards PA and exercise, including barriers, facilitators and motivators, was used. Data on the informants' medical history, demographics and PA level was collected.RESULTS: Identified themes were: 1) a general positive perception of physical activity is expressed 2) comorbidities and external circumstances prevent physical activity, 3) fatigue overshadows life, 4) social support is key to short and long-term motivation, 5) fixed conditions keep one focused, 6) familiarity raises confidence and motivation.CONCLUSIONS: Even though perceptions of PA were positive among older patients with cancer, most struggled to stay physically active during oncological treatment. Several factors related to cancer and aging were identified as barriers; most profoundly was the overwhelming feeling of fatigue. Improving physical and mental well-being, fixed conditions (e.g. group-based exercise and supervision) and social support were identified as motivators and facilitators. Preferences for PA varied, but activities that were familiar increased motivation. Exercise programs for older patients with cancer must be adjustable to each patient's limitations, needs and personal resources.

Objective Factors influencing engagement with self-managed rehabilitation are not well understood, but evidence suggests they may change over time. Despite increasing digitalisation of self-managed interventions, little is known about the role of internet-based interventions in patients’ experiences of self-directed rehabilitation. This longitudinal qualitative study investigated individuals’ on-going experiences of internet-guided, self-managed rehabilitation within the context of rehabilitation for dizziness. Methods Eighteen adults aged fifty and over who experienced dizziness used the ‘Balance Retraining’ internet intervention for six weeks. Participants took part in semi-structured telephone interviews at two week intervals to explore their experiences. Data were inductively thematically analysed. Results The internet intervention was reported to facilitate engagement with rehabilitation exercises, providing motivation to continue through symptom reduction and simple but helpful strategies. It was perceived as informative, reassuring, visually pleasing and easy to use. Barriers to engagement included practicalities, symptoms, and doubts about exercise efficacy. Participants’ perceptions did not always remain consistent over time. Conclusion The internet intervention may be a feasible method of supporting self-managed vestibular rehabilitation. More generally, longitudinal findings suggest that appearance-related perceptions of online interventions may be especially important for initial engagement. Furthermore, intervention features targeting self-efficacy seem important in overcoming barriers to engagement.

Background Patient perceptions may influence the effectiveness and utilization of healthcare interventions, particularly for complex health conditions such as sciatica or back-related leg pain (BRLP). Objectives To explore BRLP patients' perceptions of spinal manipulative therapy (SMT) and home exercise with advice (HEA). Design Qualitative study in a controlled clinical trial. Method Semi-structured interviews conducted after 12 weeks of treatment asked participants about satisfaction with care and whether treatment was worthwhile. An interdisciplinary research team conducted content analysis using qualitative data analysis software to identify and summarize themes. Results Of 192 trial participants, 174 (91%) completed interviews (66% female, age 57.0 ± 11.5 years). Participants identified interactions with providers and staff, perceived treatment effects, and information as key contributors to both their satisfaction and the worthwhile nature of treatment. HEA was liked for its convenience and ability to foster an exercise habit. SMT was liked for specific aspects of the modality (e.g. manipulation, stretching) and provider competency. Most participants reported no dislikes for SMT or HEA, but some noted the dose/time commitment for SMT and discipline of HEA as least liked aspects of the interventions. Conclusions The quality of patient–provider interactions, perceived treatment effects, and information sharing influenced BRLP patients' satisfaction with care. Qualitative research describing patients' preferences can facilitate translation of study findings into practice and allow clinicians to tailor treatments to facilitate compliance and satisfaction with care.

Background Polycystic ovary syndrome (PCOS) is often associated with an increased waist circumference and with lower cardio-respiratory fitness as a consequence of obesity, which may be improved by physical activity. Objective To investigate the effect of high-intensity aerobic training combined with group counselling sessions on anthropometry and cardio-respiratory fitness in women with PCOS. Design Seventeen sedentary, overweight women with PCOS were randomized in a cross-over design to 16 weeks of intervention: eight weeks high-intensity aerobic exercise was followed by eight weeks of group counselling (n = 8) or vice versa (n = 9). Fourteen of the women completed the tests. Main outcome measures Waist circumference, body mass index and maximal aerobic capacity (VO 2max) were measured at baseline, cross-over and post-intervention. Results There was a decrease in waist circumference (119.9 vs. 106.5 cm) and body mass index (34.9 vs. 34.4 kg/m 2) and an increase in VO 2max (2554.9 vs. 2807.9 mL/min) during the intervention period (t = 16 weeks, n = 14), all p < 0.05. Weight loss tended to be highest in the group which started with group counselling (2.9 vs. 0.6 kg, t = 16 weeks, n = 14, p = 0.055). Conclusion Exercise in groups followed by counselling or vice versa had beneficial effects on waist circumference, weight, and VO 2max in women with PCOS. Future studies should examine possible beneficial effects of combined group counselling and exercise on weight loss and adherence to exercise protocols among women with PCOS.

BACKGROUND: Studies of physical exercise in patients with Alzheimer's disease (AD) are few and results have been inconsistent.OBJECTIVE: To assess the effects of a moderate-to-high intensity aerobic exercise program in patients with mild AD.METHODS: In a randomized controlled trial, we recruited 200 patients with mild AD to a supervised exercise group (60-min sessions three times a week for 16 weeks) or to a control group. Primary outcome was change from baseline in cognitive performance estimated by Symbol Digit Modalities Test (SDMT) in the intention-to-treat (ITT) group. Secondary outcomes included changes in quality of life, ability to perform activities of daily living, and in neuropsychiatric and depressive symptoms.RESULTS: The ITT analysis showed no significant differences between intervention and control groups in change from baseline of SDMT, other cognitive tests, quality of life, or activities of daily living. The change from baseline in Neuropsychiatric Inventory differed significantly in favor of the intervention group (mean: -3.5, 95% confidence interval (CI) -5.8 to -1.3, p = 0.002). In subjects who adhered to the protocol, we found a significant effect on change from baseline in SDMT as compared with the control group (mean: 4.2, 95% CI 0.5 to 7.9, p = 0.028), suggesting a dose-response relationship between exercise and cognition.CONCLUSIONS: This is the first randomized controlled trial with supervised moderate-to-high intensity exercise in patients with mild AD. Exercise reduced neuropsychiatric symptoms in patients with mild AD, with possible additional benefits of preserved cognition in a subgroup of patients exercising with high attendance and intensity.

Objective: To investigate the validity and reliability of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), a brief questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease. Design: Methodological research (cross-sectional study). Subjects: A total of 332 patients, mean age 65 years (standard deviation 9.1) diagnosed with coronary artery disease at a university hospital were included in the study. Methods: The psychometric properties of the TSK-SV Heart were tested. The tests of validity comprised face, content, and construct validity. The reliability tests included composite reliability, internal consistency and stability over time. Results: In terms of reliability, the TSK-SV Heart was found to be stable over time (intra-class correlation coefficient 0.83) and internally consistent (Cronbach's alpha 0.78). Confirmatory factor analysis provided acceptable fit for a hypothesized 4-factor model with inclusion of a method factor. Conclusion: These results provide support for the reliability of the TSK-SV Heart. The questionnaire appears to be valid for use in patients with coronary artery disease. However, some items require further investigation due to low influence on some sub-dimensions of the test. The sub-dimensions of kinesiophobia require future research concerning their implications for the target group.