Julie Adsett - Academia.edu (original) (raw)

Papers by Julie Adsett

Journal of Cardiopulmonary Rehabilitation and Prevention

Physiotherapy Theory and Practice

Exercise offers significant health benefits to older people, but may also carry risks of injury a... more Exercise offers significant health benefits to older people, but may also carry risks of injury and cardiovascular events. These can be minimized with appropriate screening, prescription, and monitoring of an exercise program. Tailored exercise prescription is developed in consultation with the participant, taking into account identified risks, functional limitations, and individual goals. Exercise professionals can provide valuable assistance with screening, prescription, and supervision of an exercise program, but limited access to experienced staff and supervised programs remains a significant barrier to exercise participation. Innovative models of care are required to investigate optimal participant targeting, long-term exercise adherence, and cost-effectiveness

Heart & Lung, 2018

Background: Aquatic exercise training may be suitable for people with stable heart failure (HF) t... more Background: Aquatic exercise training may be suitable for people with stable heart failure (HF) to engage in physical activity. Objectives: Acceptability, experiences and preferences regarding aquatic and traditional land-based exercise training, were explored in people with HF. Methods: As part of a comparative intervention study, participants completed a questionnaire assessing acceptability, benefits and challenges of aquatic compared to land-based programs. Semi-structured interviews explored participant experiences in greater depth. Results: Forty-eight participants, (mean age 70 +/-11 years), completed the questionnaire and 14 participated in semi structured interviews. Aquatic exercise was regarded as acceptable and beneficial. Motivators were similar for both programs and included: a skilled and compassionate workforce, tailored care, perceived health benefit, sense of safety and an inclusive and enjoyable environment. Few barriers were identified for either program. Conclusions: Aquatic and land-based exercise training are equally acceptable for people with stable HF and motivators are similar for both programs.

Critical Care, 2006

Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II ce... more Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II cells (A549). To study in vitro the direct influence of alveolar type II cells on mechanical stretch. Methods A549 were treated with different doses of lipopolysaccharide (LPS), 0 ng/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1000 ng/ml, and then A549 were lengthened 5%, 15%, 30% using a FLEXCELL tension unit 4000, a vacuum-driven device that applies strain to cells, which were cultured in six-well plates coated with collagen-I, and 12 cycles/min for 4 hours. Apoptosis was measured using the flow cytometry method that measures annexin V and propidium iodide (PI) staining. The morphological changes of apoptotic cells were observed by transmission electron microscope. Results Apoptosis could be induced in alveolar type II cells (A549) by mechanical stretch. The percentage of annexin V + PI cells increased after being treated with cyclic stretch for 4 hours by 5%, 15%, 30% in all groups. The morphological features of apoptotic cells demonstrated by transmission electron microscope were as follows: shrinkage of the cell, chromatin condensation and aggregation under the nuclear membrane as a crescent or lump, membrane-encapsulated nuclear fragment or cell organ formed by invagination of the cell membrane, and apoptotic body formation followed by vacuolization. Conclusion Apoptosis induced by mechanical stretch and LPS is dose dependent. Mechanical stretch aggravates apoptosis especially in cells treated with LPS. Annexin V and PI double staining is a specific, sensitive, and quantitative method for analyzing apoptotic cells. It is also helpful to clarify the protective mechanism of low-volume ventilation in ARDS. Acknowledgement The study was funded by the 'One Hundred People' project of Shanghai Sanitary Bureau (03-77-20).

Journal of Burn Care & Research, 2021

Physical activity behavior has not been previously described in hospitalized adults with burn inj... more Physical activity behavior has not been previously described in hospitalized adults with burn injuries. This prospective, cross-sectional study used a standardized behavioral mapping protocol to observe patient behavior related to physical activity over a 12-hour period on one weekday in a quaternary referral specialist burn center. Structured observations were recorded for each of four domains: 1) patient location, 2) position, 3) activity performed, and 4) the presence of others. Observations were summarized across all participants as median (interquartile range [IQR]) proportion of time. Participants (n = 17) were predominantly male (82%) with a mean age of 44.3 (SD 15.2) years, a mean burn size of 34.9% (SD 26.7) TBSA, and a median hospital length of stay of 18 (IQR 6–49) days at time of observation. Participants spent a median of 83% (IQR 73–93) of time in their bedroom, 92% (IQR 68–97) of time in or on their bed and a median of 5% (IQR 3–13) of time mobilizing. Exercise accoun...

Physiotherapy, 2021

Background With the change in healthcare to one that adopts a greater reliance on remote delivery... more Background With the change in healthcare to one that adopts a greater reliance on remote delivery, guidance regarding functional exercise testing, either in-person in the home or performed remotely, is urgently needed for people with cardiac conditions. Objectives To identify functional exercise tests that have been conducted in the home or remotely in patients with cardiac conditions. Data sources A search was undertaken across four electronic databases and grey literature for English language publications without time restrictions. Study eligibility criteria Studies of any designs were selected if they reported an exercise test conducted at home or remotely in patients with cardiac conditions. Study appraisal and synthesis Studies were independently screened and graded by two reviewers according to the Downs and Black checklist. A narrative synthesis of the included studies was undertaken. Results Five studies (six articles) were included, with a total of 438 patients with cardiac conditions. Tests used at home or remotely were the 6-minute walk test (6MWT, five studies) and the timed up and go test (one study). No studies reported the use of step tests in the home or remotely. The 6MWTs were administered via a smartphone application, rope, videoconferencing and accelerometer and proved to be feasible, valid and reliable. Conclusions Despite a marked demand for home-based exercise programs, the 6MWT remains the most commonly administered functional exercise test for people with cardiac conditions. Surprisingly few studies have explored alternative tests for this patient population that may be more suitable for home or remote performance. Systematic review registration number PROSPERO: CRD42020219512.

Journal of the American Geriatrics Society, 2021

Frailty is common in people with heart failure (HF) and associated with poorer outcomes. The aim ... more Frailty is common in people with heart failure (HF) and associated with poorer outcomes. The aim of this study was to describe the characteristics, exercise participation, and outcomes of frail and not‐frail participants enrolled in a randomized trial of exercise training (ET) within a cardiac rehabilitation (CR) program.

Heart, Lung and Circulation, 2018

Physiotherapy Theory and Practice, 2019

Journal of Cardiopulmonary Rehabilitation and Prevention, 2019

For individuals with heart failure (HF), frequent attendance at exercise training programs and me... more For individuals with heart failure (HF), frequent attendance at exercise training programs and meeting physical activity (PA) guidelines are signifi cantly associated with improvements in 6-min walk distance. Despite the evidence, adherence to exercise interventions remains poor. The aim of this study was to identify predictors of these 2 variables in patients recently hospitalized with HF. Methods: In this substudy of the Exercise Joins Education: Combined Therapy to Improve Outcomes in Newly-discharged Heart Failure (EJECTION-HF) trial, all participants were enrolled in a HF disease management program, including weekly review of a home exercise program for 12 wk. Intervention group participants additionally undertook twice weekly supervised exercise training. Primary outcomes were frequent exercise training program attendance (≥ 12 sessions) and attainment of PA guidelines (150 min/wk of moderate intensity exercise) at 12 wk. Participant and clinical characteristics were analyzed using a logistic regression model to identify signifi cant predictors of each outcome. Results: A total of 278 participants provided PA data and 140 contributed attendance data. New diagnosis of HF was a signifi cant predictor of frequent program attendance (OR = 2.3; 95% CI, 1.1-4.7; P = .03). Predictors of meeting PA guidelines at follow-up included new HF diagnosis (OR = 2.4; 95% CI, 1.2-4.8, P = .013), and being physically active at baseline (OR = 2.7; 95% CI, 1.3-5.6; P = .007). Gender, symptom severity, multimorbidity, and disability were not signifi cantly associated with either outcome in multivariate analysis. Conclusion: To improve adherence, specifi c strategies may be required for patients with decompensated HF and those physically inactive at time of referral.

Cardiopulmonary Physical Therapy Journal, 2013

Purpose: Exercise rehabilitation improves fitness and functional status for patients with cardior... more Purpose: Exercise rehabilitation improves fitness and functional status for patients with cardiorespiratory conditions; however, poor adherence to continuing exercise may erode long‐term benefits. An understanding of patient barriers to group maintenance programs may assist uptake and continuation. Methods: Observational study of prospectively recruited cardiac, heart failure, and pulmonary rehabilitation patients referred to newlyestablished, community‐based maintenance exercise programs in Brisbane, Australia. Factors associated with initial attendance (attended at least once) and continuing attendance (attended at least 6 of the first 12 weeks) were identified using pre‐attendance survey data, integrated with attendance data collected at the receiving programs. Results: Of 241 referred participants, 140 provided survey data for this analysis. Of these, 98 (70%) attended the community program at least once, and 59 (60% of initial attenders) continued for at least 6 of the first 12 weeks. Significant predictors of initial attendance were referring site, familiarity with the community model, perceived cost, and social barriers. Continuing attendance was significantly higher in retired participants and those with established exercise habits, and lower in those with perceived transport and safety barriers. Conclusion: This study proposes several barriers that could be addressed by rehabilitation staff and by receiving exercise programs in order to facilitate adherence to regular post‐rehabilitation exercise.

JACC. Heart failure, 2018

This study sought to measure the impact on all-cause death or readmission of adding center-based ... more This study sought to measure the impact on all-cause death or readmission of adding center-based exercise training (ET) to disease management programs for patients with a recent acute heart failure (HF) hospitalization. ET is recommended for patients with HF, but evidence is based mainly on ET as a single intervention in stable outpatients. A randomized, controlled trial with blinded outcome assessor, enrolling adult participants with HF discharged from 5 hospitals in Queensland, Australia. All participants received HF-disease management program plus supported home exercise program; intervention participants were offered 24 weeks of supervised center-based ET. Primary outcome was all-cause 12-month death or readmission. Pre-planned subgroups included age (<70 years vs. older), sex, left ventricular ejection fraction (≤40% vs. >40%), and exercise adherence. Between May 2008 and July 2013, 278 participants (140 intervention, 138 control) were enrolled: 98 (35.3%) age ≥70 years, ...

Heart, Lung and Circulation, 2017

Background The benefits of exercise rehabilitation for people with heart failure (HF) are well es... more Background The benefits of exercise rehabilitation for people with heart failure (HF) are well established. In Australia, little is known about how the guidelines around exercise rehabilitation for people with HF are being implemented in clinical practice. Furthermore, it is unknown what organisational barriers are faced in providing exercise rehabilitation programs for this population. The aim of this study is to provide an updated review of exercise rehabilitation services for people with HF in Australia and to identify perceived organisational barriers to providing these services. Methods A cross-sectional survey of cardiac rehabilitation centres in Australia, investigating the number and characteristics of services providing exercise rehabilitation for people with HF. Results A total of 334 of 457 identified services responded to the survey. Of these, 251 reported providing a supervised group-based exercise rehabilitation program for people with HF. These services were mapped, showing their distribution across Australia. Services which were unable to provide group-based exercise training for HF patients reported organisational barriers including insufficient funding (60%), staffing (56%) and clinical resources (53%). Of the 78 services that reported patients in their local area were unable to access appropriate exercise guidance, 81% were located in regional or remote areas. We found that reported exercise practices align with current best-practice guidelines with 99% of group based exercise programs reportedly including endurance training and 89% including resistance training. Conclusions In Australia, exercise practices for people with HF align with current best-practice guidelines for this condition. Limited resources, funding and geographic isolation are reported as the major organisational barriers to providing these programs. Future endeavours should include the development of alternative and flexible delivery models such as telerehabilitation and other home-based therapies to improve access for these individuals to such services.

Journal of cardiac failure, 2017

Upon heat exposure, the thermoregulatory system evokes reflex increases in sweating and skin bloo... more Upon heat exposure, the thermoregulatory system evokes reflex increases in sweating and skin blood flow responses to facilitate heat dissipation and maintain heat balance to prevent the continuing rise in core temperature. These heat dissipating responses are mediated primarily by autonomic and cardiovascular adjustments; which, if attenuated, may compromise thermoregulatory control. In patients with heart failure (HF), the neurohumoral and cardiovascular dysfunction that underpins this condition may potentially impair thermoregulatory responses and, consequently, place these patients at a greater risk of heat-related illness. The aim of this review is to describe thermoregulatory mechanisms and the factors that may increase the risk of heat-related illness in patients with HF. An understanding of the mechanisms responsible for impaired thermoregulatory control in HF patients is of particular importance, given the current and projected increase in frequency and intensity of heat wav...

Heart, lung & circulation, Jan 30, 2016

Providing flexible models and a variety of exercise options are fundamental to supporting long-te... more Providing flexible models and a variety of exercise options are fundamental to supporting long-term exercise participation for patients with heart failure (HF). The aim of this pilot study was to determine the feasibility and efficacy of aquatic exercise training during a maintenance phase for a clinical heart failure population. In this 2 x 2 crossover design trial, individuals who had previously completed HF rehabilitation were randomised into either a land-based or aquatic training program once per week for six weeks, after which time they changed to the alternate exercise training protocol for an additional six weeks. Six-minute walk test (6MWT), grip strength, walk speed, and measures of balance were compared for the two training protocols. Fifty-one participants (43 males, mean age 69.2 yrs) contributed data for the analysis. Both groups maintained function during the follow-up period, however improvements in 6MWT were greater in the land-based training group (95% CI: 0.7, 22....