49 results on '"Sherrington, C"'
Search Results
2. Understanding implementation factors and participant experiences of a cluster randomised controlled trial to prevent falls among older Aboriginal people: a process evaluation protocol.
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Macniven, R, Coombes, J, Wilson, R, Simon, A, Mackean, T, Hunter, K, Ma, T, Gwynn, J, Sherrington, C, Tiedemann, A, Hill, A-M, Delbaere, K, Lewis, C, Bennett-Brook, K, Howie, A, Stewart, G, Shakespeare, M, Rogers, K, Ivers, RQ, Clapham, K, Macniven, R, Coombes, J, Wilson, R, Simon, A, Mackean, T, Hunter, K, Ma, T, Gwynn, J, Sherrington, C, Tiedemann, A, Hill, A-M, Delbaere, K, Lewis, C, Bennett-Brook, K, Howie, A, Stewart, G, Shakespeare, M, Rogers, K, Ivers, RQ, and Clapham, K
- Abstract
Introduction Process evaluations examining programme implementation are often conducted in conjunction with effectiveness studies. Their inclusion in studies with Aboriginal participants can give an understanding of programme delivery in Aboriginal community contexts. The Ironbark: Standing Strong and Tall programme was codesigned with Aboriginal communities and includes exercise and facilitated ‘yarning’ discussion about fall risk and prevention strategies. The programme pilot showed favourable outcomes and acceptability for Aboriginal people aged 45 years and over. The Ironbark: Standing Strong and Tall programme is now being compared with a ‘Healthy Community’ programme in a cluster randomised controlled trial within Aboriginal health and community services. An embedded process evaluation aims to explore relationships between participation and programme outcomes and the quality of programme implementation. Methods and analysis The process evaluation will use a mixed methods design, guided by Indigenous research methodology. It will evaluate quantitative data (number of completed sessions, site coaching checklist tool, participant and facilitator questionnaire data and a participant habit formation scale), as well as qualitative data (open-ended responses from project and site staff and semistructured interviews using yarning with study participants and site managers). A programme logic model was developed to explain the intended inputs, activities, outputs and outcomes, which guided this process evaluation design. Conclusion This process evaluation of a fall prevention programme for older Aboriginal people using a mixed methods design and data triangulation will allow for a comprehensive understanding of study findings. Multiple study sites allow for generalisability of findings and exploration of variation across sites. Trial registration number ACTRN12619000349145.
- Published
- 2021
3. Understanding implementation factors and participant experiences of a cluster randomised controlled trial to prevent falls among older Aboriginal people: a process evaluation protocol
- Author
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Macniven, R, Coombes, J, Wilson, R, Simon, A, Mackean, T, Hunter, K, Ma, T, Gwynn, J, Sherrington, C, Tiedemann, A, Hill, A-M, Delbaere, K, Lewis, C, Bennett-Brook, K, Howie, A, Stewart, G, Shakespeare, M, Rogers, K, Ivers, RQ, and Clapham, K
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Public Health ,1106 Human Movement and Sports Sciences, 1117 Public Health and Health Services, 1701 Psychology - Abstract
Introduction Process evaluations examining programme implementation are often conducted in conjunction with effectiveness studies. Their inclusion in studies with Aboriginal participants can give an understanding of programme delivery in Aboriginal community contexts. The Ironbark: Standing Strong and Tall programme was codesigned with Aboriginal communities and includes exercise and facilitated ‘yarning’ discussion about fall risk and prevention strategies. The programme pilot showed favourable outcomes and acceptability for Aboriginal people aged 45 years and over. The Ironbark: Standing Strong and Tall programme is now being compared with a ‘Healthy Community’ programme in a cluster randomised controlled trial within Aboriginal health and community services. An embedded process evaluation aims to explore relationships between participation and programme outcomes and the quality of programme implementation. Methods and analysis The process evaluation will use a mixed methods design, guided by Indigenous research methodology. It will evaluate quantitative data (number of completed sessions, site coaching checklist tool, participant and facilitator questionnaire data and a participant habit formation scale), as well as qualitative data (open-ended responses from project and site staff and semistructured interviews using yarning with study participants and site managers). A programme logic model was developed to explain the intended inputs, activities, outputs and outcomes, which guided this process evaluation design. Conclusion This process evaluation of a fall prevention programme for older Aboriginal people using a mixed methods design and data triangulation will allow for a comprehensive understanding of study findings. Multiple study sites allow for generalisability of findings and exploration of variation across sites. Trial registration number ACTRN12619000349145.
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- 2020
4. Physical activity coaching for adults with mobility limitations: protocol for the ComeBACK pragmatic hybrid effectiveness-implementation type 1 randomised controlled trial
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Hassett, L, Tiedemann, A, Hinman, RS, Crotty, M, Hoffmann, T, Harvey, L, Taylor, NF, Greaves, C, Treacy, D, Jennings, M, Milat, A, Bennell, KL, Howard, K, van den Berg, M, Pinheiro, M, Wong, S, Kirkham, C, Ramsay, E, O'Rourke, S, Sherrington, C, Hassett, L, Tiedemann, A, Hinman, RS, Crotty, M, Hoffmann, T, Harvey, L, Taylor, NF, Greaves, C, Treacy, D, Jennings, M, Milat, A, Bennell, KL, Howard, K, van den Berg, M, Pinheiro, M, Wong, S, Kirkham, C, Ramsay, E, O'Rourke, S, and Sherrington, C
- Abstract
INTRODUCTION: Mobility limitation is common and often results from neurological and musculoskeletal health conditions, ageing and/or physical inactivity. In consultation with consumers, clinicians and policymakers, we have developed two affordable and scalable intervention packages designed to enhance physical activity for adults with self-reported mobility limitations. Both are based on behaviour change theories and involve tailored advice from physiotherapists. METHODS AND ANALYSIS: This pragmatic hybrid effectiveness-implementation type 1 randomised control trial (n=600) will be undertaken among adults with self-reported mobility limitations. It aims to estimate the effects on physical activity of: (1) an enhanced 6-month intervention package (one face-to-face physiotherapy assessment, tailored physical activity plan, physical activity phone coaching from a physiotherapist, informational/motivational resources and activity monitors) compared with a less intensive 6-month intervention package (single session of tailored phone advice from a physiotherapist, tailored physical activity plan, unidirectional text messages, informational/motivational resources); (2) the enhanced intervention package compared with no intervention (6-month waiting list control group); and (3) the less intensive intervention package compared with no intervention (waiting list control group). The primary outcome will be average steps per day, measured with the StepWatch Activity Monitor over a 1-week period, 6 months after randomisation. Secondary outcomes include other physical activity measures, measures of health and functioning, individualised mobility goal attainment, mental well-being, quality of life, rate of falls, health utilisation and intervention evaluation. The hybrid effectiveness-implementation design (type 1) will be used to enable the collection of secondary implementation outcomes at the same time as the primary effectiveness outcome. An economic analysis will estimate the
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- 2020
5. Effect of cognitive-only and cognitive-motor training on preventing falls in community-dwelling older people: protocol for the smart +/- step randomised controlled trial
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Sturnieks, DL, Menant, J, Valenzuela, M, Delbaere, K, Sherrington, C, Herbert, RD, Lampit, A, Broadhouse, K, Turner, J, Schoene, D, Lord, SR, Sturnieks, DL, Menant, J, Valenzuela, M, Delbaere, K, Sherrington, C, Herbert, RD, Lampit, A, Broadhouse, K, Turner, J, Schoene, D, and Lord, SR
- Abstract
BACKGROUND: Physical and cognitive impairments are important risk factors for falls in older people. However, no studies have been adequately powered to examine whether cognitive or cognitive-motor training can prevent falls in older people. This is despite good evidence of improvements in fall-related cognitive and physical functions following both intervention types. This manuscript describes the study protocol for a three-arm randomised controlled trial to evaluate the effectiveness of home-based cognitive and cognitive-motor training interventions, compared to a minimal-intervention control group, in preventing falls in older people. This trial was prospectively registered with the Australia New Zealand Clinical Trial Registry, number ACTRN12616001325493. METHODS AND ANALYSIS: Community-dwelling adults aged 65 years and over, residing in Sydney Australia, will be recruited. Participants (n=750) will be randomly allocated to (1) cognitive-only training, (2) cognitive-motor training or (3) control groups. Both training interventions involve the use of the smart±step home-based computerised game playing system for a recommended 120 min/week for 12 months. Cognitive training group participants will use a desktop electronic touch pad to play games with the smart±step system while seated and using both hands. The cognitive-motor training group participants will use a wireless electronic floor step mat that requires accurate stepping using both legs for playing the same smart±step games, hence incorporating balance exercises. All groups will receive an education booklet on fall prevention. The primary outcome will be rate of falls, reported by monthly diaries during the 12-month duration of the study and analysis will be by intention-to-treat. Secondary outcomes include the proportion of fallers, physical and cognitive performance in 300 participants, and brain structure and function in 105 participants who will undertake MRI scans at baseline and 6 months. Cost-effect
- Published
- 2019
6. In-hospital falls and fall-related injuries: a protocol for a cost of fall study.
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Morello, R., Barker, A., Haines, T., Zavarsek, S., Hill, Keith, Brand, C., Sherrington, C., Wolfe, R., Bohensky, M., Stoelwinder, J., Morello, R., Barker, A., Haines, T., Zavarsek, S., Hill, Keith, Brand, C., Sherrington, C., Wolfe, R., Bohensky, M., and Stoelwinder, J.
- Abstract
BACKGROUND: In-hospital falls are common and pose significant economic burden on the healthcare system. To date, few studies have quantified the additional cost of hospitalisation associated with an in-hospital fall or fall-related injury. The aim of this study is to determine the additional length of stay and hospitalisation costs associated with in-hospital falls and fall-related injuries, from the acute hospital perspective.METHODS AND DESIGN: A multisite prospective study will be conducted as part of a larger falls-prevention clinical trial—the 6-PACK project. This study will involve 12 acute medical and surgical wards from six hospitals across Australia. Patient and admission characteristics, outcome and hospitalisation cost data will be prospectively collected on approximately 15 000 patients during the 15-month study period. A review of all in-hospital fall events will be conducted using a multimodal method (medical record review and daily verbal report from the nurse unit manager, triangulated with falls recorded in the hospital incident reporting and administrative database), to ensure complete case ascertainment. Hospital clinical costing data will be used to calculate patient-level hospitalisation costs incurred by a patient during their inpatient stay. Additional hospital and hospital resource utilisation costs attributable to in-hospital falls and fall-related injuries will be calculated using linear regression modelling, adjusting for a priori-defined potential confounding factors.DISCUSSION: This protocol provides the detailed statement of the planned analysis. The results from this study will be used to support healthcare planning, policy making and allocation of funding relating to falls prevention within acute hospitals.
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- 2013
7. The 6-PACK programme to decrease fall-related injuries in acute hospitals: protocol for a cluster randomised controlled trial.
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Barker, A., Brand, C., Haines, T., Hill, Keith, Brauer, S., Jolley, D., Botti, M., Cumming, R., Livingston, P., Sherrington, C., Zavarsek, S., Morello, R., Kamar, J., Barker, A., Brand, C., Haines, T., Hill, Keith, Brauer, S., Jolley, D., Botti, M., Cumming, R., Livingston, P., Sherrington, C., Zavarsek, S., Morello, R., and Kamar, J.
- Abstract
In-hospital fall-related injuries are a source of personal harm, preventable hospitalisation costs, and access block through increased length of stay. Despite increased fall prevention awareness and activity over the last decade, rates of reported fall-related fractures in hospitals appear not to have decreased. This cluster randomised controlled trial (RCT) aims to determine the efficacy of the 6-PACK programme for preventing fall-related injuries, and its generalisability to other acute hospitals. 24 acute medical and surgical wards from six to eight hospitals throughout Australia will be recruited for the study. Wards will be matched by type and fall-related injury rates, then randomly allocated to the 6-PACK intervention (12 wards) or usual care control group (12 wards). The 6-PACK programme includes a nine-item fall risk assessment and six nursing interventions: 'falls alert' sign; supervision of patients in the bathroom; ensuring patient's walking aids are within reach; establishment of a toileting regime; use of a low-low bed; and use of bed/chair alarm. Intervention wards will be supported by a structured implementation strategy. The primary outcomes are fall and fall-related injury rates 12 months following 6-PACK implementation. This study will involve approximately 16,000 patients, and as such is planned to be the largest hospital fall prevention RCT to be undertaken and the first to be powered for the important outcome of fall-related injuries. If effective, there is potential to implement the programme widely as part of daily patient care in acute hospital wards where fall-related injuries are a problem.
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- 2011
8. Does a fall prevention educational programme improve knowledge and change exercise prescribing behaviour in health and exercise professionals? A study protocol for a randomised controlled trial.
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Tiedemann, A., Sturnieks, D. L., Hill, A.-M., Lovitt, L., Clemson, L., Lord, S. R., Harvey, L., and Sherrington, C.
- Abstract
Introduction: Falling in older age is a serious and costly problem. At least one in three older people fall annually. Although exercise is recognised as an effective fall prevention intervention, low numbers of older people engage in suitable programmes. Health and exercise professionals play a crucial role in addressing fall risk in older adults. This trial aims to evaluate the effect of participation in a fall prevention educational programme, compared with a wait-list control group, on health and exercise professionals' knowledge about fall prevention and the effect on fall prevention exercise prescription behaviour and confidence to prescribe the exercises to older people. Methods and analysis: A randomised controlled trial involving 220 consenting health and exercise professionals will be conducted. Participants will be individually randomised to an intervention group (n=110) to receive an educational workshop plus access to internet-based support resources, or a waitlist control group (n=110). The two primary outcomes, measured 3 months after randomisation, are: (1) knowledge about fall prevention and (2) self-perceived change in fall prevention exercise prescription behaviour. Secondary outcomes include: (1) participants' confidence to prescribe fall prevention exercises; (2) the proportion of people aged 60+ years seen by trial participants in the past month who were prescribed fall prevention exercise; and (3) the proportion of fall prevention exercises prescribed by participants to older people in the past month that comply with evidence-based guidelines. Outcomes will be measured with a self-report questionnaire designed specifically for the trial. [ABSTRACT FROM AUTHOR]
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- 2014
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9. A novel Dance Dance Revolution (DDR) system for in-home training of stepping ability: basic parameters of system use by older adults.
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Smith ST, Sherrington C, Studenski S, Schoene D, and Lord SR
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Objective This series of studies was conducted to develop and establish characteristics of exercise videogame play in older adults. The videogame was a modified version of the popular Dance Dance Revolution (DDR; Konomi). Methods Participants aged >=70 were asked to make simple step movements in response to vertically drifting arrows presented on a video screen. Step responses were detected by a modified USB DDR mat, and characteristics of stepping performance such as step timing, percentage of missed target steps and percentage of correct steps were recorded by purpose-built software. Drift speed and step rate of visual stimuli were modified to increase task difficulty. Results Significant linear relationships between stepping performance and stimulus characteristics were observed. Performance of older adults decreased as stimulus speed and step rate were increased. Optimal step performance occurred for a stimulus speed of 17° of visual angle per second and a step rate of one step every 2 s. At fast drift speeds (up to 35°/s), participants were more than 200 ms too slow in coordinating their steps with the visual stimulus. Younger adults were better able to perform the stepping task across a wider range of drift speeds than older adults. Conclusion The findings suggest that older adults are able to interact with video games based upon DDR but that stepping performance is determined by characteristics of game play such as arrow drift speed and step rate. These novel 'exergames' suggest a low-cost method by which older adults can be engaged in exercises that challenge balance and which can be conducted in their own homes. [ABSTRACT FROM AUTHOR]
- Published
- 2011
10. An Address ON SCIENCE AND MEDICINE IN THE MODERN UNIVERSITY: Delivered to the Toronto University Trustees and Senators and to the Medical Profession of Ontario and their Guests on the Occasion of the Opening of the New Medical Buildings of the United ...
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Sherrington, C. S.
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- 1903
11. Regular review: effective physiotherapy.
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Herbert RD, Maher CG, Moseley AM, and Sherrington C
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- 2001
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12. An ADDRESS on LOCALISATION in the “MOTOR” CEREBRAL CORTEX: Delivered to the Pathological Society of London, December 17th, 1901.
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Sherrington, C. S. and Grünbaum, A. S. F.
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- 1901
13. An Address ON THE PROVINCIAL SCHOOL OF MEDICINE AND THE PROVINCIAL UNIVERSITY: Delivered at the Prize Distribution in the School of Medicine, University of Leeds.
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Sherrington, C. S.
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- 1913
14. Is exercise effective in promoting mental well-being in older age? A systematic review.
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Rosenbaum S and Sherrington C
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- 2011
15. Ten years of evidence to guide physiotherapy interventions: Physiotherapy Evidence Database (PEDro)
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Sherrington C, Moseley AM, Herbert RD, Elkins MR, and Maher CG
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- 2010
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16. Subglottic haemangioma.
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Sherrington CA, Sim DKY, Freezer NJ, Robertson CF, Sherrington, C A, Sim, D K, Freezer, N J, and Robertson, C F
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Objectives: To describe experience with subglottic haemangioma in a unit where conservative treatment has been favoured.Methods: Retrospective case note review of infants presenting with subglottic haemangioma over a 25 year period.Results: Thirty one infants were identified. Diagnosis was difficult where skin haemangiomas were absent and where the lesion was circumferential rather than asymmetrical. Tracheostomy was safe, well tolerated, and managed by the patients' family at home. Major complications were seen only when laser treatment was used.Conclusions: Aggressive treatment with substantial risks of long term complications may not be necessary in this spontaneously resolving disorder. [ABSTRACT FROM AUTHOR]- Published
- 1997
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17. Thrombolysis in stroke. Example of a health divide?
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Tyrrell PJ, Sherrington C, Wainwright J, Smith C, Grue R, Singh A, Douglass C, and Choi H
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- 2010
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18. The Teaching of Physiology and Histology.
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Sherrington, C. S.
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- 1899
19. Memorial to Sir Walter Fletcher.
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Baldwin, Stanley, Hopkins, F. G., D'Abernon, Sherrington, C. S., Gregg, Alan, Waring, H. J., Martin, C. J., Elliott, T. R., Muir, Robert, Chick, Harriette, Trevelyan, G. M., James, M. R., Boycott, A. E., Dale, H. H., and Mellanby, E.
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- 1934
20. TESTIMONIAL TO SIR RONALD ROSS.
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James, Barr, Broquet, Charles, Cardamatis, J. P., Castellani, Aldo, Crichton-Browne, James, Franchini, G., Greenwood, King, W. G., MacLean, Ewen J., Nocht, Bernard, Nuttall, G. H. F., Perroncito, Edorado, Pitfield, Robert L., Rolleston, Humphry, Sherrington, C. S., Thomson, David, Thomson, J. G., Watson, Malcolm, and Weber, F. Parkes
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- 1929
21. BRITISH EMPIRE CANCER CAMPAIGN.
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Sherrington, C. S., Goschen, and Cave
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- 1924
22. Further Experimental Note on the Correlation of Action of Antagonistic Muscles 1.
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Sherrington, C. S.
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- 1893
23. The Power to Expel Members.
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Sherrington, C. S.
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- 1892
24. Note toward the Localisation of the Knee-Jerk.
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Sherrington, C. S.
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- 1892
25. Note on Some Functions of the Cervical Sympathetic in the Monkey.
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Sherrington, C. S.
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- 1891
26. “INDUCED CELL DIVISION AND CANCER.”.
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Harvey-Gibson, R. J., Herdman, W. A., Moore, B., Green, J. Reynolds, and Sherrington, C. S.
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- 1910
27. THE ASSOCIATION AND MEDICAL RESEARCH.
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Sherrington, C. S.
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- 1907
28. BRITISH AID FOR MEN OF LETTERS AND SCIENCE IN RUSSIA.
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of Beaulieu, Montagu, Pares, Bernard, Barker, Ernest, Schuster, Arthur, Cathcart, E. P., Sherrington, C. S., Eddington, A. S., Shipley, A. E., Gollancz, I., Wells, H. G., Gregory, R. A., Woodward, A. Smith, Mitchell, P. Chalmers, and Wright, C. Hagberg
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- 1921
29. OPTIONAL OR COMPULSORY GREEK AT OXFORD.
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Thomson, Arthur, Dodds-Parker, A. P., Whitnall, S. E., Sherrington, C. S., Bazett, H. C., Dreyer, G., Walker, E. W. Ainley, Gibson, A. G., Gardner, A. D., Gunn, J. A., Vines, S. H., Bourne, G. C., Perkin, W. H., Nagel, D. H., Collier, W., Brooks, W. T., Whitelocke, R. H. Anglin, Douglas, C. G., Ormerod, A. L., and Mallam, E.
- Published
- 1919
30. Contemporary national and international guidelines on physical activity and sedentary behaviour for people living with chronic conditions, disability and advanced age: a scoping review.
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Ranasinghe MP, Andersen H, Dempsey RK, Wexler N, Davis R, Francois M, Gilbert S, Okely AD, Sherrington C, and Dempsey PC
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Objectives: Physical activity guidelines inform policy and practice in promoting healthier lifestyles. The WHO advocates for distinct recommendations for each country to address variation in needs, resources and context. Specific regional recommendations for three underactive populations facing unique barriers to movement are lacking-people with chronic conditions, disability and advanced age. We review which countries/regions provide specific physical activity guidelines for these populations to identify deficiencies in meeting WHO recommendations and inform future directions for guideline development., Design: Scoping review., Data Sources: OVID Medline, PubMed, Scopus, Embase, Web of Science, Google Scholar, ProQuest, CINAHL, Google searches, targeted websites., Eligibility Criteria: Data sources were searched from database inception to September 2023 to identify community-facing physical activity guidelines at the national/international level for these populations. We recorded, summarised and analysed physical activity guideline recommendations extracted from published guideline documents, organised by population and country/region., Results: 66 articles were identified, addressing 28 distinct countries/regions, including four international guidelines, published from 2009 to 2023. The WHO guidelines were adopted by 19 countries and the European Union. Across all regions, a lack of specific advice was identified for individuals with chronic conditions (46%), disability (46%) and advanced age (11%). Advice for chronic conditions and disability commonly replicated general adult population advice., Conclusion: Many countries/regions do not produce physical activity guidelines specific to populations with chronic conditions and disability. As such, a large proportion of countries/regions failed to meet WHO recommendations, highlighting a lack of customised advice to address unique barriers faced by vulnerable populations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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31. Falls and patterns of physical activity participation over 18 years in the Australian Longitudinal Study on Women's Health.
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Kwok WS, Khalatbari-Soltani S, Dolja-Gore X, Byles J, S Oliveira J, Pinheiro MB, Tiedemann A, and Sherrington C
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- Humans, Female, Longitudinal Studies, Australia, Middle Aged, Self Report, Aged, Risk Factors, Accidental Falls statistics & numerical data, Exercise, Women's Health
- Abstract
Objective: To explore the relationship between long-term physical activity (PA) participation and falls., Methods: Participants in the Australian Longitudinal Study of Women's Health born 1946-1951 self-reported amounts of PA every 3 years since 1998 (mean age: 54 years, n=11 796). Latent class analysis described profiles of self-reported PA participation over 18 years. Associations between patterns of PA participation and self-reported falls measured in 2019 were examined using multinomial logistic regression adjusted for directed-acyclic graph-informed potential confounders, with the highly active group as the reference category., Results: Women were grouped into five PA participation profiles. Compared with consistently highly active patterns (maintaining ≥300 min/week, 22%), consistently lower levels of PA<100 min/week (18%), consistently some PA<150 min/week (18%) and decreasing PA but maintaining≥150 min/week (n=3540, 30%) had higher odds of non-injurious falls (odds Ratio
lower level (OR): 1.59, 95% CI 1.29 to 1.97; ORsome PA : 1.27, 95% CI 1.04 to 1.55; ORdecreasing activity :1.29, 95% CI 1.02 to 1.63) and injurious falls (ORlow level : 1.32, 95% CI 1.06 to 1.64; ORsome PA : 1.27, 95% CI 1.04 to 1.54; ORdecreasing activity : 1.47, 95% CI 1.18 to 1.83). No association was found between increasing PA (≥150 min/week, 11%) for non-injurious (OR 1.07, 95% CI 0.89 to 1.29) and injurious falls (OR 1.07, 95% CI 0.90 to 1.29). After adjusting for potential confounders, consistently lower levels of PA remained associated with increased non-injurious falls odds (OR1998 survey : 1.40, 95% CI 1.11 to 1.77; OR2016 survey : 1.35, 95% CI 1.07 to 1.71)., Conclusion: The increased odds of falls among women with consistently lower levels of PA over 18 years supports ongoing participation of 150+ min/week of PA., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)- Published
- 2024
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32. Effective fall prevention exercise in residential aged care: an intervention component analysis from an updated systematic review.
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Dawson R, Suen J, Sherrington C, Kwok W, Pinheiro MB, Haynes A, McLennan C, Sutcliffe K, Kneale D, and Dyer S
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- Humans, Aged, Homes for the Aged, Accidental Falls prevention & control, Exercise Therapy methods, Randomized Controlled Trials as Topic, Postural Balance physiology
- Abstract
Objective: The effect of fall prevention exercise programmes in residential aged care (RAC) is uncertain. This paper reports on an intervention component analysis (ICA) of randomised controlled trials (RCTs), from an update of a Cochrane review, to develop a theory of features of successful fall prevention exercise in RAC., Methods: Trial characteristics were extracted from RCTs testing exercise interventions in RAC identified from an update of a Cochrane review to December 2022 (n=32). Eligible trials included RCTs or cluster RCTs in RAC, focusing on participants aged 65 or older, assessing fall outcomes with stand-alone exercise interventions. ICA was conducted on trials with >30 participants per treatment arm compared with control (n=17). Two authors coded trialists' perceptions on intervention features that may have contributed to the observed effect on falls. Inductive thematic analysis was used to identify the key differences between the trials which might account for positive and negative outcomes., Results: 32 RCTs involving 3960 residents including people with cognitive (57%) and mobility (41%) impairments were included. ICA on the 17 eligible RCTs informed the development of a theory that (1) effective fall prevention exercise delivers the right exercise by specifically targeting balance and strength, tailored to the individual and delivered simply at a moderate intensity and (2) successful implementation needs to be sufficiently resourced to deliver structured and supervised exercise at an adequate dose., Conclusions: This analysis suggests that delivering the right exercise, sufficiently resourced, is important for preventing falls in RAC. This clinical guidance requires confirmation in larger trials., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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33. Effect of a coaching intervention to enhance physical activity and prevent falls in community-dwelling people aged 60+ years: a cluster randomised controlled trial.
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Oliveira JS, Sherrington C, Rissel C, Howard K, Tong A, Merom D, Wickham J, Bauman AE, Lord SR, Lindley RI, Simpson JM, Allman-Farinelli M, Kirkham C, Ramsay E, O'Rourke S, and Tiedemann A
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- Humans, Female, Aged, Male, Quality of Life, Fear, Exercise, Independent Living, Mentoring
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Objectives: To evaluate the effect of a coaching intervention compared with control on physical activity and falls rate at 12 months in community-dwelling people aged 60+ years., Design: Cluster randomised controlled trial., Setting: Community-dwelling older people., Participants: 72 clusters (605 participants): 37 clusters (290 participants) randomised to the intervention and 35 (315 participants) to control., Intervention: Intervention group received written information, fall risk assessment and prevention advice by a physiotherapist, activity tracker and telephone-based coaching from a physiotherapist focused on safe physical activity. Control group received written information and telephone-based dietary coaching. Both groups received up to 19 sessions of telephone coaching over 12 months., Outcomes: The co-primary outcomes were device-measured physical activity expressed in counts per minute at 12 months and falls rate over 12 months. Secondary outcomes included the proportion of fallers, device-measured daily steps and moderate-to-vigorous physical activity (MVPA), self-reported hours per week of physical activity, body mass index, eating habits, goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being and disability., Results: The mean age of participants was 74 (SD 8) years, and 70% (n=425) were women. There was no significant effect of the intervention on device-measured physical activity counts per minute (mean difference 5 counts/min/day, 95% CI -21 to 31), or falls at 12 months (0.71 falls/person/year in intervention group and 0.87 falls/person/year in control group; incidence rate ratio 0.86, 95% CI 0.65 to 1.14). The intervention had a positive significant effect on device-measured daily steps and MVPA, and self-reported hours per week of walking, well-being, quality of life, and disability. No significant between-group differences were identified in other secondary outcomes., Conclusion: A physical activity and fall prevention programme including fall risk assessment and prevention advice, plus telephone-based health coaching, did not lead to significant differences in physical activity counts per minute or falls rate at 12 months. However, this programme improved other physical activity measures (ie, daily steps, MVPA, hours per week of walking), overall well-being, quality of life and disability., Trial Registration Number: ACTRN12615001190594., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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- 2024
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34. Effects of sport or physical recreation for adults with physical or intellectual disabilities: a systematic review with meta-analysis.
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Hassett L, McKay MJ, Cole J, Moseley AM, Chagpar S, Geerts M, Kwok WS, Jensen C, Sherrington C, and Shields N
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- Humans, Intellectual Disability, Quality of Life, Walking, Randomized Controlled Trials as Topic, Exercise, Disabled Persons, Sports for Persons with Disabilities
- Abstract
Objectives: To evaluate the effects of sport or physical recreation on participation, mobility and quality of life for adults living with disabilities., Design: Systematic review with meta-analysis., Data Sources: Six databases searched from inception to May 2022., Eligibility Criteria: Randomised controlled trials including adults living with a physical or intellectual disability, comparing sport or physical recreation to non-active control., Results: Seventy-four trials (n=2954; mean age 55 years) were included. Most (70) trials included people with physical disabilities, none evaluated sport and the most common physical recreation activities tested were traditional Chinese exercise (35%), yoga (27%) and dance (18%). Mean frequency and duration was 65 min/session, two times per week for 13 weeks. Most (86%) interventions were led by people with experience and/or training in the recreation activity, and only 37% reported leader experience and/or training working with people with disabilities. Participation was measured as attendance (mean 81%, 30 intervention groups). Physical recreation improved mobility (standardised mean difference (SMD) 0.38, 95% CI 0.07 to 0.69, n=469) and walking endurance (mean difference (MD) 40.3 m, 95% CI 19.5 to 61.1, n=801) with low certainty evidence and balance (Berg Balance Scale, range 0-56 points; MD 3.4 points, 95% CI 2.3 to 4.4, n=906) and quality of life (physical health; SMD 0.37, 95% CI 0.02 to 0.72, n=468) with very low certainty evidence, but not walking speed (MD 0.03 m/s, 95% CI -0.05 to 0.11, n=486)., Conclusion: Physical recreation may confer multiple benefits for people living with disabilities regardless of the activity chosen, thus offering a potentially enjoyable and scalable strategy to increase physical activity., Prospero Registration Number: CRD42018104379., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2024
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35. Physical activity research: time to scale up!
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Baldwin JN, Pinheiro MB, Hassett L, S Oliveira J, Gilchrist H, Bauman AE, Milat A, Tiedemann A, and Sherrington C
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- Humans, Exercise, Health Promotion
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2023
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36. Effect of sport on health in people aged 60 years and older: a systematic review with meta-analysis.
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S Oliveira J, Gilbert S, Pinheiro MB, Tiedemann A, Macedo LB, Maia L, Kwok W, Hassett L, and Sherrington C
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- Humans, Middle Aged, Aged, Quality of Life, Mental Health, Bone Density, Exercise, Cardiorespiratory Fitness
- Abstract
Objectives: To summarise evidence of benefits of sport for health among people aged 60+., Design: Systematic review with meta-analysis of randomised controlled trials (RCTs)., Data Sources: Medline, CINAHL, SPORTDiscus, the Physiotherapy Evidence Database from inception to April 2021., Study Selection: RCTs investigating the effect of sport on health-related outcomes in people aged 60+ compared with non-active control., Data Synthesis and Analysis: Pooled effect sizes were calculated using random-effect models. Standardised mean differences (SMD), and mean difference (MD) were calculated. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the certainty of the evidence for analyses with ≥3 studies., Results: Nine trials (628 participants) reported in 15 articles were included. Participation in sport improved cardiorespiratory fitness (n=5 trials; SMD=0.43, 95% CI 0.17 to 0.70; low certainty evidence), physical function (n=4; SMD=0.62, 95% CI 0.05 to 1.18; very low certainty evidence), and mental health (n=2; SMD=0.28, 95% CI 0.06 to 0.51) and reduced fat mass (n=6; MD=-0.99 kg, 95% CI -1.75kg to -0.23 kg; low certainty evidence) among older people. We found no significant effects of sport on overall physical activity participation, strength, balance, lean mass and bone mineral density (BMD). One study investigating quality of life reported a positive, but non-significant effect of sport., Conclusion: Sport may have a positive impact on health outcomes in people aged 60+. There was uncertainty on the effect of sport on strength, balance, lean mass and BMD. Further research is needed to investigate the optimal type and dose of sport to maximise the long-term benefits among older people., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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37. Economic evaluations of fall prevention exercise programs: a systematic review.
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Pinheiro MB, Sherrington C, Howard K, Caldwell P, Tiedemann A, Wang B, S Oliveira J, Santos A, Bull FC, Willumsen JF, Michaleff ZA, Ferguson S, Mayo E, Fairhall NJ, Bauman AE, and Norris S
- Subjects
- Humans, Aged, Cost-Benefit Analysis, Quality-Adjusted Life Years, Exercise, Exercise Therapy methods
- Abstract
Objective: To investigate cost-effectiveness and costs of fall prevention exercise programmes for older adults., Design: Systematic review., Data Sources: Medline, Embase, Web of Science, Scopus, National Institute for Health Research Economic Evaluation Database, Health Technology Assessment database, Tufts Cost-Effectiveness Analysis Registry, Research Papers in Economics and EconLit (inception to May 2022)., Eligibility Criteria for Study Selection: Economic evaluations (trial-based or model-based) and costing studies investigating fall prevention exercise programmes versus no intervention or usual care for older adults living in the community or care facilities, and reporting incremental cost-effectiveness ratio (ICER) for fall-related outcomes or quality-adjusted life years (QALY, expressed as cost/QALY) and/or intervention costs., Results: 31 studies were included. For community-dwelling older adults (21 economic evaluations, 6 costing studies), results ranged from more effective and less costly (dominant) interventions up to an ICER of US$279 802/QALY gained and US$11 986/fall prevented (US$ in 2020). Assuming an arbitrary willingness-to-pay threshold (US$100 000/QALY), most results (17/24) were considered cost-effective (moderate certainty). The greatest value for money (lower ICER/QALY gained and fall prevented) appeared to accrue for older adults and those with high fall risk, but unsupervised exercise appeared to offer poor value for money (higher ICER/QALY). For care facilities (two economic evaluations, two costing studies), ICERs ranged from dominant (low certainty) to US$35/fall prevented (moderate certainty). Overall, intervention costs varied and were poorly reported., Conclusions: Most economic evaluations investigated fall prevention exercise programmes for older adults living in the community. There is moderate certainty evidence that fall prevention exercise programmes are likely to be cost-effective. The evidence for older adults living in care facilities is more limited but promising., Prospero Registration Number: PROSPERO 2020 CRD42020178023., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
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38. Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance.
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Ardern CL, Büttner F, Andrade R, Weir A, Ashe MC, Holden S, Impellizzeri FM, Delahunt E, Dijkstra HP, Mathieson S, Rathleff MS, Reurink G, Sherrington C, Stamatakis E, Vicenzino B, Whittaker JL, Wright AA, Clarke M, Moher D, Page MJ, Khan KM, and Winters M
- Subjects
- Evidence-Based Medicine, Exercise, Exercise Therapy, Humans, Systematic Reviews as Topic, Sports, Sports Medicine
- Abstract
Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality., Competing Interests: Competing interests: RA, MCA, FB, MC, SH, FMI, SM, MSR, GS, BV, JLW, MW and AAW declare they have no competing interests. CLA was a Deputy Editor (Systematic Reviews) for BJSM from 2016 to 2018. ED, HPD and AW are associate editors for BJSM. MCA was a member of the BJSM editorial board from 2008 to 2020. KMK was Editor-in-Chief of BJSM from 2008 to 2020. He holds no position with the BJSM or the BMJ Group at present (September 2021). DM is Chair of the PRISMA group, led the PRISMA 2009 statement and co-led the PRISMA 2020 statement. MJP co-led the PRISMA 2020 statement. ES was editor of BJSM from 2017 to 2020, and editor-in-chief of BMJ Open Sport & Exercise Medicine from 2019 to 2020. He is a senior adviser to BJSM (September 2021)., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
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39. Effect of interventions using physical activity trackers on physical activity in people aged 60 years and over: a systematic review and meta-analysis.
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S Oliveira J, Sherrington C, R Y Zheng E, Franco MR, and Tiedemann A
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- Healthy Lifestyle, Humans, Mental Health, Middle Aged, Quality of Life, Exercise, Fitness Trackers
- Abstract
Background: Older people are at high risk of physical inactivity. Activity trackers can facilitate physical activity. We aimed to investigate the effect of interventions using activity trackers on physical activity, mobility, quality of life and mental health among people aged 60+ years., Methods: For this systematic review, we searched eight databases, including MEDLINE, Embase and CENTRAL from inception to April 2018. Randomised controlled trials of interventions that used activity trackers to promote physical activity among people aged 60+ years were included in the analyses. The study protocol was registered with PROSPERO, number CRD42017065250., Results: We identified 23 eligible trials. Interventions using activity trackers had a moderate effect on physical activity (23 studies; standardised mean difference (SMD)=0.55; 95% CI 0.40 to 0.70; I
2 =86%) and increased steps/day by 1558 (95% CI 1099 to 2018 steps/day; I2 =92%) compared with usual care, no intervention and wait-list control. Longer duration activity tracker-based interventions were more effective than short duration interventions (18 studies, SMD=0.70; 95% CI 0.47 to 0.93 vs 5 studies, SMD=0.14; 95% CI -0.26 to 0.54, p for comparison=0.02). Interventions that used activity trackers improved mobility (three studies; SMD=0.61; 95% CI 0.31 to 0.90; I2 =10%), but not quality of life (nine studies; SMD=0.09; 95% CI -0.07 to 0.25; I2 =45%). Only one trial included mental health outcomes and it reported similar effects of the activity tracker intervention compared with control., Conclusions: Interventions using activity trackers improve physical activity levels and mobility among older people compared with control. However, the impact of activity tracker interventions on quality of life, and mental health is unknown., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2020
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40. Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review.
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Sherrington C, Fairhall N, Wallbank G, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, and Lamb S
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- Aged, Humans, Middle Aged, Postural Balance physiology, Randomized Controlled Trials as Topic, Resistance Training, Risk Factors, Tai Ji, Accidental Falls prevention & control, Exercise, Independent Living
- Abstract
Objectives: To assess the effects of exercise interventions for preventing falls in older people living in the community., Selection Criteria: We included randomised controlled trials evaluating the effects of any form of exercise as a single intervention on falls in people aged 60+years living in the community., Results: Exercise reduces the rate of falls by 23% (rate ratio (RaR) 0.77, 95% CI 0.71 to 0.83; 12 981 participants, 59 studies; high-certainty evidence). Subgroup analyses showed no evidence of a difference in effect on falls on the basis of risk of falling as a trial inclusion criterion, participant age 75 years+ or group versus individual exercise but revealed a larger effect of exercise in trials where interventions were delivered by a health professional (usually a physiotherapist). Different forms of exercise had different impacts on falls. Compared with control, balance and functional exercises reduce the rate of falls by 24% (RaR 0.76, 95% CI 0.70 to 0.81; 7920 participants, 39 studies; high-certainty evidence). Multiple types of exercise (commonly balance and functional exercises plus resistance exercises) probably reduce the rate of falls by 34% (RaR 0.66, 95% CI 0.50 to 0.88; 1374 participants, 11 studies; moderate-certainty evidence). Tai Chi may reduce the rate of falls by 19% (RaR 0.81, 95% CI 0.67 to 0.99; 2655 participants, 7 studies; low-certainty evidence). We are uncertain of the effects of programmes that primarily involve resistance training, dance or walking., Conclusions and Implications: Given the certainty of evidence, effective programmes should now be implemented., Competing Interests: Competing interests: Several authors (CS, AT, SH, KH and SL) are currently running trials of fall prevention interventions; including the following ongoing trials in this review (ACTRN 12615000138583; ACTRN 12615000865516; ISRCTN71002650). These trials are all funded by national grant agencies. No review author was involved in study selection or processing of any trials in which they were or are involved. CS is an author of several trials considered in this review, including four included trials.21 22 23 24 25 NF has no known conflicts of interest. GW has no known conflicts of interest. AT has no known conflicts of interest. ZAM has no known conflicts of interest. KH is an author of several trials considered in this review, including one included trial.22 LC is an author of several trials considered in this review, including two included trials.26 27 SH has no known conflicts of interest. SL is lead author of the ProFaNE consensus for falls guidance and is an author of one of the trials considered in this review., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
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41. Infographic: Exercise to prevent falls in older adults.
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Smirmaul BPC, Tiedemann A, and Sherrington C
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2019
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42. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis.
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Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, and Lord SR
- Subjects
- Aged, Cognitive Dysfunction therapy, Humans, Parkinson Disease therapy, Postural Balance, Randomized Controlled Trials as Topic, Accidental Falls prevention & control, Exercise, Exercise Therapy
- Abstract
Objective: Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects., Design: Update of a systematic review with random effects meta-analysis and meta-regression., Data Sources: Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched from January 2010 to January 2016., Study Eligibility Criteria: We included randomised controlled trials that compared fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group., Results: 99 comparisons from 88 trials with 19 478 participants were available for meta-analysis. Overall, exercise reduced the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, p<0.001, I
2 47%, 69 comparisons) with greater effects seen from exercise programmes that challenged balance and involved more than 3 hours/week of exercise. These variables explained 76% of the between-trial heterogeneity and in combination led to a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, p<0.001). Exercise also had a fall prevention effect in community-dwelling people with Parkinson's disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I2 21%, 3 comparisons). There was no evidence of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital., Summary/conclusions: Exercise as a single intervention can prevent falls in community-dwelling older people. Exercise programmes that challenge balance and are of a higher dose have larger effects. The impact of exercise as a single intervention in clinical groups and aged care facility residents requires further investigation, but promising results are evident for people with Parkinson's disease and cognitive impairment., Competing Interests: Competing interests: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)- Published
- 2017
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43. What is the effect of health coaching on physical activity participation in people aged 60 years and over? A systematic review of randomised controlled trials.
- Author
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Oliveira JS, Sherrington C, Amorim AB, Dario AB, and Tiedemann A
- Subjects
- Affect, Aged, Humans, Middle Aged, Quality of Life, Randomized Controlled Trials as Topic, Exercise, Health Promotion methods, Mentoring
- Abstract
Background: Physical inactivity is common in older age, yet increased activity benefits older people in terms of preventing chronic disease and maximising independence. Health coaching is a behaviour change intervention that has been shown to increase physical activity in clinical populations. This systematic review and meta-analysis investigated the effect of health coaching on physical activity, mobility, quality of life and mood in older people., Methods: MEDLINE, EMBASE, CENTRAL, PsycINFO, PEDro, SPORTDiscus, LILACS and CINAHL databases were used to identify randomised controlled trials which evaluated the effect of health coaching on physical activity (primary outcome) among people aged 60+. Secondary outcomes were mobility, quality of life and mood. We calculated standardised mean differences (SMDs, Hedges' g) with 95% CIs from random effects meta-analyses., Results: 27 eligible trials were included. Health coaching had a small, statistically significant effect on physical activity (27 studies; SMD = 0.27; 95% CI 0.18 to 0.37; p<0.001). There was no evidence of an effect of health coaching on mobility (eight studies; SMD = 0.10; 95% CI -0.03 to 0.23; p=0.13), quality of life (eight studies; SMD = 0.07; 95% CI -0.06 to 0.20; p<0.05) or mood (five studies; SMD = 0.02; 95% CI -0.12 to 0.16; p=0.83)., Conclusions: Health coaching significantly increased physical activity in people aged 60+. There was no evidence of an effect of health coaching on quality of life, mobility and mood, so different approaches may be required to impact on these outcomes., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
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44. Structured exercise improves mobility after hip fracture: a meta-analysis with meta-regression.
- Author
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Diong J, Allen N, and Sherrington C
- Subjects
- Activities of Daily Living, Humans, Mobility Limitation, Postural Balance, Quality of Life, Randomized Controlled Trials as Topic, Resistance Training, Walking, Exercise Therapy, Hip Fractures rehabilitation, Physical Therapy Modalities
- Abstract
Objectives: To determine the effect of structured exercise on overall mobility in people after hip fracture. To explore associations between trial-level characteristics and overall mobility., Design: Systematic review, meta-analysis and meta-regression., Data Sources: MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials, the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register and the Physiotherapy Evidence Database to May 2014., Study Eligibility Criteria, Participants and Interventions: Randomised controlled trials of structured exercise, which aimed to improve mobility compared with a control intervention in adult participants after surgery for hip fracture were included., Data Extraction and Synthesis: Data were extracted by one investigator and checked by an independent investigator. Standardised mean differences (SMD) of overall mobility were meta-analysed using random effects models. Random effects meta-regression was used to explore associations between trial-level characteristics and overall mobility., Results: 13 trials included in the meta-analysis involved 1903 participants. The pooled Hedges' g SMD for overall mobility was 0.35 (95% CI 0.12 to 0.58, p=0.002) in favour of the intervention. Meta-regression showed greater treatment effects in trials that included progressive resistance exercise (change in SMD=0.58, 95% CI 0.17 to 0.98, p=0.008, adjusted R2=60%) and delivered interventions in settings other than hospital alone (change in SMD=0.50, 95% CI 0.08 to 0.93, p=0.024, adjusted R2=49%)., Conclusions and Implications: Structured exercise produced small improvements on overall mobility after hip fracture. Interventions that included progressive resistance training and were delivered in other settings were more effective, although the latter may have been confounded by duration of interventions., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Published
- 2016
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45. Physical activity interventions: an essential component in recovery from mental illness.
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Rosenbaum S, Tiedemann A, Ward PB, Curtis J, and Sherrington C
- Subjects
- Humans, Exercise Therapy, Mental Disorders rehabilitation
- Published
- 2015
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46. Older people's perspectives on participation in physical activity: a systematic review and thematic synthesis of qualitative literature.
- Author
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Franco MR, Tong A, Howard K, Sherrington C, Ferreira PH, Pinto RZ, and Ferreira ML
- Subjects
- Aged, Aged, 80 and over, Anxiety psychology, Costs and Cost Analysis, Environment Design, Humans, Interpersonal Relations, Leisure Activities psychology, Middle Aged, Motivation, Muscle Strength physiology, Sedentary Behavior, Self Concept, Walking psychology, Attitude to Health, Exercise psychology
- Abstract
Background: Physical inactivity accounts for 9% of all deaths worldwide and is among the top 10 risk factors for global disease burden. Nearly half of people aged over 60 years are inactive. Efforts to identify which factors influence physical activity behaviour are needed., Objective: To identify and synthesise the range of barriers and facilitators to physical activity participation., Methods: Systematic review of qualitative studies on the perspectives of physical activity among people aged 60 years and over. MEDLINE, EMBASE, CINAHL, PsychINFO and AMED were searched. Independent raters assessed comprehensiveness of reporting of included studies. Thematic synthesis was used to analyse the data., Results: From 132 studies involving 5987 participants, we identified six major themes: social influences (valuing interaction with peers, social awkwardness, encouragement from others, dependence on professional instruction); physical limitations (pain or discomfort, concerns about falling, comorbidities); competing priorities; access difficulties (environmental barriers, affordability); personal benefits of physical activity (strength, balance and flexibility, self-confidence, independence, improved health and mental well-being); and motivation and beliefs (apathy, irrelevance and inefficacy, maintaining habits)., Conclusions: Some older people still believe that physical activity is unnecessary or even potentially harmful. Others recognise the benefits of physical activity, but report a range of barriers to physical activity participation. Strategies to enhance physical activity participation among older people should include (1) raising awareness of the benefits and minimise the perceived risks of physical activity and (2) improving the environmental and financial access to physical activity opportunities., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Published
- 2015
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47. 15 years of tracking physiotherapy evidence on PEDro, where are we now?
- Author
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Kamper SJ, Moseley AM, Herbert RD, Maher CG, Elkins MR, and Sherrington C
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- Evidence-Based Medicine trends, Forecasting, Humans, Practice Guidelines as Topic, Professional Practice, Randomized Controlled Trials as Topic, Review Literature as Topic, Databases, Bibliographic trends, Physical Therapy Modalities trends
- Published
- 2015
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48. Why does exercise reduce falls in older people? Unrecognised contributions to motor control and cognition?
- Author
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Sherrington C and Henschke N
- Subjects
- Humans, Accidental Falls prevention & control, Executive Function physiology, Exercise Therapy methods
- Published
- 2013
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49. Growth in the Physiotherapy Evidence Database (PEDro) and use of the PEDro scale.
- Author
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Elkins MR, Moseley AM, Sherrington C, Herbert RD, and Maher CG
- Subjects
- Databases, Bibliographic, Databases, Factual, Physical Therapy Modalities
- Published
- 2013
- Full Text
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