(BRC) Person-centred Physical Activity Intervention for individuals with lupus (PPAI-LUPUS): intervention development and randomised pilot study


   Faculty of Biology, Medicine and Health

This project is no longer listed on FindAPhD.com and may not be available.

Click here to search FindAPhD.com for PhD studentship opportunities
  Dr Benjamin Parker, Dr Katie Druce, Dr Michelle Barraclough, Dr Tiago Pecanha  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disorder that can affect multiple systems and cause different symptoms, such as fatigue, pain, and mood (e.g., anxiety and depression) and sleep disorders. Even medically optimized patients with SLE may present with persistent symptoms, which highlights the importance of investigating the effects of interventions that can have an adjuvating effect on SLE-related symptoms.

Physical activity is a promising non-pharmacological intervention for symptoms in SLE that are not always alleviated by standard medication. Engagement in physical activity can promote clinically meaningful improvements in a wide range of symptoms in this population. However, despite the well-described health benefits associated with physical activity, patients with SLE usually have low levels of physical activity and increased sedentary behaviour. Part of the low engagement with physical activity in this population may be due to the lack of person-centred physical activity programmes, co-developed with direct input from patients. Also, the fluctuating nature of SLE symptoms imposes additional barriers to the long-term engagement with physical activity in this population.

This PhD studentship project will develop and test the preliminary efficacy and feasibility of a person-centred, symptom-regulated, physical activity intervention for patients with SLE. The first phase of this project will involve the co-development of a Person-centred Physical Activity Intervention for individuals with SLE (PPAI-LUPUS) through patient involvement activities and meetings. The second phase of this of this project will involve the execution of a randomised controlled trial investigating the efficacy of the PPAI-LUPUS to increase participants’ physical activity levels and improve relevant SLE-symptoms, as well as testing the intervention’s feasibility. Participants with SLE will be randomly assigned to perform 3-months of the PPAI-LUPUS or control intervention. The PPAI-LUPUS intervention will be a multicomponent individualised physical activity intervention that will employ educational and motivational techniques to increase the participants’ physical activity levels and reduce their sedentary behaviour in line with current physical activity recommendations.

Participants assigned to the control intervention will only be instructed to increase their physical activity levels but will not receive any additional support. Before and after the intervention, participants will have their physical activity levels measured using physical activity trackers. A wide range of SLE symptoms (mental and physical fatigue, mood profile, sleep quality, cognitive function, and pain) will be assessed using specific questionnaires. The intervention feasibility will be assessed in relation to the study recruitment and attrition rates, adherence, and acceptability of the intervention. 

Supervisory team profile webpages:

Prof Ben Parker

https://mft.nhs.uk/mri/consultants/dr-ben-parker/

Dr Michelle Barraclough

https://research.manchester.ac.uk/en/persons/michelle.barraclough

Dr Tiago Pecanha

https://www.mmu.ac.uk/staff/profile/dr-tiago-pecanha

Dr Joseph Firth

https://research.manchester.ac.uk/en/persons/joseph.firth

Dr Katie Druce

https://research.manchester.ac.uk/en/persons/katie.druce

Eligibility 

Applicants must have obtained or be about to obtain a First or Upper Second class UK honours degree, or the equivalent qualifications gained outside the UK, in a relevant discipline.

Before you Apply 

Applicants must make direct contact with the primary supervisor before applying to discuss their interest in the project. It is your responsibility to make arrangements to meet with potential supervisors, prior to submitting a formal online application.  

How to Apply 

To be considered for this project you MUST submit a formal online application form - full details on how to apply can be found on the BRC website https://www.bmh.manchester.ac.uk/study/research/funded-programmes/manchester-brc-phd-studentships/ 

Your application form must be accompanied by a number of supporting documents by the advertised deadlines. Without all the required documents submitted at the time of application, your application will not be processed and we cannot accept responsibility for late or missed deadlines. Incomplete applications will not be considered. If you have any queries regarding making an application please contact our admissions team.

Equality, Diversity and Inclusion  

Equality, diversity and inclusion is fundamental to the success of The University of Manchester, and is at the heart of all of our activities. The full Equality, diversity and inclusion statement can be found on the website https://www.bmh.manchester.ac.uk/study/research/apply/equality-diversity-inclusion/  

Biological Sciences (4) Medicine (26) Psychology (31)

Funding Notes

This studentship covers tuition fees and stipend and is open to both the UK and international applicants. We are able to offer a limited number of studentships to applicants outside the UK. Therefore, full studentships will only be awarded to exceptional quality candidates, due to the competitive nature of this scheme.

References

1. Fortuna G, Brennan MT. (2013) Systemic lupus erythematosus: epidemiology, pathophysiology, manifestations, and management. Dental Clinics.57(4):631-55.
2. Gomez A, Qiu V, Cederlund A, Borg A, Lindblom J, Emamikia S, et al. (2021) Adverse health-related quality of life outcome despite adequate clinical response to treatment in systemic lupus erythematosus. Frontiers in Medicine.8:651249.
3. Schmeding A, Schneider M. (2013) Fatigue, health-related quality of life and other patient-reported outcomes in systemic lupus erythematosus. Best Practice & Research Clinical Rheumatology.27(3):363-75. doi: https://doi.org/10.1016/j.berh.2013.07.009.
4. O'Dwyer T, Durcan L, Wilson F. (2017) Exercise and physical activity in systemic lupus erythematosus: A systematic review with meta-analyses. Semin Arthritis Rheum.47(2):204-15. doi: 10.1016/j.semarthrit.2017.04.003.
5. Yuen HK, Cunningham MA. (2014) Optimal management of fatigue in patients with systemic lupus erythematosus: a systematic review. Ther Clin Risk Manag.10:775-86. doi: 10.2147/TCRM.S56063.
6. Santos EJF, Farisogullari B, Dures E, Geenen R, Machado PM. (2023) Efficacy of non-pharmacological interventions: a systematic review informing the 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases. RMD Open.9(3):e003350. doi: 10.1136/rmdopen-2023-003350.
7. Wu M-L, Tsai J-C, Yu K-H, Chen J-J. (2019) Effects of physical activity counselling in women with systemic lupus erythematosus: A randomized controlled trial. International Journal of Nursing Practice.25(5):e12770. doi: https://doi.org/10.1111/ijn.12770.
8. Bachmair EM, Martin K, Aucott L, Dhaun N, Dures E, Emsley R, et al. (2022) Remotely delivered cognitive behavioural and personalised exercise interventions for fatigue severity and impact in inflammatory rheumatic diseases (LIFT): a multicentre, randomised, controlled, open-label, parallel-group trial. Lancet Rheumatol.4(8):e534-e45. doi: 10.1016/s2665-9913(22)00156-4.
9. Fanouriakis A, Kostopoulou M, Andersen J, Aringer M, Arnaud L, Bae S-C, et al. (2023) EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Annals of the Rheumatic Diseases.ard-2023-224762. doi: 10.1136/ard-2023-224762.
10. Mancuso C, Perna M, Sargent A, Salmon J. (2011) Perceptions and measurements of physical activity in patients with systemic lupus erythematosus. Lupus.20(3):231-42. doi: 10.1177/0961203310383737.
11. Legge A, Blanchard C, Hanly JG. (2020) Physical activity, sedentary behaviour and their associations with cardiovascular risk in systemic lupus erythematosus. Rheumatology (Oxford).59(5):1128-36. doi: 10.1093/rheumatology/kez429.
12. Pinto AJ, Roschel H, de Sá Pinto AL, Lima FR, Pereira RMR, Silva CA, et al. (2017) Physical inactivity and sedentary behavior: Overlooked risk factors in autoimmune rheumatic diseases? Autoimmun Rev.16(7):667-74. doi: 10.1016/j.autrev.2017.05.001.
13. Boström C, Elfving B, Dupré B, Opava CH, Lundberg IE, Jansson E. (2016) Effects of a one-year physical activity programme for women with systemic lupus erythematosus – a randomized controlled study. Lupus.25(6):602-16. doi: 10.1177/0961203315622817.
14. Yuen HK, Holthaus K, Kamen DL, Sword DO, Breland HL. (2011) Using Wii Fit to reduce fatigue among African American women with systemic lupus erythematosus: A pilot study. Lupus.20(12):1293-9. doi: 10.1177/0961203311412098.
15. Metsios GS, Fenton SAM, Tzika K, Moe RH, Fragoulis GE, Vlieland T, et al. (2023) Barriers and facilitators for physical activity in rheumatic and musculoskeletal disease: a European-based survey. Clin Rheumatol.42(7):1897-902. doi: 10.1007/s10067-023-06518-7.
16. Crocker JC, Ricci-Cabello I, Parker A, Hirst JA, Chant A, Petit-Zeman S, et al. (2018) Impact of patient and public involvement on enrolment and retention in clinical trials: systematic review and meta-analysis. Bmj.363:k4738. doi: 10.1136/bmj.k4738.
17. Collado-Mateo D, Lavín-Pérez AM, Peñacoba C, Del Coso J, Leyton-Román M, Luque-Casado A, et al. (2021) Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. Int J Environ Res Public Health.18(4). doi: 10.3390/ijerph18042023.
18. Pearce G, Holliday N, Sandhu H, Eftekhari H, Bruce J, Timms E, et al. (2023) Co-creation of a complex, multicomponent rehabilitation intervention and feasibility trial protocol for the PostUraL tachycardia Syndrome Exercise (PULSE) study. Pilot and Feasibility Studies.9(1):143. doi: 10.1186/s40814-023-01365-4.
19. Pinto AJ, Peçanha T, Meireles K, Benatti FB, Bonfiglioli K, de Sá Pinto AL, et al. (2020) A randomized controlled trial to reduce sedentary time in rheumatoid arthritis: protocol and rationale of the Take a STAND for Health study. Trials.21(1):171. doi: 10.1186/s13063-020-4104-y.
20. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. (2020) World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine.54(24):1451-62.
21. Rausch Osthoff AK, Niedermann K, Braun J, Adams J, Brodin N, Dagfinrud H, et al. (2018) 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis.77(9):1251-60. doi: 10.1136/annrheumdis-2018-213585.
22. Billingham SA, Whitehead AL, Julious SA. (2013) An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database. BMC medical research methodology.13:1-6.
23. Cella M, Chalder T. (2010) Measuring fatigue in clinical and community settings. Journal of psychosomatic research.69(1):17-22.
24. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. (1989) The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of neurology.46(10):1121-3.
25. Penner IK, Raselli C, Stöcklin M, Opwis K, Kappos L, Calabrese P. (2009) The Fatigue Scale for Motor and Cognitive Functions (FSMC): validation of a new instrument to assess multiple sclerosis-related fatigue. Mult Scler.15(12):1509-17. doi: 10.1177/1352458509348519.
26. Nicklin J, Cramp F, Kirwan J, Greenwood R, Urban M, Hewlett S. (2010) Measuring fatigue in rheumatoid arthritis: a cross-sectional study to evaluate the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional questionnaire, visual analog scales, and numerical rating scales. Arthritis Care Res (Hoboken).62(11):1559-68. doi: 10.1002/acr.20282.
27. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res.28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
28. Dozois DJ, Dobson KS, Ahnberg JL. (1998) A psychometric evaluation of the Beck Depression Inventory–II. Psychological assessment.10(2):83.
29. Sullivan MJ, Edgley K, Dehoux E. (1990) A survey of multiple sclerosis: I. Perceived cognitive problems and compensatory strategy use. Canadian Journal of Rehabilitation.4(2):99-105.
30. Lee EC, Whitehead AL, Jacques RM, Julious SA. (2014) The statistical interpretation of pilot trials: should significance thresholds be reconsidered? BMC Medical Research Methodology.14(1):41. doi: 10.1186/1471-2288-14-41.