• Physical activity self-management and coaching compared to social interaction in huntington disease: results from the ENGAGE-HD randomized, controlled, pilot feasibility trial.

      Busse, Monica; Quinn, Lori; Drew, Cheney; Kelson, Mark; Trubey, Rob; McEwan, Kirsten; Jones, Carys; Townson, Julia; Dawes, Helen; Tudor-Edwards, Rhiannon; et al. (Oxford Academic, 2017-03-24)
      Abstract Background: Self-management and self-efficacy for physical activity is not routinely considered in neurologic rehabilitation. Objective: We assessed feasibility and outcomes of a 14 week physical activity self-management and coaching intervention compared with social contact in Huntington's disease (HD) to inform the design of a future full-scale trial. Design: Assessor blind, multi-site, randomized pilot feasibility trial. Setting: Participants were recruited and assessed at baseline, 16 weeks following randomisation, and then again at 26 weeks in HD specialist clinics with intervention delivery by trained coaches in the participants’ homes. Patients and Intervention: People with HD were allocated to the ENGAGE-HD physical activity coaching intervention or a social interaction intervention. Measurements: Eligibility, recruitment, retention and intervention adherence were determined at 16 weeks. Other outcomes of interest included measures of functional, home and community mobility, self-efficacy, physical activity and disease-specific measures of motor and cognition. Fidelity and costs for both the physical activity and social comparator interventions were established. Results: Forty % (n=46) of eligible patients were enrolled and 22 randomised to the physical intervention and 24 to social intervention. Retention rates in the physical intervention and social intervention were 77% and 92% respectively. Minimum adherence criteria were achieved by 82% of participants in the physical intervention and 100% in the social intervention. There was no indication of between group treatment effects on function, however increases in self-efficacy for exercise and self-reported levels of physical activity in the physical intervention lends support to our pre-defined intervention logic model. Limitations: The use of self-report measures may have introduced bias. Conclusions: An HD physical activity self-management and coaching intervention is feasible and worthy of further investigation.
    • Self-confidence and performance: A little self-doubt helps.

      Woodman, Tim; Akehurst, Sally; Hardy, Lew; Beattie, Stuart; Aberystwyth University; Bangor University (Elsevier, 2010-06-04)
      Objectives: To test the hypothesis that a decrease in confidence on a well-learned task will increase effort and performance. Design: A 2 (group: control, experimental) 2 (trial: practice, competition) mixed-model with repeated measures on the second factor. Method: Expert skippers’ (n ¼ 28) self-confidence was reduced via a combination of task (i.e., change of rope) and competitive demands. Performance was the number of skips in a 1-min period. On-task effort was measured via the verbal reaction time to an auditory probe. Results: The group trial interaction (F (1, 26) ¼ 6.73, p < .05, h2 ¼ .21) supported the hypothesis: Posthoc tests revealed a significant decrease in self-confidence and a significant improvement in performance from practice to competition for the experimental group only. No significant effort effects were revealed. Conclusions: Some self-doubt can benefit performance, which calls into question the widely accepted positive linear relationship between self-confidence and performance. As effort did not increase with decreased confidence, the precise mechanisms via which self-confidence will lead to an increase or a decrease in performance remain to be elucidated.