Sandra Webber - Academia.edu (original) (raw)

Papers by Sandra Webber

Journal of Aging and Physical Activity

The purpose of this study was to measure heart rate, activity intensity, and steps in recreationa... more The purpose of this study was to measure heart rate, activity intensity, and steps in recreational singles and doubles pickleball players. We collected data in 22 singles and 31 doubles players (62.1 ± 9.7 years of age) using Garmin Fenix 5 watches (Garmin International, Inc.) and ActiGraph GT3X+ (ActiGraph LLC) accelerometers. Mean heart rates during singles and doubles were 111.6 ± 13.5 and 111.5 ± 16.2 beats/min (70.3% and 71.2% of predicted maximum heart rate), respectively. Over 70% of singles and doubles playing time was categorized in moderate to vigorous heart rate zones whereas 80.5% of singles time and 50.4% of doubles time were moderate based on Freedson accelerometer cut-points. Steps per hour were higher in singles versus doubles (3,322 ± 493 vs. 2,791 ± 359), t(51) = 4.540, p < .001. Singles and doubles pickleball are moderate- to vigorous-intensity activities that can contribute substantially toward older adults meeting physical activity guidelines.

Pilot and Feasibility Studies

Background Seventy-five per cent of individuals with prediabetes will eventually be diagnosed wit... more Background Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. Methods This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical acti...

Physiotherapy Canada, 2022

Purpose: Multiple Canadian jurisdictions have curtailed public funding for outpatient physiothera... more Purpose: Multiple Canadian jurisdictions have curtailed public funding for outpatient physiotherapy services, impacting access and potentially creating or worsening inequities in access. We sought to identify evaluated organizational strategies that aimed to improve access to physiotherapy services for community-dwelling persons. Method: We used Arksey and O’Malley’s scoping review methods, including a systematic search of CINAHL, MEDLINE, and Embase for relevant peer-reviewed texts published in English, French, or German, and we performed a qualitative content analysis of included articles. Results: Fifty-one peer-reviewed articles met inclusion criteria. Most studies of interventions or system changes to improve access took place in the United Kingdom (17), the United States (12), Australia (9), and Canada (8). Twenty-nine studies aimed to improve access for patients with musculoskeletal conditions; only five studies examined interventions to improve equitable access for underserv...

While much is not yet known about the long-term physiological, psychological and functional effec... more While much is not yet known about the long-term physiological, psychological and functional effects related to COVID-19, reports suggest that some individuals are severely affected and suffer from significant and prolonged effects after discharge from hospital. This scoping review will examine the extent, range and nature of literature describing rehabilitation recommendations for patients recovering outside of hospital in the post-acute phase of COVID-19 infection. We will focus on synthesizing out-patient and/or telerehabilitation physical therapy, occupational therapy and respiratory therapy assessment and treatment recommendations and provide information about the quality of the recommendations (primarily focused on the process used to arrive at the recommendations).

Journal of American College Health

Objective: To explore university students' knowledge, self-efficacy, outcome expectations, ba... more Objective: To explore university students' knowledge, self-efficacy, outcome expectations, barriers and ideas related to reducing sedentary behavior using a qualitative approach. Participants: Nineteen students from a Canadian university participated. Methods: Four focus groups were conducted. Discussions were recorded, transcribed, and coded to identify categories and themes. Results: Some students lacked knowledge of the concept, but most were generally aware of health risks associated with sedentary behavior. Most students were confident they could reduce sedentary behavior, but felt it would be unlikely they would actually do so because: (a) it is not a priority, (b) the health consequences are distal, (c) increasing standing and light-intensity activity would not provide meaningful health benefits, and (d) class schedules/norms/infrastructure encourage sitting and are not under their control to change. Conclusion: Findings from this study may help inform intervention strategies aimed at decreasing excessive sedentary behavior among university students.

Journal of American College Health

OBJECTIVE Examine effects of self-affirmation on university students' processing of health ri... more OBJECTIVE Examine effects of self-affirmation on university students' processing of health risk messages related to sedentary behavior. PARTICIPANTS Eighty-eight students from a Canadian university (females = 53; males = 35; Mage = 21.74, SD = 5.36) participated during the 2018-2019 academic year. METHODS Participants were randomized to a self-affirmation (n = 43) or control group (n = 45), watched a video conveying sedentary behavior risk messages, and completed measures of acceptance, derogation, risk perceptions, negative affect, and intentions. A one-way between-groups multivariate analysis of variance (MANOVA) examined effects of condition on the combined set of outcome variables. RESULTS Self-affirmation had no observable effect on any outcome variables. CONCLUSION Self-affirmation did not appear to impact students' reactions to sedentary behavior risk messages. Given the lack of a manipulation check, however, this finding must be interpreted with caution. The Trigger and Channel framework offers a useful account of factors that influence self-affirmation effects. Implications and future research directions are discussed.

Physical Therapy

Objective Physical therapists play an important role in responding to pandemic and physical disas... more Objective Physical therapists play an important role in responding to pandemic and physical disaster situations. Existing literature can provide guidance to health care leadership teams to appropriately and safely leverage physical therapy resources and skill sets during the COVID-19 pandemic. The purpose of this study was to provide a review of the pandemic and physical disaster management literature to summarize physical therapy–specific operational considerations to assist hospital-based leadership teams in planning and response efforts during the COVID-19 pandemic. Methods A rapid review was conducted over a 4-week time frame (April–May 2020). The review team included 3 physical therapist clinician researchers, a health librarian, and a member of the physical therapy leadership team. The initial search strategy identified 303 articles, 80 of which were retained for full-text screening. Twenty articles were included in the review. Results Five main categories of operational consi...

Journal of American College Health

OBJECTIVES To measure and compare distress in entry-level masters occupational therapy (OT) and p... more OBJECTIVES To measure and compare distress in entry-level masters occupational therapy (OT) and physical therapy (PT) students; to evaluate distress levels relative to existing data; and to explore factors that cause stress, effects of stress, and coping strategies. Participants: Ninety-eight OT and PT students (75 females, 23 males) from two cohorts at a Canadian university. Methods: Sequential mixed-methods including questionnaires and inductive analysis of focus group discussions. Results: OT and PT students from one cohort reported higher levels of stress, anxiety and/or depression compared to the following academic year and compared to undergraduate and general population samples. The overall theme was the unrelenting tug of war between school and other aspects of students' lives. Factors related to academic workload negatively affected mental health. Coping strategies included physical activity, strategic selection of peers, and modifying expectations. Conclusions: Wellness in OT and PT students is an important concern that deserves attention.

Reviews, 1996

Exercise training is commonly recommended for individuals with fibromyalgia. This review examined... more Exercise training is commonly recommended for individuals with fibromyalgia. This review examined the effects of supervised group aquatic training programs (led by an instructor). We defined aquatic training as exercising in a pool while standing at waist, chest, or shoulder depth. This review is part of the update of the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Exercise for treating fibromyalgia syndrome&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; review first published in 2002, and previously updated in 2007. The objective of this systematic review was to evaluate the benefits and harms of aquatic exercise training in adults with fibromyalgia. We searched The Cochrane Library 2013, Issue 2 (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, NHS Economic Evaluation Database), MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, WHO international Clinical Trials Registry Platform, and AMED, as well as other sources (i.e., reference lists from key journals, identified articles, meta-analyses, and reviews of all types of treatment for fibromyalgia) from inception to October 2013. Using Cochrane methods, we screened citations, abstracts, and full-text articles. Subsequently, we identified aquatic exercise training studies. Selection criteria were: a) full-text publication of a randomized controlled trial (RCT) in adults diagnosed with fibromyalgia based on published criteria, and b) between-group data for an aquatic intervention and a control or other intervention. We excluded studies if exercise in water was less than 50% of the full intervention. We independently assessed risk of bias and extracted data (24 outcomes), of which we designated seven as major outcomes: multidimensional function, self reported physical function, pain, stiffness, muscle strength, submaximal cardiorespiratory function, withdrawal rates and adverse effects. We resolved discordance through discussion. We evaluated interventions using mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (95% CI). Where two or more studies provided data for an outcome, we carried out meta-analysis. In addition, we set and used a 15% threshold for calculation of clinically relevant differences. We included 16 aquatic exercise training studies (N = 881; 866 women and 15 men). Nine studies compared aquatic exercise to control, five studies compared aquatic to land-based exercise, and two compared aquatic exercise to a different aquatic exercise program.We rated the risk of bias related to random sequence generation (selection bias), incomplete outcome data (attrition bias), selective reporting (reporting bias), blinding of outcome assessors (detection bias), and other bias as low. We rated blinding of participants and personnel (selection and performance bias) and allocation concealment (selection bias) as low risk and unclear. The assessment of the evidence showed limitations related to imprecision, high statistical heterogeneity, and wide confidence intervals. Aquatic versus controlWe found statistically significant improvements (P value &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in all of the major outcomes. Based on a 100-point scale, multidimensional function improved by six units (MD -5.97, 95% CI -9.06 to -2.88; number needed to treat (NNT) 5, 95% CI 3 to 9), self reported physical function by four units (MD -4.35, 95% CI -7.77 to -0.94; NNT 6, 95% CI 3 to 22), pain by seven units (MD -6.59, 95% CI -10.71 to -2.48; NNT 5, 95% CI 3 to 8), and stiffness by 18 units (MD -18.34, 95% CI -35.75 to -0.93; NNT 3, 95% CI 2 to 24) more in the aquatic than the control groups. The SMD for muscle strength as measured by knee extension and hand grip was 0.63 standard deviations higher compared to the control group (SMD 0.63, 95% CI 0.20 to 1.05; NNT 4, 95% CI 3 to 12) and cardiovascular submaximal function improved by 37 meters on six-minute walk test (95% CI 4.14 to 69.92). Only two major outcomes, stiffness and muscle strength, met the 15% threshold for clinical relevance (improved by 27% and 37% respectively). Withdrawals were similar in the aquatic and control groups and adverse effects were poorly reported, with no serious adverse effects reported. Aquatic versus land-basedThere were no statistically significant differences between interventions for multidimensional function, self reported…

Current Pain and Headache Reports, 2011

factors contributing to in vivo eccentric moment generation.

Canadian Journal on Aging / La Revue canadienne du vieillissement

Upper body and neck range of motion (ROM) are important for safe walking and driving. The purpose... more Upper body and neck range of motion (ROM) are important for safe walking and driving. The purpose of this study was to determine whether stretching would improve neck, trunk, and shoulder ROM. Forty-eight community-dwelling women (75 ± 3 years of age) were randomly allocated to intervention (upper body stretching, n = 15) and control conditions (lower body power training, n = 33). All participants exercised in supervised 45-minute sessions twice weekly for 12 weeks. Testing of upper body ROM included a cervical ROM, device-based measurement and field tests of the neck, trunk, and shoulder ranges. Shoulder ROM was the only movement that improved in the intervention group beyond levels seen in control participants (33% increase, p < 0.01). Neck and trunk ROM did not change in response to a specific stretching program. Older adults with ROM limitations may need to explore other exercise options or focus on compensatory strategies for safe community mobility.

Innovation in Aging

During the COVID-19 pandemic, in-person exercise programs for older people were temporarily close... more During the COVID-19 pandemic, in-person exercise programs for older people were temporarily closed, and some were replaced with online exercise. We explored the online exercise experiences of older people in Manitoba, Canada, using an online survey. We recruited a convenience sample (≥ 65 years), primarily through community organizations, and 745 people (57.5% female) consented. About 38.2% reported participating in online exercise during the pandemic. Most used pre-recorded classes (80.4%), from their local community (79.7%), and YouTube was the most used platform (57.4%). Almost all (82.7%) found the classes had the right variety and intensity. Of those who had participated in online exercise, 67.0% said they would participate in an online exercise class outside of a pandemic time. Participants like the following aspects better about online exercise: no transportation arrangements, it doesn’t matter what they wear, no travel time, and they like to exercise without others seeing th...

Journal of Aging and Physical Activity

Objective: To determine the optimal threshold, based on cadence and lifestyle counts per minute, ... more Objective: To determine the optimal threshold, based on cadence and lifestyle counts per minute, to detect outdoor walking in mobility-limited older adults. Methods: Older adults (N = 25, median age: 77.0 years, interquartile range: 10.5) wore activity monitors during 80 outdoor walks. Walking bouts were identified manually (reference standard) and compared with identification using cadence thresholds (≥30, ≥35, ≥40, ≥45, and ≥50 steps/min) and >760 counts per minute using low frequency extension analysis. Results: Median walking bout duration was 10.5 min (interquartile range 4.8) and median outdoor walking speed was 0.70 m/s (interquartile range 0.20). Cadence thresholds of ≥30, ≥35, and ≥40 steps/min demonstrated high sensitivity (1.0, 95% confidence intervals [0.95, 1.0]) to detect walking bouts; estimates for specificity and positive predictive value were highest for ≥40 steps/min. Conclusion: A cadence threshold of ≥40 steps/min is recommended for detecting sustained outdoo...

Cochrane Database of Systematic Reviews

What is fibromyalgia and what is mixed exercise? Fibromyalgia is a condition causing chronic pain... more What is fibromyalgia and what is mixed exercise? Fibromyalgia is a condition causing chronic pain and soreness throughout the body. People with this condition often feel depressed, tired, and stiff, and have difficulty sleeping. Mixed exercise is defined as regular sessions of two or more types of exercise including aerobic (walking or cycling), strengthening (lifting weights or pulling against resistance bands), or flexibility (stretching) exercise. Study characteristics Reviewers searched for studies until December 2017, and found 29 studies (2088 people) conducted in 12 different countries. The average age of study participants was 51 years, and 98% were female. The average exercise programme was 14 weeks long with three sessions of 50 to 60 minutes per week. All exercise programmes were fully or partially supervised. Reviewers were most interested in comparing mixed exercise groups to control groups (19 studies; 1065 people). People in control groups either received no treatment or continued their usual care. Key results - mixed exercise vs control Each outcome below is measured on a scale that goes from 0 to 100, where lower scores are better. Health-related quality of life (HRQL) After 5 to 26 weeks, people who exercised were 7% better (3% better to 11% better) or improved by 7 points on a 100 point scale. People who exercised rated their HRQL at 49 points. People in the control group rated their HRQL at 56 points. Pain After 5 to 26 weeks, people who exercised had 5% less pain (1% better to 9% better) or improved by 5 points on a 100 point scale. People who exercised rated their pain at 53 points. People in the control group rated their pain at 58.6 points. Tiredness After 14 to 24 weeks, people who exercised were 13% less tired (8% better to 18% better) or improved by 13 points on a 100 point scale People who exercised rated their tiredness at 59 points. People in the control group rated their tiredness at 72 points. Stiffness After 16 weeks, people who exercised were 7% less stiff (1% better 1 to 12% better) or improved by 7 points on a 100 point scale. People who exercised rated their stiffness at 61 points. People in the control group rated their stiffness at 68 points. Ability to do daily activities (physical function) After 8 to 24 weeks, people who exercised were 11% better (7% to 15%) or improved by 11 points on a 100 point scale. People who exercised rated their physical function at 38 points. People in the control group rated their physical function at 49 points. Harms - Some participants experienced increased pain, soreness, or tiredness during or after exercise. Studies reported no injuries or other harms. However, reporting of harms was missing or incomplete in many studies. We are uncertain whether risk is increased with exercise. Leaving the study early - 11% of control participants left the study early compared with 12% of exercisers. Long-term effects - Analysis of long-term effects of HRQL showed maintenance of mixed exercise effects at 6 to 12 weeks and at 13 to 26 weeks but not at 27 to 52 weeks. Very low-quality evidence suggests that it is uncertain whether mixed exercises improve HRQL in the long term. Withdrawals and adverse events were not measured. Other - Reviewers found no evidence that the benefits and harms of mixed exercise were any different from education programmes, cognitive-behavioural training, biofeedback, medication, or other types of exercise. Conclusions and quality of evidence Mixed exercise may improve HRQL and the ability to do daily activities, may decrease pain and tiredness, and may be acceptable to individuals with fibromyalgia. Low-quality evidence suggests that mixed exercise may slightly improve stiffness. When compared to other exercise or non-exercise interventions, we are uncertain about the effects of mixed exercise. Although mixed exercise appears to be well tolerated (similar numbers of people leaving the study across groups), evidence on harms was scarce, so we are uncertain about its safety. Reviewers considered the quality of evidence to be low to moderate because of small numbers of people in the studies, some issues involving study design, and the low quality of results.

Medicine & Science in Sports & Exercise

Journal of Aging and Physical Activity

The purpose of this study was to measure heart rate, activity intensity, and steps in recreationa... more The purpose of this study was to measure heart rate, activity intensity, and steps in recreational singles and doubles pickleball players. We collected data in 22 singles and 31 doubles players (62.1 ± 9.7 years of age) using Garmin Fenix 5 watches (Garmin International, Inc.) and ActiGraph GT3X+ (ActiGraph LLC) accelerometers. Mean heart rates during singles and doubles were 111.6 ± 13.5 and 111.5 ± 16.2 beats/min (70.3% and 71.2% of predicted maximum heart rate), respectively. Over 70% of singles and doubles playing time was categorized in moderate to vigorous heart rate zones whereas 80.5% of singles time and 50.4% of doubles time were moderate based on Freedson accelerometer cut-points. Steps per hour were higher in singles versus doubles (3,322 ± 493 vs. 2,791 ± 359), t(51) = 4.540, p < .001. Singles and doubles pickleball are moderate- to vigorous-intensity activities that can contribute substantially toward older adults meeting physical activity guidelines.

Pilot and Feasibility Studies

Background Seventy-five per cent of individuals with prediabetes will eventually be diagnosed wit... more Background Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. Methods This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical acti...

Physiotherapy Canada, 2022

Purpose: Multiple Canadian jurisdictions have curtailed public funding for outpatient physiothera... more Purpose: Multiple Canadian jurisdictions have curtailed public funding for outpatient physiotherapy services, impacting access and potentially creating or worsening inequities in access. We sought to identify evaluated organizational strategies that aimed to improve access to physiotherapy services for community-dwelling persons. Method: We used Arksey and O’Malley’s scoping review methods, including a systematic search of CINAHL, MEDLINE, and Embase for relevant peer-reviewed texts published in English, French, or German, and we performed a qualitative content analysis of included articles. Results: Fifty-one peer-reviewed articles met inclusion criteria. Most studies of interventions or system changes to improve access took place in the United Kingdom (17), the United States (12), Australia (9), and Canada (8). Twenty-nine studies aimed to improve access for patients with musculoskeletal conditions; only five studies examined interventions to improve equitable access for underserv...

While much is not yet known about the long-term physiological, psychological and functional effec... more While much is not yet known about the long-term physiological, psychological and functional effects related to COVID-19, reports suggest that some individuals are severely affected and suffer from significant and prolonged effects after discharge from hospital. This scoping review will examine the extent, range and nature of literature describing rehabilitation recommendations for patients recovering outside of hospital in the post-acute phase of COVID-19 infection. We will focus on synthesizing out-patient and/or telerehabilitation physical therapy, occupational therapy and respiratory therapy assessment and treatment recommendations and provide information about the quality of the recommendations (primarily focused on the process used to arrive at the recommendations).

Journal of American College Health

Objective: To explore university students' knowledge, self-efficacy, outcome expectations, ba... more Objective: To explore university students' knowledge, self-efficacy, outcome expectations, barriers and ideas related to reducing sedentary behavior using a qualitative approach. Participants: Nineteen students from a Canadian university participated. Methods: Four focus groups were conducted. Discussions were recorded, transcribed, and coded to identify categories and themes. Results: Some students lacked knowledge of the concept, but most were generally aware of health risks associated with sedentary behavior. Most students were confident they could reduce sedentary behavior, but felt it would be unlikely they would actually do so because: (a) it is not a priority, (b) the health consequences are distal, (c) increasing standing and light-intensity activity would not provide meaningful health benefits, and (d) class schedules/norms/infrastructure encourage sitting and are not under their control to change. Conclusion: Findings from this study may help inform intervention strategies aimed at decreasing excessive sedentary behavior among university students.

Journal of American College Health

OBJECTIVE Examine effects of self-affirmation on university students' processing of health ri... more OBJECTIVE Examine effects of self-affirmation on university students' processing of health risk messages related to sedentary behavior. PARTICIPANTS Eighty-eight students from a Canadian university (females = 53; males = 35; Mage = 21.74, SD = 5.36) participated during the 2018-2019 academic year. METHODS Participants were randomized to a self-affirmation (n = 43) or control group (n = 45), watched a video conveying sedentary behavior risk messages, and completed measures of acceptance, derogation, risk perceptions, negative affect, and intentions. A one-way between-groups multivariate analysis of variance (MANOVA) examined effects of condition on the combined set of outcome variables. RESULTS Self-affirmation had no observable effect on any outcome variables. CONCLUSION Self-affirmation did not appear to impact students' reactions to sedentary behavior risk messages. Given the lack of a manipulation check, however, this finding must be interpreted with caution. The Trigger and Channel framework offers a useful account of factors that influence self-affirmation effects. Implications and future research directions are discussed.

Physical Therapy

Objective Physical therapists play an important role in responding to pandemic and physical disas... more Objective Physical therapists play an important role in responding to pandemic and physical disaster situations. Existing literature can provide guidance to health care leadership teams to appropriately and safely leverage physical therapy resources and skill sets during the COVID-19 pandemic. The purpose of this study was to provide a review of the pandemic and physical disaster management literature to summarize physical therapy–specific operational considerations to assist hospital-based leadership teams in planning and response efforts during the COVID-19 pandemic. Methods A rapid review was conducted over a 4-week time frame (April–May 2020). The review team included 3 physical therapist clinician researchers, a health librarian, and a member of the physical therapy leadership team. The initial search strategy identified 303 articles, 80 of which were retained for full-text screening. Twenty articles were included in the review. Results Five main categories of operational consi...

Journal of American College Health

OBJECTIVES To measure and compare distress in entry-level masters occupational therapy (OT) and p... more OBJECTIVES To measure and compare distress in entry-level masters occupational therapy (OT) and physical therapy (PT) students; to evaluate distress levels relative to existing data; and to explore factors that cause stress, effects of stress, and coping strategies. Participants: Ninety-eight OT and PT students (75 females, 23 males) from two cohorts at a Canadian university. Methods: Sequential mixed-methods including questionnaires and inductive analysis of focus group discussions. Results: OT and PT students from one cohort reported higher levels of stress, anxiety and/or depression compared to the following academic year and compared to undergraduate and general population samples. The overall theme was the unrelenting tug of war between school and other aspects of students' lives. Factors related to academic workload negatively affected mental health. Coping strategies included physical activity, strategic selection of peers, and modifying expectations. Conclusions: Wellness in OT and PT students is an important concern that deserves attention.

Reviews, 1996

Exercise training is commonly recommended for individuals with fibromyalgia. This review examined... more Exercise training is commonly recommended for individuals with fibromyalgia. This review examined the effects of supervised group aquatic training programs (led by an instructor). We defined aquatic training as exercising in a pool while standing at waist, chest, or shoulder depth. This review is part of the update of the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Exercise for treating fibromyalgia syndrome&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; review first published in 2002, and previously updated in 2007. The objective of this systematic review was to evaluate the benefits and harms of aquatic exercise training in adults with fibromyalgia. We searched The Cochrane Library 2013, Issue 2 (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, NHS Economic Evaluation Database), MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, WHO international Clinical Trials Registry Platform, and AMED, as well as other sources (i.e., reference lists from key journals, identified articles, meta-analyses, and reviews of all types of treatment for fibromyalgia) from inception to October 2013. Using Cochrane methods, we screened citations, abstracts, and full-text articles. Subsequently, we identified aquatic exercise training studies. Selection criteria were: a) full-text publication of a randomized controlled trial (RCT) in adults diagnosed with fibromyalgia based on published criteria, and b) between-group data for an aquatic intervention and a control or other intervention. We excluded studies if exercise in water was less than 50% of the full intervention. We independently assessed risk of bias and extracted data (24 outcomes), of which we designated seven as major outcomes: multidimensional function, self reported physical function, pain, stiffness, muscle strength, submaximal cardiorespiratory function, withdrawal rates and adverse effects. We resolved discordance through discussion. We evaluated interventions using mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (95% CI). Where two or more studies provided data for an outcome, we carried out meta-analysis. In addition, we set and used a 15% threshold for calculation of clinically relevant differences. We included 16 aquatic exercise training studies (N = 881; 866 women and 15 men). Nine studies compared aquatic exercise to control, five studies compared aquatic to land-based exercise, and two compared aquatic exercise to a different aquatic exercise program.We rated the risk of bias related to random sequence generation (selection bias), incomplete outcome data (attrition bias), selective reporting (reporting bias), blinding of outcome assessors (detection bias), and other bias as low. We rated blinding of participants and personnel (selection and performance bias) and allocation concealment (selection bias) as low risk and unclear. The assessment of the evidence showed limitations related to imprecision, high statistical heterogeneity, and wide confidence intervals. Aquatic versus controlWe found statistically significant improvements (P value &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) in all of the major outcomes. Based on a 100-point scale, multidimensional function improved by six units (MD -5.97, 95% CI -9.06 to -2.88; number needed to treat (NNT) 5, 95% CI 3 to 9), self reported physical function by four units (MD -4.35, 95% CI -7.77 to -0.94; NNT 6, 95% CI 3 to 22), pain by seven units (MD -6.59, 95% CI -10.71 to -2.48; NNT 5, 95% CI 3 to 8), and stiffness by 18 units (MD -18.34, 95% CI -35.75 to -0.93; NNT 3, 95% CI 2 to 24) more in the aquatic than the control groups. The SMD for muscle strength as measured by knee extension and hand grip was 0.63 standard deviations higher compared to the control group (SMD 0.63, 95% CI 0.20 to 1.05; NNT 4, 95% CI 3 to 12) and cardiovascular submaximal function improved by 37 meters on six-minute walk test (95% CI 4.14 to 69.92). Only two major outcomes, stiffness and muscle strength, met the 15% threshold for clinical relevance (improved by 27% and 37% respectively). Withdrawals were similar in the aquatic and control groups and adverse effects were poorly reported, with no serious adverse effects reported. Aquatic versus land-basedThere were no statistically significant differences between interventions for multidimensional function, self reported…

Current Pain and Headache Reports, 2011

factors contributing to in vivo eccentric moment generation.

Canadian Journal on Aging / La Revue canadienne du vieillissement

Upper body and neck range of motion (ROM) are important for safe walking and driving. The purpose... more Upper body and neck range of motion (ROM) are important for safe walking and driving. The purpose of this study was to determine whether stretching would improve neck, trunk, and shoulder ROM. Forty-eight community-dwelling women (75 ± 3 years of age) were randomly allocated to intervention (upper body stretching, n = 15) and control conditions (lower body power training, n = 33). All participants exercised in supervised 45-minute sessions twice weekly for 12 weeks. Testing of upper body ROM included a cervical ROM, device-based measurement and field tests of the neck, trunk, and shoulder ranges. Shoulder ROM was the only movement that improved in the intervention group beyond levels seen in control participants (33% increase, p < 0.01). Neck and trunk ROM did not change in response to a specific stretching program. Older adults with ROM limitations may need to explore other exercise options or focus on compensatory strategies for safe community mobility.

Innovation in Aging

During the COVID-19 pandemic, in-person exercise programs for older people were temporarily close... more During the COVID-19 pandemic, in-person exercise programs for older people were temporarily closed, and some were replaced with online exercise. We explored the online exercise experiences of older people in Manitoba, Canada, using an online survey. We recruited a convenience sample (≥ 65 years), primarily through community organizations, and 745 people (57.5% female) consented. About 38.2% reported participating in online exercise during the pandemic. Most used pre-recorded classes (80.4%), from their local community (79.7%), and YouTube was the most used platform (57.4%). Almost all (82.7%) found the classes had the right variety and intensity. Of those who had participated in online exercise, 67.0% said they would participate in an online exercise class outside of a pandemic time. Participants like the following aspects better about online exercise: no transportation arrangements, it doesn’t matter what they wear, no travel time, and they like to exercise without others seeing th...

Journal of Aging and Physical Activity

Objective: To determine the optimal threshold, based on cadence and lifestyle counts per minute, ... more Objective: To determine the optimal threshold, based on cadence and lifestyle counts per minute, to detect outdoor walking in mobility-limited older adults. Methods: Older adults (N = 25, median age: 77.0 years, interquartile range: 10.5) wore activity monitors during 80 outdoor walks. Walking bouts were identified manually (reference standard) and compared with identification using cadence thresholds (≥30, ≥35, ≥40, ≥45, and ≥50 steps/min) and >760 counts per minute using low frequency extension analysis. Results: Median walking bout duration was 10.5 min (interquartile range 4.8) and median outdoor walking speed was 0.70 m/s (interquartile range 0.20). Cadence thresholds of ≥30, ≥35, and ≥40 steps/min demonstrated high sensitivity (1.0, 95% confidence intervals [0.95, 1.0]) to detect walking bouts; estimates for specificity and positive predictive value were highest for ≥40 steps/min. Conclusion: A cadence threshold of ≥40 steps/min is recommended for detecting sustained outdoo...

Cochrane Database of Systematic Reviews

What is fibromyalgia and what is mixed exercise? Fibromyalgia is a condition causing chronic pain... more What is fibromyalgia and what is mixed exercise? Fibromyalgia is a condition causing chronic pain and soreness throughout the body. People with this condition often feel depressed, tired, and stiff, and have difficulty sleeping. Mixed exercise is defined as regular sessions of two or more types of exercise including aerobic (walking or cycling), strengthening (lifting weights or pulling against resistance bands), or flexibility (stretching) exercise. Study characteristics Reviewers searched for studies until December 2017, and found 29 studies (2088 people) conducted in 12 different countries. The average age of study participants was 51 years, and 98% were female. The average exercise programme was 14 weeks long with three sessions of 50 to 60 minutes per week. All exercise programmes were fully or partially supervised. Reviewers were most interested in comparing mixed exercise groups to control groups (19 studies; 1065 people). People in control groups either received no treatment or continued their usual care. Key results - mixed exercise vs control Each outcome below is measured on a scale that goes from 0 to 100, where lower scores are better. Health-related quality of life (HRQL) After 5 to 26 weeks, people who exercised were 7% better (3% better to 11% better) or improved by 7 points on a 100 point scale. People who exercised rated their HRQL at 49 points. People in the control group rated their HRQL at 56 points. Pain After 5 to 26 weeks, people who exercised had 5% less pain (1% better to 9% better) or improved by 5 points on a 100 point scale. People who exercised rated their pain at 53 points. People in the control group rated their pain at 58.6 points. Tiredness After 14 to 24 weeks, people who exercised were 13% less tired (8% better to 18% better) or improved by 13 points on a 100 point scale People who exercised rated their tiredness at 59 points. People in the control group rated their tiredness at 72 points. Stiffness After 16 weeks, people who exercised were 7% less stiff (1% better 1 to 12% better) or improved by 7 points on a 100 point scale. People who exercised rated their stiffness at 61 points. People in the control group rated their stiffness at 68 points. Ability to do daily activities (physical function) After 8 to 24 weeks, people who exercised were 11% better (7% to 15%) or improved by 11 points on a 100 point scale. People who exercised rated their physical function at 38 points. People in the control group rated their physical function at 49 points. Harms - Some participants experienced increased pain, soreness, or tiredness during or after exercise. Studies reported no injuries or other harms. However, reporting of harms was missing or incomplete in many studies. We are uncertain whether risk is increased with exercise. Leaving the study early - 11% of control participants left the study early compared with 12% of exercisers. Long-term effects - Analysis of long-term effects of HRQL showed maintenance of mixed exercise effects at 6 to 12 weeks and at 13 to 26 weeks but not at 27 to 52 weeks. Very low-quality evidence suggests that it is uncertain whether mixed exercises improve HRQL in the long term. Withdrawals and adverse events were not measured. Other - Reviewers found no evidence that the benefits and harms of mixed exercise were any different from education programmes, cognitive-behavioural training, biofeedback, medication, or other types of exercise. Conclusions and quality of evidence Mixed exercise may improve HRQL and the ability to do daily activities, may decrease pain and tiredness, and may be acceptable to individuals with fibromyalgia. Low-quality evidence suggests that mixed exercise may slightly improve stiffness. When compared to other exercise or non-exercise interventions, we are uncertain about the effects of mixed exercise. Although mixed exercise appears to be well tolerated (similar numbers of people leaving the study across groups), evidence on harms was scarce, so we are uncertain about its safety. Reviewers considered the quality of evidence to be low to moderate because of small numbers of people in the studies, some issues involving study design, and the low quality of results.

Medicine & Science in Sports & Exercise