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Bjelica B, Bartels MB, Hesebeck-Brinckmann J, Petri S. Non-motor symptoms in patients with amyotrophic lateral sclerosis: current state and future directions. J Neurol 2024; 271:3953-3977. [PMID: 38805053 PMCID: PMC11233299 DOI: 10.1007/s00415-024-12455-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the progressive degeneration of both upper and lower motor neurons. A defining histopathological feature in approximately 97% of all ALS cases is the accumulation of phosphorylated trans-activation response (TAR) DNA-binding protein 43 protein (pTDP-43) aggregates in the cytoplasm of neurons and glial cells within the central nervous system. Traditionally, it was believed that the accumulation of TDP-43 aggregates and subsequent neurodegeneration primarily occurs in motor neurons. However, contemporary evidence suggests that as the disease progresses, other systems and brain regions are also affected. Despite this, there has been a limited number of clinical studies assessing the non-motor symptoms in ALS patients. These studies often employ various outcome measures, resulting in a wide range of reported frequencies of non-motor symptoms in ALS patients. The importance of assessing the non-motor symptoms reflects in a fact that they have a significant impact on patients' quality of life, yet they frequently go underdiagnosed and unreported during clinical evaluations. This review aims to provide an up-to-date overview of the current knowledge concerning non-motor symptoms in ALS. Furthermore, we address their diagnosis and treatment in everyday clinical practice.
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Affiliation(s)
- Bogdan Bjelica
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Strasse, 30625, Hannover, Germany.
| | - Maj-Britt Bartels
- Precision Neurology of Neuromuscular and Motoneuron Diseases, University of Luebeck, Lübeck, Germany
| | - Jasper Hesebeck-Brinckmann
- Neurology Department, Division for Neurodegenerative Diseases, University Medicine Mannheim, Heidelberg University, Mannheim Center for Translational Medicine, Mannheim, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Strasse, 30625, Hannover, Germany
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2
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McCloy K, Hughes C, Dunwoody L, Marley J, Cleland I, Cruciani F, Saunders C, Gracey J. Evaluating the effectiveness of mindfulness alone compared to exercise and mindfulness on fatigue in women with gynaecology cancer (GEMS): Protocol for a randomised feasibility trial. PLoS One 2023; 18:e0278252. [PMID: 37883461 PMCID: PMC10602305 DOI: 10.1371/journal.pone.0278252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/30/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND In 2020 Globocan reported nearly 1.4 million new cases of gynaecology cancer worldwide. Cancer related fatigue has been identified as a symptom that can be present for gynaecology cancer patients many years after treatment. The current evidence around the management of this symptom suggests that exercise has the most positive outcome. However, some ambiguity remains around the evidence and whether it can address all areas of fatigue effectively. More recently, other interventions such as mindfulness have begun to show a favourable response to the management of symptoms for cancer patients. To date there has been little research that explores the feasibility of using both these interventions together in a gynaecology cancer population. This study aims to explore the feasibility of delivering an intervention that involves mindfulness and mindfulness and exercise and will explore the effect of this on fatigue, sleep, mood and quality of life. METHODS/DESIGN This randomised control trial will assess the interventions outcomes using a pre and post design and will also include a qualitative process evaluation. Participants will be randomised into one of 2 groups. One group will undertake mindfulness only and the other group will complete exercise and mindfulness. Both groups will use a mobile application to complete these interventions over 8 weeks. The mobile app will be tailored to reflect the group the participants have drawn during randomisation. Self-reported questionnaire data will be assessed at baseline prior to commencing intervention and at post intervention. Feasibility will be assessed through recruitment, adherence, retention and attrition. Acceptability and participant perspective of participation (process evaluation), will be explored using focus groups. DISCUSSION This trial will hope to evidence and demonstrate that combination of two interventions such as mindfulness and exercise will further improve outcomes of fatigue and wellbeing in gynaecology cancer. The results of this study will be used to assess (i) the feasibility to deliver this type of intervention to this population of cancer patients using a digital platform; (ii) assist this group of women diagnosed with cancer to manage fatigue and other symptoms of sleep, mood and impact their quality of life. TRIAL REGISTRATION NCT05561413.
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Affiliation(s)
- Kairen McCloy
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, United Kingdom
| | - Joanne Marley
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
| | - Ian Cleland
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | - Federico Cruciani
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | | | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, United Kingdom
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3
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Zhao Y, Tang L, Shao J, Chen D, Jiang Y, Tang P, Wang X. The effectiveness of exercise on the symptoms in breast cancer patients undergoing adjuvant treatment: an umbrella review of systematic reviews and meta-analyses. Front Oncol 2023; 13:1222947. [PMID: 37799468 PMCID: PMC10548878 DOI: 10.3389/fonc.2023.1222947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
Background Exercise has the potential to reduce symptoms for breast cancer patients during adjuvant treatment, and high-quality systematic reviews are essential for guiding clinical practice. The objective of this umbrella review is to examine current research evidence concerning the effectiveness of exercise on symptom management in breast cancer patients undergoing adjuvant treatment. Methods An umbrella review was conducted. We searched for eligible systematic reviews through 11 databases until August 13rd, 2023. Two authors independently screened titles and abstracts, assessing the full-text studies based on inclusion criteria. We used AMSTAR-2 to appraise the quality of the meta-analyses. The results would be presented with narrative summaries if the replication rate of the original study for a symptom was higher than 5% (calculated via the Corrected Covered Area, CCA). The protocol was documented in the PROSPERO registry (CRD42023403990). Results Of the 807 systematic reviews identified, 15 met the inclusion criteria, and 7 symptoms were the main focus. The main form of exercise mentioned was aerobic combined resistance exercise. The results of the quality assessment were mostly critically low (10/15). The repetition rate calculated by CCA showed moderate to very high repetition rates (10% to 18.6%). The findings of the included reviews indicated that the effects of exercise on relieving symptoms during breast cancer adjuvant treatment were mixed. Conclusions Research is still needed to confirm the majority of studies' recommendations for exercise during adjuvant treatment for breast cancer patients, as it is crucial for managing symptoms in the rehabilitation process. To increase the efficiency of exercise in symptom management, future studies may focus more on the application of bridge symptoms, symptom networks, and ecological instantaneous assessment.
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Affiliation(s)
- Yuan Zhao
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Leiwen Tang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Jing Shao
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Dandan Chen
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Yueying Jiang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Panpan Tang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Xueqing Wang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
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4
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Darvishi E, Musarezaie A, Bahrami M, Karimian J. The Effect of a Combined Exercise Program on the Fatigue Severity of Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Clinical Trial Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:398-404. [PMID: 37694198 PMCID: PMC10484386 DOI: 10.4103/ijnmr.ijnmr_399_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 09/12/2023]
Abstract
Background Breast Cancer (BC) is one of the most common cancers in the world, including in Iran. Chemotherapy as one of the basic treatments for BC leads to many side effects such as fatigue. This study aimed to examine the effect of a combined exercise program on the intensity of fatigue in patients with BC undergoing chemotherapy. Materials and Methods This clinical trial study was conducted on 64 patients with BC undergoing chemotherapy referring to the Seyyed al-Shoada and the Al-Zahra clinics from January to April 2022. Eligible patients who met inclusion criteria were recruited by the convenience sampling and then assigned randomly to intervention and control groups. The combined exercise program in the intervention group was done for 8 weeks as three sessions a week (34 sessions) each for 35-40 min. Piper's Fatigue Scale was completed for both groups before and after the intervention. Data were analyzed using descriptive and inferential statistical methods. Results The results showed that the mean score of fatigue intensity in both control and intervention groups had a statistically significant difference after the intervention (p = 0.004). The mean fatigue intensity score in the intervention group decreased significantly from mean (SD) 8.17 (1.88) to 5.56 (1.74). Conclusions Based on the results, a combined exercise program can reduce fatigue in patients with BC. Therefore, nurses can utilize exercise programs and practices as a subset of complementary medicine alongside other treatment methods, which can effectively promote cancer patients' quality of life by reducing their fatigue.
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Affiliation(s)
- Elahe Darvishi
- Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Musarezaie
- Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Bahrami
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jahangir Karimian
- Department of General Course, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Petrigna L, Zanghì M, Maugeri G, D'Agata V, Musumeci G. Methodological consideration for a physical activity intervention in breast cancer population: An umbrella review. Heliyon 2023; 9:e17470. [PMID: 37455988 PMCID: PMC10338308 DOI: 10.1016/j.heliyon.2023.e17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Breast cancer patients and survivors are increasing in the last years such as their mean age. A feasible and useful complementary intervention to improve physical and psychological health, and decrease some disease symptoms seems to be physical activity. Consequently, this umbrella review wanted to analyze the protocols of different physical activity interventions and to eventually propose a standard operating procedure for possible exercise training in breast cancer patients.Design, Data sources, Eligibility criteria. The electronic databases PubMed, Scopus, and Web of Science were searched till 25 March 2022 to detect all systematic review and meta-analysis of randomized controlled trials on this topic. The studies were analyzed narratively and evaluated with a scale to assess their quality. Results The studies presented heterogeneity in their population included in terms of disease stage and treatments, intervention protocols and outcomes evaluated. This made difficult to synthesize the findings. Conclusion It was not possible to propose a standard operating procedure but some indications were proposed to provide feedback for future studies. Ideally, an intervention should be composed of combined training (aerobic and resistance training) with a component of a mindfulness intervention, with an intensity from moderate to high, and 3 times a week. The intervention should be supervised in the first period and then it could be home-based. Exercise training should be personalized to the patients treated.
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Affiliation(s)
- Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Velia D'Agata
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Department of Biology, College of Science and Technology, Sbarro Health Research Organization, Temple University, Philadelphia, PA, 19122, USA
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Lorca LA, Sacomori C, Vera-Llanos S, Hinrichsen-Ramírez AE, López K, Vega M, Contalba P, Sperandio FF. Quality of Life of Chilean Breast Cancer Survivors: Multicentric Study. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2023v69n1.2757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction: As breast cancer survivorship rates increase, so does the necessity to improve survivors’ health-related quality of life (HRQoL). Objective: To analyze HRQoL among Chilean breast cancer survivors, in general and considering geographic location. In addition, to correlate HRQoL with age, education level and body mass index (BMI). Method: Cross-sectional observational study which included 125 female breast cancer survivors from three public hospitals in three Chilean Macroregions: Central, North Central, and South. The EORTC Questionnaires, QLQ-C30 and QLQ-BR23, and sociodemographic and clinical records were applied. Results: The mean age was 56.1 (±11.9) years with a HRQoL summary score of 67.6 (21.9). HRQoL was reduced mainly in emotional functioning, pain, and insomnia. Fatigue, dyspnea, appetite loss, constipation, financial difficulties, breast and arm symptoms were also reported. The women from the South Macroregion Hospital presented the worst HRQoL scores for most of the domains [general health, functioning (physical, emotional, cognitive and social), fatigue, and nausea], p<0.001. The summary score of HRQoL was correlated to age (Spearman´s rho=0.202, p=0.033), BMI (rho=-0.341, p<0.001), and education level (rho=0.310, p=0.001). Conclusion: Women from three Macroregions showed differences in HRQoL. The latter correlated to age, BMI, and education level. Considering the high presence of symptoms, it is necessary to improve survivorship care plans, providing access to rehabilitation in the continuum of care.
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Mind–body practices for cancer-related symptoms management: an overview of systematic reviews including one hundred twenty-nine meta-analyses. Support Care Cancer 2022; 30:10335-10357. [DOI: 10.1007/s00520-022-07426-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/20/2022] [Indexed: 12/04/2022]
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8
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Beenhakker L, Witteveen A, Wijlens KAE, Siemerink EJM, van der Lee ML, Bode C, Siesling S, Vollenbroek‐Hutten MMR. Patient preference attributes in eHealth interventions for cancer-related fatigue: A scoping review. Eur J Cancer Care (Engl) 2022; 31:e13754. [PMID: 36385440 PMCID: PMC9786794 DOI: 10.1111/ecc.13754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cancer-related fatigue (CRF) is one of the most reported long-term effects breast cancer patients experience after diagnosis. Many interventions for CRF are effective, however, not for every individual. Therefore, intervention advice should be adjusted to patients' preferences and characteristics. Our aim was to develop an overview of eHealth interventions and their (preference sensitive) attributes. METHODS eHealth interventions were identified using a scoping review approach. Eligible studies included breast cancer patients and assessed CRF as outcome. Interventions were categorised as physical activity, mind-body, psychological, 'other' or 'combination'. Information was extracted on various (preference sensitive) attributes, like duration, intensity, peer support and costs. RESULTS Thirty-five interventions were included and divided over the intervention categories. (Preference sensitive) attributes varied both within and between these categories. Duration varied from 4 weeks to 6 months, intensity from daily to own pace. Peer support was present in seven interventions and costs were known for six. CONCLUSION eHealth interventions exist in various categories, additionally, there is much variation in (preference sensitive) attributes. This provides opportunities to implement our overview for personalised treatment recommendations for breast cancer patients struggling with CRF. Taking into account patients' preferences and characteristics suits the complexity of CRF and heterogeneity of patients.
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Affiliation(s)
- Lian Beenhakker
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Annemieke Witteveen
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Kim A. E. Wijlens
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | | | - Marije L. van der Lee
- Scientific Research DepartmentHelen Dowling InstituteBilthovenThe Netherlands,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic diseasesTilburg UniversityTilburgThe Netherlands
| | - Christina Bode
- Department of Psychology, Health and TechnologyUniversity of TwenteEnschedeThe Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical CentreUniversity of TwenteEnschedeThe Netherlands,Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Miriam M. R. Vollenbroek‐Hutten
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands,Board of DirectorsMedisch Spectrum TwenteEnschedeThe Netherlands
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Zanghì M, Petrigna L, Maugeri G, D’Agata V, Musumeci G. The Practice of Physical Activity on Psychological, Mental, Physical, and Social Wellbeing for Breast-Cancer Survivors: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10391. [PMID: 36012025 PMCID: PMC9407710 DOI: 10.3390/ijerph191610391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: The number of breast-cancer patients and survivors is increasing in the last years. Physical activity seems to be a feasible and useful complementary intervention to improve the physical, psychological, and social spheres and decrease some symptoms, especially for survivors. Consequently, the objective of the present umbrella review was to analyze the efficacy of different physical-activity interventions in the physical, mental, and social spheres of breast-cancer survivors. (2) Methods: Systematic reviews and meta-analyses of randomized controlled trials on breast-cancer survivors and physical-activity effects were searched on the electronic databases PubMed, Web of Science, and Scopus till 9 August 2022. The quality of the studies included was evaluated, and the results were narratively analyzed. (3) Results: Physical-activity intervention generally improves the physical, mental, and social spheres of breast-cancer survivors, but the studies included present heterogeneity in the protocols adopted. (4) Conclusions: A well-structured and planned physical-activity intervention is useful for improvements in the physical, mental, and social spheres of breast-cancer survivors, but the studies presented high heterogeneity. Yoga seems to be the most effective physical intervention to complement medical therapy.
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Affiliation(s)
- Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Velia D’Agata
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Science Section, School of Medicine, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
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Gable KL, Peric S, Lutz MW, Bozovic I, Petrovic M, Stojanov A, Basta I, Allen JA. A longitudinal evaluation of fatigue in chronic inflammatory demyelinating polyneuropathy. Brain Behav 2022; 12:e2712. [PMID: 35862228 PMCID: PMC9392529 DOI: 10.1002/brb3.2712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/24/2022] [Accepted: 07/03/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Fatigue is a common but poorly understood complaint in patients with immune-mediated polyneuropathies. We sought to evaluate changes in fatigue over 1 year in a cohort of chronic inflammatory demyelinating polyneuropathy (CIDP) patients and to correlate changes in fatigue with changes in disability and quality of life. Investigation into other factors that may contribute to fatigue with a particular interest in the role other chronic disease states may play was also performed. METHODS Fifty patients with CIDP who satisfied the 2010 EFNS/PNS diagnostic criteria were followed over the period of 1 year at three tertiary care centers in Serbia. Assessments of disability, quality of life, and patient perception of change and fatigue were collected at two time points 12 months apart. Comorbidities, treatment regimens, and sedating medication use was collected. RESULTS Disability, quality of life, and patient perception of change showed statistically significant correlations with change in fatigue (p < .01). Increased levels of fatigue were noted in patients who used sedating medications (p = .05) and who had a comorbid chronic medical condition (p = .01). INTERPRETATION Worsening fatigue correlates over time with increased disability and worse quality of life. Fatigue is not specific to CIDP, but is common in many chronic medical conditions and with the use of sedating medications. Our findings support the importance of identifying and supportively managing fatigue in patients with CIDP, but cautions against considering fatigue as a CIDP diagnostic symptom or using fatigue to justify immunotherapy utilization.
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Affiliation(s)
- Karissa L Gable
- Duke Neurological Disorders Clinic, Duke University Medical Center, Durham, North Carolina, USA
| | - Stojan Peric
- Faculty of Medicine and University Clinical Center of Serbia, Neurology Clinic, University of Belgrade, Belgrade, Serbia
| | - Michael W Lutz
- Duke Neurological Disorders Clinic, Duke University Medical Center, Durham, North Carolina, USA
| | - Ivo Bozovic
- Neurology Clinic, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milutin Petrovic
- Neurology Clinic, University Clinical Center of Kragujevac, Kragujevac, Serbia
| | | | - Ivana Basta
- Faculty of Medicine and University Clinical Center of Serbia, Neurology Clinic, University of Belgrade, Belgrade, Serbia
| | - Jeffrey A Allen
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
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11
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Pérez-Bilbao T, Alonso M, San Juan AF, Bezares S, Gil L, Pollán M, González-Frutos P, Peinado AB, Casla-Barrio S. Case studies in physiology: Training adaptation in an elite athlete after breast cancer diagnosis. J Appl Physiol (1985) 2022; 133:443-448. [PMID: 35861518 DOI: 10.1152/japplphysiol.00504.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the capacity to return to competition of a 28-year-old female 400m hurdle elite athlete after a diagnosis of breast cancer. The study lasted 14 months after diagnosis. She was tested four times (T1-T4) to measure body mass (BM), body mass index (BMI), percentage of total fat mass (TFM%), total fat-free mass (TFFM%), bone mineral density (BMD), one-repetition maximum (1RM) and maximal power (MP) in bench-press and half-squat, maximum oxygen uptake, 400m dash and hurdles. T0 (baseline time) was established with values prior to diagnosis. BM and BMI increased from T0 to T1 (5.3% and 5.2%) and remained stable. BMD experienced no change. TFM% values decreased from T1 to T4 (3.5%). TFFM% values increased from T1 to T3 (0.9%). During T1-T2, the athlete presented a global decline from T0 in 1RMSquat, 1RMBench, MPSquat and MPBench (32.6%, 27.2%, 37.5%, 27.6%, respectively). Results during T3-T4 were also lower for these parameters from T0 (23.3%, 20.6%, 23.4%, 11%). During T1-T2, the VO2max declined, compared to T0 (1.8% and 6.4%), showing a small increase at T3 (+1%) and reaching the lowest level at T4 (9%). During T1-T2, the time record of 400 m dash (8.3%) and hurdles (7.4%) increased. However, a slight improvement was found at T3 (1.3% and 0.6%, respectively). that exercise training improved body composition, maintained BMD and TFFM, but could not completely reverse the worsening of the cardiorespiratory, muscle strength and power, and running performance levels.
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Affiliation(s)
- Txomin Pérez-Bilbao
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Education, Investigation Methods and Evaluation, Faculty of Human and Social Sciences, Comillas Pontifical University, Madrid, Spain
| | - María Alonso
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Alejandro F San Juan
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | - Lucía Gil
- Asociación Española Contra el Cáncer, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Ana B Peinado
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,LFE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Soraya Casla-Barrio
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Unidad de Ejercicio Oncológico en Tigers Running Club
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12
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Ficarra S, Thomas E, Bianco A, Gentile A, Thaller P, Grassadonio F, Papakonstantinou S, Schulz T, Olson N, Martin A, Wagner C, Nordström A, Hofmann H. Impact of exercise interventions on physical fitness in breast cancer patients and survivors: a systematic review. Breast Cancer 2022; 29:402-418. [PMID: 35278203 PMCID: PMC9021138 DOI: 10.1007/s12282-022-01347-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 02/16/2022] [Indexed: 01/25/2023]
Abstract
Background This systematic review aims to identify the effects of exercise interventions in patients with breast cancer (BCP) and survivors (BCS) on selected variables of physical fitness. Methods A comprehensive literature search was conducted using Medline and Scopus. Randomized controlled trials with isolated exercise interventions in BCP and BCS women (< 5 years from therapy completion) were included. The risk of bias (RoB) assessment was conducted using the Cochrane RoB-2-tool. Variables regarding cardiorespiratory fitness (CRF), strength (ST), fatigue (F) and health-related quality of life (HRQoL) were discussed. Results Of the 336 studies initially identified, 22 met all the inclusion criteria and were deemed eligible. RoB assessment indicated that the studies had predominantly “some concerns” or had “low RoB”, with only 3 studies presenting a “high RoB”. The mean duration and frequency of exercise interventions were 19 weeks and 3 sessions/week, performed at moderate intensity (65% VO2max and 66% 1RM, for aerobic and resistance-training interventions, respectively). Conclusions Exercise interventions seem to be a valuable strategy in BCP to avoid the decline of CRF, ST, F and HRQoL. Conversely, improved physical function among BCS is observed for the same variables. Resistance training and combined interventions seem to provide the most encouraging variations of the selected outcomes. PROSPERO registration ID CRD42021237917. Supplementary Information The online version contains supplementary material available at 10.1007/s12282-022-01347-z.
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Affiliation(s)
- Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy.
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy
| | - Ambra Gentile
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy
| | - Petra Thaller
- OAC-Outdoor Against Cancer, Europe-Wide Outdoor Sport and Exercise Network for Cancer Prevention, Prinzregentenstrasse 97, 81677, Munich, Germany
| | - Fulvio Grassadonio
- International Centre for the Promotion of Education and Development (CEIPES), Via Francesco Maria Alias 20, 90145, Palermo, Italy
| | - Sofia Papakonstantinou
- Creative Thinking Development (CreThiDev), Solonos 8 & Empedokleus, 19009, Ntrafi Rafinas, Attiki, Greece
| | - Thorsten Schulz
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
| | - Nils Olson
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
| | - Alexandra Martin
- Department of Sport and Health Sciences, Technical University of Munich, Uptown Munich-Campus D Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
| | - Christian Wagner
- Naturfreunde, Bundesorganisation, Viktoriagasse 6, 1150, Vienna, Austria
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
| | - Hande Hofmann
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
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Radiotherapy-Related Fatigue Associated Impairments in Lung Cancer Survivors during COVID-19 Voluntary Isolation. Healthcare (Basel) 2022; 10:healthcare10030448. [PMID: 35326926 PMCID: PMC8954185 DOI: 10.3390/healthcare10030448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
The main objective of this study was to investigate the impairments presented after COVID-19 voluntary isolation by lung cancer survivors that experienced radiotherapy-related fatigue. In this observational study, data were collected after COVID-19 voluntary isolation. Patients were divided into two groups according to their fatigue severity reported with the Fatigue Severity Scale. Health status was assessed by the EuroQol-5D, anxiety and depression by the Hospital Anxiety and Depression Scale, and disability by the World Health Organization Disability Assessment Schedule 2.0. A total of 120 patients were included in the study. Patients with severe fatigue obtained higher impairment results compared to patients without severe fatigue, with significant differences in all the variables (p < 0.05). Lung cancer survivors who experienced severe radiotherapy-related fatigue presented higher impairments after COVID-19 voluntary isolation than lung cancer patients who did not experience severe radiotherapy-related fatigue, and showed high levels of anxiety, depression and disability, and a poor self-perceived health status.
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Prieto-Gómez V, Yuste-Sánchez MJ, Bailón-Cerezo J, Romay-Barrero H, de la Rosa-Díaz I, Lirio-Romero C, Torres-Lacomba M. Effectiveness of Therapeutic Exercise and Patient Education on Cancer-Related Fatigue in Breast Cancer Survivors: A Randomised, Single-Blind, Controlled Trial with a 6-Month Follow-Up. J Clin Med 2022; 11:269. [PMID: 35012011 PMCID: PMC8746078 DOI: 10.3390/jcm11010269] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 01/27/2023] Open
Abstract
This study aimed to determine the effectiveness of therapeutic exercise plus patient therapeutic education on perceived fatigue, functional capacity and pain in breast cancer survivors with cancer-related fatigue. A randomised, single-blind, clinical trial was conducted with a total of 80 breast cancer survivors who presented cancer-related fatigue. Women were randomised into a supervised therapeutic exercise group (STE-G) (n = 40) or an unsupervised exercise group (UE-G) (n = 40). Both interventions included patient therapeutic education and were delivered in three sessions per week over eight weeks. The main outcome was perceived fatigue as assessed by the Spanish version of the Functional Assessment of Chronic Illness Therapy-Fatigue subscale (FACIT-F). Other evaluated outcomes were pain measured on a visual analogue scale, and distance measured using the 6-Minute Walk Test. Data were collected at baseline, immediately post-intervention, and at three and six months after baseline. Significantly greater improvements across all variables were observed in the STE-G throughout the entire follow-up period with the exception of pain. Conclusions: A supervised therapeutic exercise program plus patient therapeutic education significantly reduce perceived fatigue and increase functional capacity in breast cancer survivors suffering from cancer-related fatigue compared to an unsupervised physical exercise program based on individual preferences with patient therapeutic education.
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Affiliation(s)
- Virginia Prieto-Gómez
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (V.P.-G.); (M.J.Y.-S.); (J.B.-C.); (I.d.l.R.-D.); (C.L.-R.)
- Department of Nursery, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursery, University of Castilla-La Mancha, 45071 Toledo, Spain;
| | - María José Yuste-Sánchez
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (V.P.-G.); (M.J.Y.-S.); (J.B.-C.); (I.d.l.R.-D.); (C.L.-R.)
| | - Javier Bailón-Cerezo
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (V.P.-G.); (M.J.Y.-S.); (J.B.-C.); (I.d.l.R.-D.); (C.L.-R.)
- Centro Superior de Estudios Universitarios La Salle, Department of Physical Therapy, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Helena Romay-Barrero
- Department of Nursery, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursery, University of Castilla-La Mancha, 45071 Toledo, Spain;
| | - Irene de la Rosa-Díaz
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (V.P.-G.); (M.J.Y.-S.); (J.B.-C.); (I.d.l.R.-D.); (C.L.-R.)
- Centro Superior de Estudios Universitarios La Salle, Department of Physical Therapy, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Cristina Lirio-Romero
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (V.P.-G.); (M.J.Y.-S.); (J.B.-C.); (I.d.l.R.-D.); (C.L.-R.)
- Department of Nursery, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursery, University of Castilla-La Mancha, 45071 Toledo, Spain;
| | - María Torres-Lacomba
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Madrid, Spain; (V.P.-G.); (M.J.Y.-S.); (J.B.-C.); (I.d.l.R.-D.); (C.L.-R.)
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15
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Khokhar M, Tomo S, Gadwal A, Purohit P. Multi-omics integration and interactomics reveals molecular networks and regulators of the beneficial effect of yoga and exercise. Int J Yoga 2022; 15:25-39. [PMID: 35444372 PMCID: PMC9015089 DOI: 10.4103/ijoy.ijoy_146_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/19/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background Yoga is a multifaceted spiritual tool that helps in maintaining health, peace of mind, and positive thoughts. In the context of asana, yoga is similar to physical exercise. This study aims to construct a molecular network to find hub genes that play important roles in physical exercise and yoga. Methodology We combined differentially expressed genes (DEGs) in yoga and exercise using computational bioinformatics from publicly available gene expression omnibus (GEO) datasets and identified the codifferentially expressed mRNAs with GEO2R. The co-DEGs were divided into four different groups and each group was subjected to protein-protein interaction (PPI) network, pathways analysis, and gene ontology. Results Our study identified immunological modulation as a dominant target of differential expression in yoga and exercise. Yoga predominantly modulated genes affecting the Th1 and NK cells, whereas Cytokines, Macrophage activation, and oxidative stress were affected by exercise. We also observed that while yoga regulated genes for two main physiological functions of the body, namely Circadian Rhythm (BHLHE40) and immunity (LBP, T-box transcription factor 21, CEACAM1), exercise-regulated genes involved in apoptosis (BAG3, protein kinase C alpha), angiogenesis, and cellular adhesion (EPH receptor A1). Conclusion The dissimilarity in the genetic expression patterns in Yoga and exercise highlights the discrete effect of each in biological systems. The integration and convergences of multi-omics signals can provide deeper and comprehensive insights into the various biological mechanisms through which yoga and exercise exert their beneficial effects and opens up potential newer research areas.
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Affiliation(s)
- Manoj Khokhar
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sojit Tomo
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India,Department of Biochemistry, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Ashita Gadwal
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Purvi Purohit
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India,Address for correspondence: Dr. Purvi Purohit, Department of Biochemistry, All India Institute of Medical Sciences, Basni Industrial Area, Phase-2, Jodhpur - 342 005, Rajasthan, India. E-mail:
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16
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Ghazanfari MJ, Karkhah S, Emami Zeydi A, Mortazavi H, Tabatabaee A, Adib-Hajbaghery M. A Systematic Review of Potentially Effective Nonpharmacological Interventions for Reducing Fatigue among Iranian Patients Who Receive Hemodialysis. Complement Med Res 2021; 29:147-157. [PMID: 34518448 DOI: 10.1159/000518626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 07/21/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE Fatigue control in hemodialysis (HD) patients requires a multidisciplinary approach. This study aimed to comprehensively review the available research literature regarding the nonpharmacological interventions used for reducing fatigue among Iranian HD patients. METHODS In this systematic review, an extensive search of the literature was conducted on PubMed, Web of Science, and Scopus databases, using the keywords related to the purpose. Also, the Persian equivalent of these keywords was searched in Iranian databases, such as Iranmedex and Scientific Information Database (SID) from the inception to June 16, 2020. RESULTS Of 2,761 articles, 25 studies were included in the review. Among a total of 1,748 Iranian HD patients with a mean age of 54.17 (SD = 12.27) years, 61.38% were male. Interventions such as educational-based programs (n = 5), nutrition-based programs (n = 2), massage therapy (n = 3), exercise-based programs (n = 4), relaxation technique (n = 3), combination of relaxation technique and inhalation aromatherapy (n = 1), energy therapy (reflexology and acupressure) (n = 3), and mind-guided imagery (n = 1) were effective in reducing fatigue in Iranian HD patients. DISCUSSION/CONCLUSION These simple, low-cost, and practical interventions can be used for the reduction of fatigue among HD patients by nurses. However, future well-designed studies are recommended to confirm the efficacy of these and other potentially effective interventions for reducing fatigue in HD patients.
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Affiliation(s)
- Mohammad Javad Ghazanfari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.,Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Mortazavi
- Geriatric Care Research Center, Department of Geriatric Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Amir Tabatabaee
- Nursing Department, Quchan Branch, Islamic Azad University, Quchan, Iran
| | - Mohsen Adib-Hajbaghery
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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Jang MK, Han J, Kim SH, Ko YH, Kim SY, Kim S. Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial. BMC Cancer 2021; 21:855. [PMID: 34311713 PMCID: PMC8311955 DOI: 10.1186/s12885-021-08575-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/07/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Fatigue is one of the most common and burdensome symptoms experienced by cancer patients. In interventions intended to reduce fatigue in such patients, fatigability, or perception of fatigue contextualized to activities of fixed intensity and duration, may also be measured. This study investigated the effects of a 15-month intervention on fatigue and fatigability in breast cancer survivors (BCS); explored the fatigue-fatigability relationship; and evaluated the impacts of fatigue and fatigability on anxiety, depression, sleep disturbance, and endocrine symptoms. METHODS A randomized controlled trial design was applied to an exercise program called BLESS (Better Life after cancer, Energy, Strength, and Support). The intervention included this 12-week exercise program and four follow-up contacts intended to promote exercise adherence over the following year. Participants were women aged 20 to 69 who had been diagnosed with stage I, II, or III breast cancer; had completed active treatment; and had moderate or higher fatigue. At the completion of the intervention, the survey responses of 40 BCS were evaluated using the chi-square test and multiple regression analysis. The Korean versions of the Revised Piper Fatigue Scale and Pittsburgh Fatigability Scale were used to measure fatigue and fatigability, respectively. RESULTS There was no significant difference in fatigue or fatigability between the experimental and control groups at intervention completion. However, the control group showed a stronger association than the experimental group between fatigue and physical fatigability. In the control group, fatigue and fatigability were significantly associated with anxiety, depression, sleep disturbance, and endocrine symptoms. In the experimental group, only the cognitive/mood fatigue score and depression were significantly associated. Only endocrine symptoms influenced mental fatigability (B = - 0.185, P < 0.05), and only depression influenced cognitive/mood fatigue (B = 1.469, P < 0.05). CONCLUSIONS Fatigue and fatigability showed different correlations with cancer-related symptoms after the exercise intervention. Future assessments of fatigability in intervention studies will allow measurement of the spectrum of patients' abilities to overcome fatigue at various physical activity levels while capturing different aspects of cancer-related symptoms. TRIAL REGISTRATION This study was retrospectively registered on Clinical Research Information Service ( KCT0005763 ; date of registration: 31/12/2020).
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Affiliation(s)
- Min Kyeong Jang
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jeehee Han
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
| | - Sung Hae Kim
- Department of Nursing, College of Health, Welfare and Education, Tongmyong University, Busan, South Korea
| | - Yun Hee Ko
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Soo Yeon Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Sue Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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18
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Bulaj G, Clark J, Ebrahimi M, Bald E. From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies. Front Pharmacol 2021; 12:612602. [PMID: 33972825 PMCID: PMC8105510 DOI: 10.3389/fphar.2021.612602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
To improve long-term outcomes of therapies for chronic diseases, health promotion and lifestyle modifications are the most promising and sustainable strategies. In addition, advances in digital technologies provide new opportunities to address limitations of drug-based treatments, such as medication non-adherence, adverse effects, toxicity, drug resistance, drug shortages, affordability, and accessibility. Pharmaceutical drugs and biologics can be combined with digital health technologies, including mobile medical apps (digital therapeutics), which offer additional clinical benefits and cost-effectiveness. Promises of drug+digital combination therapies are recognized by pharmaceutical and digital health companies, opening opportunities for integrating pharmacotherapies with non-pharmacological interventions (metapharmacology). Herein we present unique features of digital health technologies which can deliver personalized self-care modalities such as breathing exercises, mindfulness meditation, yoga, physical activity, adequate sleep, listening to preferred music, forgiveness and gratitude. Clinical studies reveal how aforementioned complimentary practices may support treatments of epilepsy, chronic pain, depression, cancer, and other chronic diseases. This article also describes how digital therapies delivering “medicinal” self-care and other non-pharmacological interventions can also be personalized by accounting for: 1) genetic risks for comorbidities, 2) adverse childhood experiences, 3) increased risks for viral infections such as seasonal influenza, or COVID-19, and 4) just-in-time stressful and traumatic circumstances. Development and implementation of personalized pharmacological-behavioral combination therapies (precision metapharmacology) require aligning priorities of key stakeholders including patients, research communities, healthcare industry, regulatory and funding agencies. In conclusion, digital technologies enable integration of pharmacotherapies with self-care, lifestyle interventions and patient empowerment, while concurrently advancing patient-centered care, integrative medicine and digital health ecosystems.
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Affiliation(s)
- Grzegorz Bulaj
- Department of Medicinal Chemistry, Skaggs Pharmacy Institute, University of Utah, Salt Lake City, UT, United States
| | - Jacqueline Clark
- College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Maryam Ebrahimi
- College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Elizabeth Bald
- Department of Pharmacotherapy, Skaggs Pharmacy Institute, University of Utah, Salt Lake City, UT, United States
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19
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Peric SZ, Cornblath DR. Fatigue in chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve 2020; 62:649-651. [DOI: 10.1002/mus.27076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/11/2020] [Accepted: 09/19/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Stojan Z. Peric
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine University of Belgrade Belgrade Serbia
| | - David R. Cornblath
- Department of Neurology John Hopkins University School of Medicine Baltimore Maryland USA
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