Importance of Measuring for Health-related Quality of Life by Exercise Researchers and Programmers

Importance of Measuring for Health-related Quality of Life by Exercise Researchers and Programmers

Physical exercises in the management of a disease or physical disability contribute to positive physical and mental health outcomes. Positive health outcomes contribute to improved health-related quality of life in the general population. There are various reasons why exercise researchers and programmers should measure health-related quality of life (HRQoL) in developing exercise programs for people with a disease and/or disability. Firstly, HRQoL can help understand how the disease or disability burdens the individual physically and mentally. It can also act as an indicator of the health status of an individual as well as indicate the progress made in the developed exercise programs.

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Focusing on HRQoL can help understand the impact of disease and disability on an individual.

HRQoL includes the physical, psychological, and social aspects of quality of life that are directly or indirectly related to the individual’s health status. Diseases and disabilities create hardships and loss of function due to the individual’s increasing dependency on others. The loss of function and independence has a negative impact on how the individual perceives their mental and physical well-being over time. Studies have proved that diseases and disabilities significantly impact the various domains of quality of life. For instance, Bos et al. (2019) noted that the experiences related to a neuromuscular disease, such as pain, can impair the patient’s mental abilities and lead to a lowered quality of life.

Measuring HRQoL can help researchers and programmers determine and understand the individual’s experiences with the disease or a disability. This can provide exercise researchers and programmers with valuable insights to create more personalized exercise programs to achieve their mental and physical health goals.

HRQoL indicates the current physical health status of an individual.

HRQoL is a subjective patient-reported health outcome. The severity of the experiences of a disease or a health condition that affects the quality of life can only be felt and reported by the patient. As earlier noted, HRQoL is how the individual perceives the effect of a disease or a disability on the physical, psychological, and social domains of their daily living. A patient’s self-reported quality of life in relation to their health reflects their actual health status (Stigson et al., 2020). Exercise researchers and programmers can utilize the client’s self-reported health status and their own observations to have a relatable view of the client’s quality of life and determine the individual’s exercise needs. Therefore, measuring HRQoL can help exercise researchers and programmers subjectively evaluate their clients’ current health status to create an exercise program that sufficiently supports the management of their disease or disability.

HRQoL as an Indicator for the Progress of the Exercise Plan

HRQoL outcomes such as improved mental health and physical experiences are indicators of improving health. It is proven that people who engage in physical activities and exercises to manage or prevent diseases or improve their physical abilities have better health outcomes and self-reported quality of life in relation to their health status. Engaging in physical exercises, especially high-intensity exercises, can improve psychological and physical aspects of quality of life. High-intensity interval training (HIIT) and moderate-intensity training (MIT) have been noted to significantly improve anxiety and depressive disorder outcomes as well as improve patient resilience (Borrega-Mouquinho et al., 2021). Therefore, measuring HRQoL can help exercise researchers and programmers determine the progress achieved through an exercise program and adjust the program accordingly.

Conclusion

Conclusively, HRQoL is a patient-reported outcome. Measuring HRQoL can help exercise researchers and programmers understand the burden of the disease or disability on the individual, determine their mental and physical health status, and determine the progress of the exercise programs toward achieving the program’s objectives.

 References

Borrega-Mouquinho, Y., Sánchez-Gómez, J., Fuentes-García, J. P., Collado-Mateo, D., & Villafaina, S. (2021). Effects of High-Intensity Interval Training and Moderate-Intensity Training on Stress, Depression, Anxiety, and Resilience in Healthy Adults During Coronavirus Disease 2019 Confinement: A Randomized Controlled Trial. Frontiers in Psychology, 12, 270. https://doi.org/10.3389/FPSYG.2021.643069/BIBTEX

Bos, I., Wynia, K., Almansa, J., Drost, G., Kremer, B., & Kuks, J. (2019). The prevalence and severity of disease-related disabilities and their impact on quality of life in neuromuscular diseases. Disability and Rehabilitation, 41(14), 1676–1681. https://doi.org/10.1080/09638288.2018.1446188

Stigson, H., Boström, M., & Kullgren, A. (2020). Health status and quality of life among road users with permanent medical impairment several years after the crash. Traffic Injury Prevention, 21(S1), S43–S48. https://doi.org/10.1080/15389588.2020.1817416/SUPPL_FILE/GCPI_A_1817416_SM2742.DOCX

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Imagine that you have been hired to develop an exercise program for a group of men and women with arthritis. You are trying to convince your boss of the importance of measuring HRQoL. Write an essay that discusses at least three reasons why it is important for exercise researchers and programmers to measure HRQoL when creating exercise programs for people with disease and/or disability.

Lox, C. L., Ginis, K.A. M., Gainforth, H. L., & Petruzzello, S. J. (2019). The Psychology of Exercise (5th ed.). Taylor & Francis. https://online.vitalsource.com/books/9781000011999

Chapters: 13-14

Weblinks:
Weblinks Week 5
To enhance your understanding of the correlation between cognitive function and exercise, please read the following:

“Physical Activity Improves Cognitive Function”

https://www.psychologytoday.com/us/blog/the-athletes-way/201404/physical-activity-improves-cognitive-functionLinks to an external site.

“Regular exercise changes the brain to improve memory, thinking skills.”

https://www.health.harvard.edu/blog/regular-exercise-changes-brain-improve-memory-thinking-skills-201404097110

Lecture Notes Week 5
Slide 1

Cognitive function and exercise

Slide 2

In this week’s lesson, we are going to learn about the relationships between exercise and cognitive function and exercise and quality of life.

To start, let’s take a look at cognitive function. What does that mean? Cognitive function refers to the process of perceiving, recognizing, and understanding thoughts and ideas. Cognitive function is related to organization and planning, problem-solving, recognition and memory, reaction time, and more.

Slide 3

As people get older, their brains begin to atrophy or shrink. This often results in decreased cognitive function, making older adults an ideal demographic for studying cognitive function. Research on the effects of exercise on cognitive function has shown that both chronic and acute exercise can improve function. We will take a closer look in the following sections.

Slide 4

Executive control processes are cognitive functions that do not become automatic with practice. Functions such as short-term working memory, interference control, task coordination, and multitasking all fall within the realm of executive control processes. These processes are the most likely to decline with age.

Slide 5

Several intervention studies have been performed by researchers to determine if exercise can influence cognitive function. The studies focused on the cognitive function of older sedentary individuals before and after exercise intervention. The results suggest that 30 or more minutes per session of aerobic training plus strength and flexibility training significantly improves cognitive tasks involving executive control processes.

Slide 6

Several studies on the effects of exercise on the brain have shown that after 6 months of regular aerobic exercise, brain mass reduction can be stopped or even reversed in older individuals, creating a “sparing” effect. The sparing effect is directly proportional to the individual’s level of fitness.

Slide 7

Other studies on the effects of exercise on the brain have focused on the hippocampus, which is important for memory formation, and the attentional network, which is a neural network involved with executive control processes that affect attention and distraction. The various studies concluded that aerobic exercise improves memory function, and that fit individuals deal more effectively with distractions and are able to keep greater focus.

Slide 8

Several researchers have turned to psychophysiological studies to determine the effect of exercise on cognitive function. They were able to detect electrical responses in the brain in nearly real-time by applying sensors to the individual’s scalp. They measured brain response to stimuli in what is known as the event-related potential, or ERP. The two primary measures of ERP are latency, or how long it takes from the time stimulus is applied to the time the brain responds, as well as amplitude, the degree to which the electrical activity changes. Various studies have shown that individuals with higher levels of aerobic fitness have larger amplitudes on the ERP, indicating a greater degree of cognitive function following stimuli.

Slide 9

Research into how exercise affects cognitive function in children has not been studied as much as with seniors. However, evidence does show that exercise impacts cognitive function, and there are positive relationships between physical fitness and academic achievement. Fit children’s brains function more effectively than less fit children overall. Unfortunately, research has not been able to determine if fitness causes children to have higher cognitive function or if other factors that lead children to be more active also lead children to have a higher cognitive function.

Slide 10

Our practical recommendations might sound like a bit of a broken record by now; exercise is good for the brain, so go out an exercise and get fit without overdoing it. We’ve determined that moderate exercise correlates with improved cognitive function and might prevent brain deterioration that usually accompanies aging. Physical activity has been shown to be important to the development of the brain in children as well.

Slide 11

Health-related quality of life and exercise

Slide 12

In this final lesson, we are going to piece together everything we have learned so far to determine how exercise influences peoples’ quality of life. Quality of life is defined as the subjective and objective evaluations of the “goodness” of one’s life overall. Throughout the rest of this lesson, we will specifically focus on health-related quality of life, or HRQoL, which refers specifically to the dimensions of life that can be affected by health and health interventions. Physical functioning, health, emotional well-being, social functioning, and cognitive functioning are all part of a person’s HRQoL.

Slide 13

Quality of life is a large topic that encompasses many diverse aspects of a person’s life. Dimensions of quality of life can generally be categorized as psychological, physical health, social relationships, and the environment. Within each of those dimensions, we have a wide range of specific concepts and feelings that contribute to one’s overall quality of life.

Slide 14

HRQoL is important to us as exercise professionals because it can be an indicator that your exercise programs are effective or ineffective. If your clients’ HRQoL is not improving at the rate you expect, then it might be time to re-evaluate your intervention techniques.

Slide 15

Measuring HRQoL can be tricky, but there are a few techniques we can use. Self-reported HRQoL tends to be subjective, which we will cover next. However, HRQoL evaluations made by other people tend to be more objective. It might be easier for you to notice that your friend’s mood improved than it is for them to see themselves. We can also measure HRQoL by directly measuring other meaningful indicators. If your client’s goal is to bench press 200 pounds, then when they reach that goal, there is a high likelihood that their HRQoL improved as well. Finally, researchers developed a measure called quality-adjusted life years, or QALY. In short, QALY doesn’t measure a person’s life expectancy, but rather, measures the quality of the years they have left to live. For example, someone with chronic knee pain might live as long as someone without pain, but the QALY for the person with pain will be lower.

Slide 16

Subjective measures of HRQoL rely on the individual’s perception of their quality of life. The most commonly used method of determining someone’s perceived level of functioning, and QoL, is with the 36-item Short-Form Health Survey, or SF-36 for short. Someone might have a very different satisfaction with their functioning than their perceived level of functioning though, and that’s where the Perceived Quality of Life Scale, or PQOL, comes in. You can see some examples of questions on the PQOL here.

When the individual is unable to complete the quality of life surveys, usually due to injury or illness, a qualified health care professional can complete the survey for them. This is known as a proxy measure because the individual is not performing a self-evaluation. Proxy evaluations tend to be less accurate than self-evaluations because in most cases it is difficult for a proxy to accurately evaluate an individual’s functioning.

Slide 17

Research has shown that exercise can lead to significant improvements in HRQoL across demographics and populations. Everyone from healthy people to people with disabilities and a wide range of conditions showed subjective and objective improvements to their HRQoL.

Slide 18

The HRQoL dimensions that are most likely to be affected by exercise are perceptions of physical functioning, health status, emotional well-being, social functioning, and cognitive functioning. That’s not to say that other dimensions of HRQoL won’t be affected as well, just that these are the most likely to be affected.

Slide 19

Interestingly, research has shown that the intention of the exerciser can influence how exercise affects HRQoL. People who exercise to improve health or to prevent disease showed much greater improvements in HRQoL than those who exercise to mitigate an existing disease or rehabilitate an injury. Another factor that influences the impact of exercise on HRQoL is the perceived value of the HRQoL dimension that was affected. Say for example that someone exercises regularly for a year and improves their body image, but they never really cared about their body image to begin with. In this case, exercise didn’t make as much of an impact as it would have if the individual really cared about their body image.

Slide 20

We talked earlier about some of the ways we can measure HRQoL, and researchers have learned that a person doesn’t need to experience objective improvements in order to experience subjective improvements. Someone who started exercising last week might report that their quality of life has improved since they started, even though they haven’t lost any weight yet. Exercise might also improve HRQoL by enhancing individuals’ belief that they can control their health, improving their self-efficacy.

Slide 21

In order for exercise to enhance an individual’s HRQoL, the individual must perceive that the activity of exercise is at least partly responsible for increased HRQoL. If they don’t believe it, then they won’t acknowledge that exercise plays a role. They should be encouraged to engage in various types of exercise, since different forms of exercise have been shown to affect different dimensions of HRQoL.

Slide 22

Special populations are particularly prone to HRQoL problems because of the increased number of barriers they have to exercise. As a fitness professional, you can help these populations by targeting your efforts and interventions to helping them overcome their barriers. Special populations experience biological factors such as fatigue and pain, and psychological factors such as depression and fear, at greater rates than others. Special populations might lack the social support needed to help them get started with exercise, or lack access to facilities that can accommodate them.

Slide 23

To help people in special populations overcome the barriers to exercise that we discussed in the previous slide, we can engage several interventions. Informational approaches give people evidence-based resources that explain the benefits of exercise and the exercise techniques that will be most beneficial for them. Behavioral approaches teach people the behavioral skills needed to overcome exercise barriers. Social approaches teach influential others, such as healthcare providers or family members, how to provide social support to facilitate exercise among special populations. Finally, environmental approaches are geared toward making communities and fitness centers more accessible for special populations.