and meta-analyses that synthesize the scientific knowledge available on the subject, especially those based on the results from randomized controlled trials (RCTs), which are traditionally considered the gold standard for judging the benefits of treatments. 24 To the authors’ knowledge, only one
Miguel A. Sanchez-Lastra, Kyle J. Miller, Rodolfo I. Martínez-Lemos, Antón Giráldez and Carlos Ayán
Linda Corbally, Mick Wilkinson and Melissa A. Fothergill
the review to randomized controlled trials (RCTs). Studies of all design types were included because non-randomized trials and simple before-after and case-control designs have been suggested to still have value in systematic reviews for exploring unknown benefits and harms, and adding to evidence
randomized controlled trials (RCTs) of complex interventions for recovery should be an imperative ( Campbell et al., 2000 ). We return to the issue raised earlier, “social and personal factors can have a high impact on stroke recovery in humans….and are not well modelled in preclinical research”. One noted
Bradley M. Wipfli, Chad D. Rethorst and Daniel M. Landers
A meta-analysis was conducted to examine the effects of exercise on anxiety. Because previous meta-analyses in the area included studies of varying quality, only randomized, controlled trials were included in the present analysis. Results from 49 studies show an overall effect size of -0.48, indicating larger reductions in anxiety among exercise groups than no-treatment control groups. Exercise groups also showed greater reductions in anxiety compared with groups that received other forms of anxiety-reducing treatment (effect size = -0.19). Because only randomized, controlled trials were examined, these results provide Level 1, Grade A evidence for using exercise in the treatment of anxiety. In addition, exercise dose data were calculated to examine the relationship between dose of exercise and the corresponding magnitude of effect size.
Tyler L. Malone, Adam Kern, Emily Klueh and Daniel Eisenberg
relative to articles for both coping strategies. To test both hypotheses, we used a randomized controlled trial to compare video- and text-based interventions designed to deliver coping skills information to college student-athletes. Method Participants We recruited study participants via e-mail from all
Brad Donohue, Yulia Gavrilova, Marina Galante, Elena Gavrilova, Travis Loughran, Jesse Scott, Graig Chow, Christopher P. Plant and Daniel N. Allen
health help-seeking in elite athletes: An exploratory randomized controlled trial . Journal of Medical Internet Research, 14 ( 3 ), 69 . doi:10.2196/jmir.1864 10.2196/jmir.1864 Gulliver , A. , Griffiths , K.M. , Mackinnon , A. , Batterham , P.J. , & Stanimirovic , R. ( 2015 ). The mental
Thelma J. Mielenz, Michael C. Edwards and Leigh F. Callahan
Benefits of physical activity for those with arthritis are clear, yet physical activity is difficult to initiate and maintain. Self-efficacy is a key modifiable psychosocial determinant of physical activity. This study examined two scales for self-efficacy for exercise behavior (SEEB) to identify their strengths and weaknesses using item response theory (IRT) from community-based randomized controlled trials of physical activity programs in adults with arthritis. The 2 SEEB scales included the 9-item scale by Resnick developed with older adults and the 5-item scale by Marcus developed with employed adults. All IRT analyses were conducted using the graded-response model. IRT assumptions were assessed using both exploratory and confirmatory factor analysis. The IRT analyses indicated that these scales are precise and reliable measures for identifying people with arthritis and low SEEB. The Resnick SEEB scale is slightly more precise at lower levels of self-efficacy in older adults with arthritis.
Carolyn Rabin, Bernardine M. Pinto and Georita M. Frierson
Physical activity (PA) interventions diminish some of the physical and psychosocial sequelae of breast cancer diagnosis and treatment. To increase intervention efficacy and portability, it is necessary to determine the factors mediating intervention effects on physical and psychosocial outcomes. This study presents mediator analyses from a randomized controlled trial of a home-based PA intervention (focused primarily on brisk walking) for breast cancer survivors. Eighty-six survivors were randomized to PA or contact control groups (mean age = 53.42 years, SD = 9.08 and 52.86 years, SD = 10.38 respectively; mean time since diagnosis < 2 years). The PA intervention was based on the transtheoretical model (TTM). Kraemerʼs approach was used to test hypothesized mediators. TTM variables did not mediate intervention effects on PA. Data indicate that increases in moderate-intensity PA and improved fitness may mediate intervention effects on vigor (β = .21; p = .01) and fatigue (β = .24; p = .05) and suggest the value of future research on these potential mediators.
Seung-Youn Hong, Susan Hughes and Thomas Prohaska
Many different constructs are used currently in the literature to assess exercise adherence. This study examined whether the same or different variables predict exercise attendance and exercise completion among sedentary older adults.
Thirty-seven randomized control trials were selected from articles published between 1980 and 2000 that tested exercise interventions for sedentary older adults. Block-entry, weighted, hierarchical meta-regression analyses were conducted.
Different factors predicted attendance and completion. Group-based (P < .05) and resistance exercise (P < .1) predicted higher attendance rates than individual-based and aerobic exercise. In contrast, facility-based exercise was associated with higher completion rates than home-based exercise (P < .1).
Results show that completing a program is not synonymous with good attendance. Program designers need to consider different strategies to boost both of these rates that need to be maximized to best benefit program participants.
Kathleen T. Rhyner and Amber Watts
Depressive symptoms are common in older adults, but antidepressant medications may be contraindicated or poorly tolerated in this population. Intervention studies demonstrate that exercise may be an effective alternative. This meta-analysis included 41 randomized controlled trials of aerobic and nonaerobic exercise interventions investigating the effect of exercise on depressive symptoms in adults aged 60 or older. A random effects model demonstrated that exercise was associated with significantly lower depression severity (SMD = 0.57, 95% CI 0.36–0.78). This effect was not significantly different for different ages of participants, types of control groups, or types of exercise interventions. Studies requiring a diagnosis of depression had significantly greater mean effect sizes than studies that did not require a depression diagnosis (Qbet = 6.843, df = 1, p = .009). These findings suggest that exercise is an effective treatment option for older individuals with depressive symptoms.