Purpose To investigate the feasibility of an exergame-driven high-intensity interval training (HIIT) and its effects on cardiovascular fitness in untrained community dwelling older adults. Methods Twelve older participants [10 women, age 72.3 ( SD : 4.44) years] performed a high-intensity interval exergame intervention three times a week for 4 weeks. Data was acquired during two baseline and one final measurement. Feasibility outcomes included attrition, adherence, acceptability [Technology Acceptance Model Questionnaire (TAM)], usability [System Usability Scale (SUS)], and enjoyment of exergaming. Furthermore, participants’ physical activity levels pre and post intervention were compared to physical activity levels for similar types of training. The secondary outcome was exercise capacity [heart rate at rest (HRrest), heart rate variability (HRV), maximum heart rate (HRmax), and maximum workload (W, in watt)] evaluated through maximal exercise testing. Results Eleven participants completed the study (8% attrition), without any adverse events. Adherence to the HIIT intervention was 91% and participants showed high acceptance of the intervention with TAM scores between 5.8 and 6.7 points. User satisfaction was rated as excellent (SUS total score: 93.5 of 100) and the overall enjoyment of exergaming scored 4.5 of 5 possible points. Total exercise time ranged from 19 to 35 min with a mean of 30.8 ( SD : 3.6) min. Actual high-intensity exercise time showed consistency with the target exercise time in 98% percent of trainings. Eighty-six percent of high-intensity intervals met the targeted intensity range (>70–90% of HRmax). Thirty-six percent of the recovery periods were completed with a heart rate above the target range of 50–70% of HRmax. Maximum workload (W) during the incremental exercise test post-training increased significantly compared to the baseline measurements one and two ( p = 0.032, effect size r = 0.77 and p = 0.012, r = 0.87). Conclusion High-intensity interval training through exergaming is feasible, safe, and shows high usability and acceptance in community dwelling older people. Exergame-driven HIIT had a significant effect on maximum power output on an incremental exercise test. A more extensive exergame intervention period, higher work to recovery ratios as well as a higher-intensity activity should be considered in future projects.
Background Low back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. Providing inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during weekends. Delays in therapeutic procedures may result in a prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates the influence of weekday of admission and distress on LoS of inpatients with LBP. Methods This retrospective cohort study was conducted between 1 February 2019 and 31 January 2020. In part 1, a negative binomial model was fitted to LoS with weekday of admission as a predictor. In part 2, the same model included weekday of admission, distress level, and their interaction as covariates. Planned contrast was used in part 1 to estimate the difference in log-expected LoS between group 1 (admissions Friday/Saturday) and the reference group (admissions Sunday-Thursday). In part 2, the same contrast was used to estimate the corresponding difference in (per-unit) distress trends. Results We identified 173 patients with LBP. The mean LoS was 7.8 days (SD = 5.59). Patients admitted on Friday (mean LoS = 10.3) and Saturday (LoS = 10.6) had longer stays, but not those admitted on Sunday (LoS = 7.1). Analysis of the weekday effect and planned contrast showed that admission on Friday or Saturday was associated with a significant increase in LoS (log ratio = 0.42, 95% CI = 0.21 to 0.63). A total of 101 patients (58%) returned questionnaires, and complete data on distress were available from 86 patients (49%). According to the negative binomial model for LoS and the planned contrast, the distress effect on LoS was significantly influenced (difference in slopes = 0.816, 95% CI = 0.03 to 1.60) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday). Conclusions Delays in interdisciplinary LBP management over the weekend may prolong LoS. This may particularly affect patients reporting high levels of distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.
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