Effect of the cooling suit method applied to individuals with multiple sclerosis on fatigue and activities of daily living

Sedentary behaviour among elderly patients after total knee arthroplasty and its influencing factors

To understand the status of sedentary behaviour in elderly patients after total knee arthroplasty and analyse its influencing factors so as to provide a reference for developing targeted interventions. Conveniently selected elderly patients undergoing total knee arthroplasty (> 6 months) in a tertiary hospital in Jiangsu Province were investigated using a general information questionnaire, the Charlson Comorbidity Index, patients' self-reported sedentary behaviour information, the WOMAC Score, The Groningen Orthopaedic Social Support Scale, and Lee's Fatigue. The median daily sedentary time was 5.5 h (4.5 h, 6.625 h) in 166 elderly patients after total knee arthroplasty, of whom 82 (49.40%) showed sedentary behaviour (≥ 6 h per day). Logistic regression analysis showed that being retired/unemployed (OR = 8.550, 95% CI 1.732-42.207, P = 0.0084), having a CCI score ≥ 3 (OR = 9.018, 95% CI 1.288-63.119, P < 0.0001), having high WOMAC scores (OR = 1.783, 95% CI 1.419-2.238, P < 0.0001), having a high social support score (OR = 1.155, 95% CI 1.031-1.294, P = 0.0130), and having a fatigue score ≥ 5 (OR = 4.848, 95% CI 1.084-21.682, P = 0.0389) made patients more likely to be sedentary. The sedentary time of elderly patients after total knee arthroplasty is long, and sedentary behaviour is common among them. Healthcare professionals should develop targeted sedentary behaviour interventions based on the influencing factors of sedentary behaviour in order to reduce the occurrence of sedentary behaviour in elderly patients after total knee arthroplasty.

An assessment of informal caregivers' knowledge levels on daily and emergency care practices for the elderly: A descriptive cross-sectional study

This study was aimed to determine knowledge level of informal caregivers daily care, emergency situations and the effect of the socio-demographic characteristics of informal caregivers on their knowledge levels. This descriptive and cross-sectional study was conducted between November 1, 2021, and June 30, 2022, with 83 (79.8 %) informal caregivers living in rural areas in northeast Türkiye. The data were collected using the Barthel Index for Activities of Daily Living, the Socio-Demographic Questionnaire, and the Questionnaire for Information on Elderly Care and Situations Requiring Emergency Care. 54 (65.1 %) of caregivers were women, 74 (89.2 %) did not receive training on the daily care of the elderly. A statistically significant difference was determined between the level of knowledge of caregivers about elderly care, caring experience for the elderly and emergency situations, their education level, and their perceptions of needing further information about elderly care (p < 0.05). Informal care givers should be trained by nurses.

The effect of cooling garments to improve physical function in people with multiple sclerosis: A systematic review and meta-analysis

BACKGROUND

There is strong evidence for the benefits of exercise for people with Multiple Sclerosis (MS), however, up to 80% of people with MS report experiencing exacerbated symptoms with elevated body temperatures. A range of cooling garments to assist people with MS manage symptoms of heat sensitivity have been investigated. Therefore, the aim of this systematic review was to assess the effect of cooling garments to improve physical function in people with MS, and to determine any associated physiological and perceptual responses.

METHOD

A systematic review adhering to the PRISMA guidelines was performed. The eligibility criteria required investigations to have conducted a randomized controlled trial or cross-over study to assess the effect of a cooling garment to improve physical function, or a related physiological or perceptual measure, in people with MS.

RESULTS

Thirteen empirical studies were identified, compromising of acute cross-over designs (61.5%), longitudinal parallel group designs (23.1%) or a combination of both (15.4%). The studies included 384 participants with MS with an expanded disability status scale range of 1-7.5. Garments included liquid-perfused cooling vests/tops/hoods (50.0%), phase-change cooling vests (38.9%), a cooling thigh-cuff (5.6%) and a palm cooling device (5.6%). The cooling garments were effective at improving walking capacity and functional mobility, and some studies demonstrated improvements in muscular strength and balance, but not manual dexterity. The garments also resulted in improved core temperature, skin temperature, thermal sensation and subjective fatigue. Improvements occurred in temperate and warm conditions, and both with and without an exercise stimulus.

DISCUSSION

Cooling garments can improve physical function for people with MS. Since none of the cooling garments caused harm, and no particular cooling garment could be identified as being superior, people with MS should experiment with different cooling garments to determine their preference, and industry should focus on cooling garments that are effective, accessible and user-friendly.

The effectiveness of nontraditional or home-based programing on ADL performance of individuals living with multiple sclerosis: A systematic review

PURPOSE

To examine evidence-based nontraditional and home-based interventions and their efficacy for use in individuals with MS to improve performance in their daily activities.

MATERIALS AND METHODS

A search of five databases including PubMed, CINAHL, Cochrane Library, OT Seeker, and Ovid Medline produced 924 research articles. Thirty-two articles were selected for full-text review, of which 15 were included in this systematic review.

INCLUSION CRITERIA

Articles were level 2B or higher evidence, had a minimum of 19 participants with MS, addressed ADLs or body functions supporting ADL performance, and were published since 2010.

EXCLUSION CRITERIA

Articles not written in English and not identified as nontraditional or home-based programming.

RESULTS

The review uncovered strong evidence for the use of the nontraditional interventions of vestibular rehabilitation, self-management, yoga, musical production, and ELEVIDA to improve ADL performance in individuals with MS. Strong evidence supported the use of home-based programs that included cognitive behavioral therapy, cooling suits, manual dexterity, strengthening, vestibular rehabilitation, and physical activity.

CONCLUSIONS

High levels of evidence support the use of nontraditional or home-based interventions to improve ADL performance in clients with MS. Innovation and technology continue to expand the occupational therapist's toolbox of interventions.

Is the Cooling Vest an Ergogenic Tool for Physically Active Individuals? Assessment of Perceptual Response, Thermo-Physiological Behavior, and Sports Performance: A Systematic Review and Meta-Analysis

Exercise capacity is limited by environmental heat stress because thermoregulatory systems are altered and cannot prevent the elevation of body temperature due to a complex interplay of physiological, physical, and perceptual alterations. Cooling is an effective strategy to attenuate the temperature rise. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PEDro scale for assessing methodological quality, we systematically reviewed studies indexed in Medline, Web of Science, EMBASE, Science Direct, Sportdiscus, and Scopus, to evaluate the effects of the cooling vest (CVs) on perceptual response, physiological behavior, and sports performance in adult physical activity practitioners under heat stress conditions. Among the 711 studies identified in the search, 10 studies for the systematic review and eight for the meta-analysis met the inclusion and exclusion criteria. Overall, the use of CVs showed improvements in certain sports performance indicators, being significant (p < 0.05) in test time and substantial in peak power that could be influenced directly by the significant reduction (p < 0.05) in skin temperature and indirectly by the significant improvement (p < 0.05) in thermal and exertional perceptual responses, without the involvement of core temperature. In conclusion, the use of CVs is a cooling technique that influences perceptual response, thermo-physiological behavior, and sports performance. However, further studies are needed to elucidate the relevance of its application to CVs.

New Strategies for Rehabilitation and Pharmacological Treatment of Fatigue Syndrome in Multiple Sclerosis

Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system (CNS), with an inflammatory demyelinating basis and a progressive course. The course of the disease is very diverse and unpredictable. Patients face many problems on a daily basis, such as problems with vision; sensory, balance, and gait disturbances; pain; muscle weakness; spasticity; tremor; urinary and fecal disorders; depression; and rapidly growing fatigue, which significantly influences quality of life among MS patients. Excessive fatigue occurs in most MS patients in all stages of this disease and is named MS-related fatigue. The crucial issue is the lack of effective treatment; therefore, this review focuses not only on the most common treatment methods, but also on additional novel therapies such as whole-body cryotherapy (WBC), functional electrical stimulation (FES), and non-invasive brain stimulation (NIBS). We also highlight the advantages and disadvantages of the most popular clinical scales used to measure fatigue. The entire understanding of the origins of MS-related fatigue may lead to the development of more effective strategies that can improve quality of life among MS patients. A literature search was performed using MEDLINE, EMBASE, and PEDro databases.

Effects of the caregiver burden perceived by caregivers of patients with neurological disorders on caregiver wellbeing and caregiver stress

PURPOSE

The present study was conducted to determine the effects of the caregiver burden perceived by caregivers of patients with neurological disorders on caregiver wellbeing and stress.

DESIGN AND METHODS

The study was designed as a descriptive, cross-sectional, and correlational study.

FINDINGS

In the study, it was determined that the care burden is related to a caregiver's wellbeing and stress level and that the caregivers' levels of performing activities of living decreased and their stress levels increased as their perceived burden of care increased.

IMPLICATIONS FOR PRACTICE

Determining caregivers' difficulties in providing care and providing them with professional support will contribute to reducing the burden of care.