A lifestyle adjustments program in long COVID-19 improves symptomatic severity and quality of life. A randomized control trial

OBJECTIVE

To evaluate the efficacy of a therapeutic intervention based on self-adjustment strategies for improving of symptomatic severity and quality of life.

METHODS

The study was a randomised single-blind clinical trial. Quality of life, disability, and functional impairment were collected. The control group received a leaflet with information on the main symptoms of Long-COVID-19 syndrome, in addition to standard medical treatment. The intervention group received treatment following a dual approach; on the one hand, monitoring and recognition of symptomatology and on the other hand, adaptation and functional improvement.

RESULTS

A total of 54 participants were included, 27 were included in the intervention group and 27 in the control group. At the beginning of the study, no significant differences were found between groups. After intervention, the quality of life variable showed significant differences between groups in the self-care and anxiety/depression dimensions. Significant between-groups differences were also found for the self-care subscale of the disability variable. The intervention group showed significant differences from baseline on some subscales of the quality of life, disability, and functional impairment variables.

CONCLUSION

Strategies based on lifestyle adjustments are adequate for the improvement of quality of life and symptom severity in the long COVID-19 population.

PRACTICE IMPLICATION

The findings suggest that applying an intervention focused in self-adjustment for long COVID patients can have positive effects.

Effects of Telerehabilitation on Pain and Disability in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis

(1) Background: This systematic review and meta-analysis explores the effectiveness of telerehabilitation in patients suffering from chronic neck pain, specifically on pain and disability. The research delves into an area of growing significance within the realm of healthcare, aiming to understand the impact of digital interventions on the rehabilitation process for individuals with prolonged neck pain. (2) Methods: The comprehensive review encompasses a wide array of studies evaluating the collective outcomes of numerous trials focused on telerehabilitation strategies. In this systematic review, PubMed/MEDLINE, Scopus, and Web of Science databases were systematically searched to identify studies on telerehabilitation's impact on pain. (3) Results: Eight studies met the inclusion criteria. Using the Downs and Black quality assessment, three studies were classified as good and five as fair. The authors identify specific modalities within telerehabilitation, such as remote exercise programs and virtual consultations, that contribute significantly to positive patient outcomes. Meta-analysis indicated a significant overall effect of telerehabilitation on pain reduction (MD = -1.27; 95% CI = -2.06; -0.47; p = 0.002). These findings support telerehabilitation's efficacy in pain management. (4) Conclusions: The synthesis of evidence presented in this systematic review and meta-analysis underscores the potential of telerehabilitation as an effective and accessible means of managing chronic neck pain, offering valuable insights for both healthcare practitioners and policymakers in advancing patient-centered care.

Effects of Tai-Chi on Quality of Life in People With Neurodegenerative Diseases. A systematic Review of Randomised Clinical Trials

OBJECTIVE

This systematic review aimed to evaluate the effects of Tai Chi on the health-related quality of life (HRQoL) of people with neurodegenerative diseases.

DATA SOURCE

This review followed the guidelines of the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. A systematic search in five electronic databases (Medline via PubMed, Web of Science, Scopus, PEDro, and OTseeker) was performed.

STUDY INCLUSION AND EXCLUSION CRITERIA

Randomized control trials (RCTs) examining Tai Chi interventions to improve HRQoL in patients with neurodegenerative diseases published through March 2023 were included.

DATA EXTRACTION

Data were extracted from each study by two independent researchers into a data extraction form based on the Cochrane recommendations. Methodological quality and risk of bias were assessed.

DATA SYNTHESIS

A meta-analysis was performed using Review Manager 5.3 software.

RESULTS

Of the 439 records that were screened, eight RCTs met the eligibility criteria. They assessed cognitive decline (n = 2) or Parkinson's disease (n = 6). RCT comparison groups included active interventions or usual care. The duration of Tai Chi therapy ranged from 8 to 24 weeks. A sensitivity analysis using a fixed effect model indicated that Tai Chi therapy significantly increased HRQoL [P < 001, SMD (95% CI) = .41 [.21, .60], I2 = 4%].

CONCLUSION

Tai Chi can effectively improve the HRQoL of people with neurodegenerative diseases, but the heterogeneity across intervention was relatively high. Further studies are needed as research into the benefits of Tai Chi in neurodegenerative disease rehabilitation is still limited.

Association between Post-Hospitalization Psychological Distress, Exercise Capacity, Physical Function and Health Status in COVID-19 Survivors

This study aims to determine whether post-hospitalization psychological distress is associated with exercise capacity, physical function and health status in COVID-19 survivors. In this observational study, hospitalized COVID patients were included and divided into two groups according to the mental component summary subscale of the 12-item Short-Form Health Survey. Patients with a score ≤ 45 were included in the psychological distress group, and patients with a score > 45 were included in the non-psychological distress group. The main variables were exercise capacity, physical function, and health status. Patients were evaluated at discharge, 3 months, and at 6 months follow-up. Finally, a total of 60 patients were included in the study. Significant differences were found in exercise capacity, physical function, and health status (p < 0.05), with worse results in the group with psychological distress at discharge and 3 months follow-up. At 6 months after discharge, COVID patients with psychological distress exhibited worse results in exercise capacity, physical function, and health status, being significant exercise capacity and physical function (p < 0.05). It can be concluded that COVID patients with psychological distress at hospital discharge reported worse exercise capacity, physical function and health status at hospital discharge, 3 months and 6 months follow-up.

Neurophysiological pain education for patients with symptomatic knee osteoarthritis: A systematic review and meta-analysis

OBJECTIVE

To evaluate the effectiveness of neurophysiological pain education in patients with symptomatic knee osteoarthritis considering pain-related variables.

METHODS

A systematic review and meta-analysis was carried out according to the PRISMA guidelines. A search was conducted in PubMed, PEDro Database, Cochrane Library, Scopus, and Web of Science. Only randomized controlled trials enrolling patients ≥ 18 years of age with symptomatic knee osteoarthritis were included. The Downs and Black quality assessment tool was used to assess the quality of the articles, and the risk of bias was evaluated with the Cochrane Risk of Bias Assessment Tool.

RESULTS

A total of 7 studies were included in the study. Most of the studies were rated as "fair" on the Downs and Black quality assessment tool, and in the category of "some concerns" according to the Cochrane Risk of Bias Assessment Tool. Neurophysiological pain education was conducted alone or combined with exercise, joint mobilizations, or self-management programs. The number of sessions ranged from 1 to 10. The meta-analysis results showed significant differences in favor of the intervention group in pain (MD = -0.49; 95% CI = -0.66; -0.32; p < 0.001) and catastrophization (MD = -1.81; 95% CI = -3.31, -0.3; p = 0.02).

CONCLUSION, PRACTICE IMPLICATIONS

Neurophysiological pain education interventions in isolation or combined with exercise, joint mobilizations, or self-management programs have proven to significantly improve pain and catastrophization in patients with symptomatic knee osteoarthritis. These findings could provide clinicians with more information regarding the management of patients with symptomatic knee osteoarthritis.

The Effectiveness of Combined Exercise and Self-Determination Theory Programmes on Chronic Low Back Pain: A Systematic Review and Metanalysis

Low back pain is a pervasive issue worldwide, having considerable prevalence and a significant impact on disability. As low back pain is a complicated condition with many potential contributors, the use of therapeutic exercise, combined with other techniques such as self-determination theory programmes, has the potential to improve several outcomes. The aim of this systematic review was to explore the effectiveness of combined exercise and self-determination theory programmes on chronic low back pain. This study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A systematic search in three databases (PubMed/MEDLINE, Web of Science, and Scopus) was conducted from September to November 2023. After screening, a total of five random control trials with patients with chronic low back pain were included in this systematic review and meta-analysis. The results showed significant differences in disability (SMD = -0.98; 95% CI = -1.86, -0.09; p = 0.03) and in quality of life (SMD = 0.23; 95% CI = 0.02, 0.44; p = 0.03) in favour of the intervention group versus the control group.

Early Effects of a Pain-Informed Movement Program in Patients with Post-COVID-19 Condition Experiencing Persistent Pain: Protocol for a Randomized Controlled Trial

(1) Background: The COVID-19 pandemic has generated 771 million confirmed cases. Of these patients, 60% have developed persistent symptoms including pain. This pain is a complex symptom that needs comprehensive therapeutic strategies to address it holistically. The main objective of this study will be to evaluate the early impact of the Pain Informed Movement (PIM) program in patients with post-COVID-19 conditions experiencing new-onset persistent pain. (2) Methods: A randomized, single-blind clinical trial will be performed. Patients will be randomly assigned (1:1) to the experimental or control group. The experimental group will undergo a PIM program consisting of low-intensity functional exercises, pain neuroscience education, and relaxation techniques. The control group will receive no intervention. (3) Results: The results will be published as a peer-reviewed article. (4) Conclusions: This study will provide a basis for future research to support the implementation of comprehensive therapeutic approaches in the care of patients with post-COVID-19 persistent pain.

Effectiveness of self-management interventions during the peri-hospitalization period in patients with stroke: A systematic review and meta-analysis

OBJECTIVE

To synthesize the evidence of the effectiveness of self-management interventions during the peri-hospitalization period.

DATA SOURCES

Three databases (i.e. PubMed, Web of Science, and Scopus) were systematically searched.

REVIEW METHODS

Full-text randomized controlled studies that assessed the effects of self-management interventions initiated during the peri-hospitalization period in patients with stroke were included. Two independent reviewers performed data extraction. A third reviewer was available for discrepancies. The methodological quality was evaluated using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2). Data were pooled and a meta-analysis was performed.

RESULTS

Eight studies comprising 1030 participants were included. The self-management interventions showed considerable heterogeneity in their protocols, although most of them included an individualized plan based on the patient's needs. The meta-analysis was performed with data from the self-efficacy domains. The pooled results showed a trend towards the self-management intervention on quality of life (1.07, 95% confidence interval [CI] 0.52 to 1.63; P = 0.0002) but neither in dependence (0.80, 95% CI -0.14 to 1.74; P = 0.10) nor in self-efficacy (0.77, 95% CI -0.44 to 1.98; P = 0.21).

CONCLUSION

Most of the studies reviewed suggest that self-management interventions had an impact on dependency, quality of life and self-efficacy when compared with usual care, written materials about stroke, or post-discharge rehabilitation recommended by a physician. However, the evidence in this review neither supports nor refutes self-management interventions used in addition to usual care, or other interventions, to improve dependency, quality of life and/or self-efficacy in patients' post-stroke.

Musculoskeletal, Functional and Performance Impairment in Female Overhead Athletes with a Previous Shoulder Injury

BACKGROUND

Shoulder injuries are substantial problems in overhead athletes, and more studies are necessary to deepen the knowledge on this type of injury. The objective of this study was to compare the overall function and performance of female overhead athletes with and without a previous history of shoulder injuries.

METHODS

In this cross-sectional study, female overhead athletes with and without a previous shoulder injury were included. Muscular impairment, the stability of the shoulder, strength, scapular dyskinesia, functionality and sports performance were evaluated. A total of 50 females were included.

RESULTS

There were significant differences in strength (p = 0.046) and stability (p = 0.039) between groups, with a poorer score in the group with a history of shoulder injury. Regarding scapular dyskinesia, significant differences were also observed between groups (p = 0.048), with higher levels of dyskinesia in the group with previous shoulder injury. Also, muscular impairment showed significant differences between groups for the three muscles evaluated (p < 0.005). Additionally, the group without a previous shoulder injury presented with a significantly greater score in functionality (p = 0.046) and sports performance (p = 0.004).

CONCLUSION

In conclusion, previous shoulder injuries are an important factor to take into account in female overhead athletes. Players with a history of shoulder injury present clinical impairments during the game, leading to poorer functional status and performance in sport.

Effectiveness of Self-Care Education for Chronic Neck Pain: A Systematic Review and Meta-Analysis

Self-care programs for chronic neck pain are relevant to everyday life and can lead to long- term improvement. More studies on their effectiveness, key components and appropriate duration are needed. The aim of this study was to determine the effectiveness of self-care programs for patients with chronic neck pain. A systematic review and meta-analysis of randomized controlled trials was conducted according to the PRISMA guidelines. After searching in PubMed, Web of Science, Scopus and ScienceDirect, eleven studies met the inclusion criteria. Self-care education interventions typically consisted of education (i.e., pain neuro-science education or general educational concepts) accompanied by exercise or manual therapy. The most frequent components were addressing physical and psychological symptoms and engaging in self-care strategies. The least frequent ones were monitoring and recording symptoms and discussing with providers of medical care. The duration of the interventions ranged from three sessions to six months. Finally, individual and supervised modalities were the most frequent. After pooling the data, a meta-analysis was carried out according to four variables (i.e., pain, disability, kinesiophobia and catastrophization) and showed significant results (p < 0.05) in favor of self-care interventions. This systematic review and meta-analysis suggests that self-education interventions improve pain, psychological pain-related variables and disability in patients with chronic neck pain. The most frequently used components were addressing physical and psychological symptoms and engaging in self-care strategies. Future trials should focus on including other components, such as discussing symptoms with providers of medical care or self-monitoring symptoms. Additional areas of focus include more homogeneous doses and comparator treatments, as well as studies with better evidence to reach more solid conclusions.

Effect of Chest Physiotherapy on Quality of Life, Exercise Capacity and Pulmonary Function in Patients with Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis

BACKGROUND

Idiopathic pulmonary fibrosis (IPF) is one of the most deleterious diseases of the pulmonary fibrosis spectrum. Its clinical presentation includes irreversible loss of lung function, and increasing cough, dyspnea and impaired quality of life. Chest physiotherapy can improve ventilation capacity, gas exchange, dyspnea, exercise capacity and quality of life. The aim of this study was to review the evidence about chest physiotherapy in IPF, specifically meta-analyzing quality of life, exercise capacity and pulmonary function.

METHODS

A wide search was conducted in PubMed, Embase, Cochrane and Web of Science for articles included until October 2023. PROSPERO Identifier: CRD42022333496. The Downs and Black scale and the Cochrane tool were employed to evaluate quality assessments and to assess the risk of bias. Data were pooled, and a meta-analysis was conducted.

RESULTS

We selected 10 studies in which a chest physiotherapy program was performed with a total of 340 patients; of these, three articles were meta-analyzed. Significant effects in favor of chest physiotherapy were found for quality of life (MD = -8.60, 95% CI = -11.30, -5.90; p < 0.00001; I2 = 24%), exercise capacity (MD = 37.62, 95% CI = 15.10, 60.13; p = 0.001; I2 = 65%) and pulmonary function (MD = 7.86, 95% CI = 2.54, 13.17; p = 0.004; I2 = 80%).

CONCLUSIONS

The systematic review showed significant results for the application of chest physiotherapy regarding pulmonary capacity, diffusion of gases and quality of life in IPF patients. The meta-analysis showed a significant improvement associated with applying chest physiotherapy in pulmonary function, exercise capacity and quality of life.

Post-COVID Patients With New-Onset Chronic Pain 2 Years After Infection: Cross-Sectional Study

BACKGROUND

Although pain is common in non-hospitalized post-COVID-19 syndrome, only a few studies have provided information on the pain experience of these patients.

AIM

To identify the clinical and psychosocial profile associated with pain in non-hospitalized patients with post-COVID-19 syndrome.

METHOD

In this study there were three groups: healthy control group, successfully recovered group, and post-COVID syndrome group. Pain-related clinical profile and pain-related psychosocial variables were collected. Pain-related clinical profile included: pain intensity and interference (Brief Pain Inventory), central sensitization (Central Sensitization Scale), insomnia severity (Insomnia Severity Index), and pain treatment. Pain-related psychosocial variables were: fear of movement and (re)injury (Tampa Scale for Kinesiophobia), catastrophizing (Pain Catastrophizing Scale), depression, anxiety and stress (Depression, Anxiety and Stress Scale), and fear-avoidance beliefs (Fear Avoidance Beliefs Questionnaire).

RESULTS

In all, 170 participants were included in the study (healthy control group n = 58, successfully recovered group n = 57, and post-COVID syndrome group n = 55). Post-COVID syndrome group obtained significantly worse punctuation in pain-related clinical profile and psychosocial variables than the other two groups (p < .05).

CONCLUSIONS

In conclusion, patients with post-COVID-19 syndrome have experienced high pain intensity and interference, central sensitization, increased insomnia severity, fear of movement, catastrophizing, fear-avoidance beliefs, depression, anxiety, and stress.

Effects of Exercise-Based Interventions on Physical Activity Levels in Persons With Parkinson's Disease: A Systematic Review With Meta-analysis

BACKGROUND AND PURPOSE

Parkinson's disease (PD) is the most common neurodegenerative movement disorder. Symptom severity leads to devastating consequences such as falls, immobility, impaired quality of life, and reduced general activity. Adopting a sedentary lifestyle creates a vicious circle, as physical inactivity can negatively affect the clinical domains of PD. Despite the recognition of the disease-modifying potential of physical activity (PA), achieving adequate exercise levels can be challenging for individuals with PD. This study aimed to investigate the repercussions of exercise-based interventions to improve PA levels in persons with PD through a systematic review with meta-analysis.

METHODS

A search was conducted from database inception to February 2021 across 3 databases: PubMed, Web of Science, and Scopus. Randomized controlled trials were included if they involved persons with PD, outcome measures associated with PA levels, and an exercise-based intervention. Two reviewers performed independent data extraction and methodologic quality assessment of the studies using the Downs and Black quality checklist.

RESULTS

A total of 6 studies were included in the study (1251 persons with PD). Four intervention types were identified: balance, strength, aerobic, and multimodal exercise (combination of several types of exercise programs). The meta-analysis showed that exercise interventions have a positive effect on PA (standard mean difference = 0.50, 95% CI =-0.02, 1.00; P = .06). The risk of bias was generally low.

CONCLUSIONS

The findings support the use of exercise-based interventions (aerobic exercise, balance exercise, strength exercise, and/or multimodal exercise) to improve PA levels. However, the limited number of studies and the heterogeneity of the interventions do not allow us to draw a definitive conclusion.

Efficacy and Safety of Respiratory Telerehabilitation in Patients with Long COVID-19: A Systematic Review and Meta-Analysis

The aim of this review was to identify, map, and synthesize the extent and nature of research activity on the use of telerehabilitation to support Long COVID-19 rehabilitation and examine the efficacy and safety of respiratory telerehabilitation in patients with Long COVID-19. A systematic review and meta-analysis of randomized controlled trials were performed. We included controlled trials that tested the effect of respiratory telerehabilitation interventions in patients with Long COVID-19 versus no intervention, usual care, placebo, or face-to-face intervention. The data were pooled, and a meta-analysis was completed for quality of life, dyspnea, lung function, anxiety and depression, respiratory muscle strength, functional capacity, and lower limb strength. Finally, 10 studies were included. The meta-analysis results show significant differences in favor of respiratory telerehabilitation in quality of life (p = 0.02), dyspnea (p < 0.00001), respiratory muscle strength (p < 0.001), functional capacity (p < 0.0001), and lower limb strength (p = 0.01) but not in lung function (p = 0.28) and anxiety and depression (p = 0.55). In addition, there were no statistically significant differences in adverse effects (p = 0.06) between the telerehabilitation and comparator groups. The results suggest that these interventions can improve quality of life, reduce dyspnea, and increase respiratory and lower extremity muscle strength as well as functional capacity in patients with Long COVID-19.

Differences of Disabling Symptoms between Previously Hospitalized or Non-Hospitalized Currently Working Long-COVID Survivors One Year after Infection: A Descriptive Study

This study aimed to describe the presence of disabling symptoms in currently working Long-COVID survivors by comparing the hospitalized and non-hospitalized one year after infection. Patients with Long-COVID syndrome (LCS) that have been infected by COVID-19 a year ago and were actually working were included. Participants that had been hospitalized due to COVID-19 were included in the LCS hospitalized group, and participants that had not been hospitalized were included in the LCS non-hospitalized group. The eligible patients were prompted to complete the latest self-report version of the COVID-19 Yorkshire Rehabilitation Screening Tool (C19-YRS). A total of 465 subjects were included in the study. Participants in the LCS hospitalized group were significantly older, had a significantly higher BMI, and had a significantly higher prevalence of women compared to the LCS non-hospitalized group. Additionally, participants in the LCS hospitalized group had obtained significantly worse results in symptom severity, functional disability, and global health perceived subscales of C19-YRS compared to the participants included in the LCS non-hospitalized group. We concluded that disabling symptoms are presented in patients with LCS at working age one year after infection and are higher in LCS hospitalized patients compared to LCS non-hospitalized patients.

Widespread distribution and altered pain processing in head and neck cancer survivors at long-term after treatment

PURPOSE

Radiotherapy (RT) treatment in head and neck cancer (HNC) patients may induce long-term sequels as pain, which nowadays is not fully understand. Therefore, there is a need of characterization of pain features in HNC to enhance after oncology treatment management. Head and neck cancer survivors develop chronic pain after radiotherapy treatment. The purpose of the current study is to evaluate the presence of pain, pain distribution, and pain processing by means of patient reported outcomes and quantitative sensory testing.

METHODS

Pain pressure threshold (PPT), temporal summation (TS), Brief Pain Inventory (BPI), Widespread Pain Index (WPI), The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and EuroQol5D5L were assessed in 20 head and neck cancer survivors (sHNC) and 20 health-related sex and age-matched controls.

RESULTS

The sHNC present lower PPT values in both the affected and non-affected side than did the healthy controls, especially in the widespread pain in the body, an altered TS in both affected and non-affected side and lower scores in quality of life and arm dysfunction.

CONCLUSIONS

Following radiotherapy treatment after 1 year, sHNC present widespread pain, hypersensitivity in the radiated area, altered pain processing, upper limb affection, and a QoL diminution. These data provide evidence that a peripheral and central sensitization is happening in sHNC. Future efforts should focus on preventing pain after oncologic treatment. The comprehension about pain and its features in sHNC enhance health professional understanding and allows to tailor an optimal patient-targeted pain treatment.

Agreement between telerehabilitation and face-to-face orofacial myofunctional assessment in persons with acquired brain injury

BACKGROUND AND OBJECTIVE

Orofacial myofunctional disorders are common in persons with acquired brain injury. A new way for early detection of orofacial myofunctional disorders via information and communication technologies may improve accessibility. The purpose of this study was to evaluate the level of agreement between face-to-face and tele-assessment of an orofacial myofunctional protocol in a sample of persons with acquired brain injury.

METHODS

A masked comparative evaluation was conducted in a local association of patients with acquired brain injury. Twenty-three participants (39.1% female, mean age of 54 years) with a diagnosis of acquired brain injury were included in the study. The patients followed a face-to-face and a real-time online assessment using the Orofacial Myofunctional Evaluation with Scores protocol. This is a protocol for evaluation with numerical scales that assess the physical characteristics and the main orofacial functions of patients including appearance, posture, and mobility of lips, tongue, cheeks, and jaws, respiration, mastication, and deglutition.

RESULTS

The analysis showed excellent interrater reliability (ρ ≥ 0.85) for all the categories. In addition, most confidence intervals were narrow.

CONCLUSIONS

This study reveals excellent interrater reliability of an orofacial myofunctional tele-assessment in patients with acquired brain injury in comparison with a traditional face-to-face evaluation.

Characteristics of Frailty in Perimenopausal Women with Long COVID-19

The aim of this study was to compare the prevalence of risk factors for frailty between perimenopausal women with long COVID-19 syndrome, women having successfully recovered from COVID-19, and controls from the community. Women with a diagnosis of long COVID-19 and at least one symptom related to the perimenopausal period, women who had successfully recovered from COVID-19, and healthy women of comparable age were included in this study. Symptom severity and functional disability were assessed with the COVID-19 Yorkshire Rehabilitation Scale, and the presence of frailty was evaluated considering the Fried criteria. A total of 195 women were included in the study, distributed over the three groups. The long COVID-19 group showed a higher prevalence of perimenopausal symptoms and impact of COVID-19. Statistically significant differences were found between the long COVID-19 group and the other two groups for the frailty variables. When studying the associations between frailty variables and COVID-19 symptom impact, significant positive correlations were found. Perimenopausal women with long COVID-19 syndrome present more frailty-related factors and experience a higher range of debilitating ongoing symptoms. A significant relationship is shown to exist between long COVID-19 syndrome-related disability and symptoms and frailty variables, resulting in an increased chance of presenting disability.

Efficacy in urinary symptom burden, psychological distress, and self-efficacy of education-enhanced interventions in prostate cancer patients: a systematic review and meta-analyses

BACKGROUND

Worldwide, prostate cancer is both the second-most diagnosed cancer and most common solid tumor in men. Prostate cancer patients present with a symptom burden that is compounded by the impact of medical oncology treatment, affecting different domains of their perceived health status. Education active techniques are a key role in chronic disease to increase participation in their recovery.

PURPOSE

The purpose of the current review was to examine the efficacy of education-enhanced in urinary symptom burden, psychological distress, and self-efficacy in patients diagnosed with prostate cancer.

METHODS

A wide search of the literature was conducted for articles from their inception to June 2022. Only randomized controlled trials were included. Data extraction and methodologic quality assessment of the studies were carried out by two reviewers. We previously registered the protocol of this systematic review on PROSPERO (CRD42022331954).

RESULTS

A total of six studies were included in the study. After education-enhanced intervention showed significant improvements in any of perceived urinary symptom burden, one in psychological distress, and one in self-efficacy in the experimental group. The meta-analysis showed that education-enhanced interventions have a significant effect on depression.

CONCLUSION

Education-enhanced could have positive effects on urinary symptom burden, psychological distress, and self-efficacy in prostate cancer survivors. Our review was unable to demonstrate the best timing to apply education-enhanced strategies.

Effects of non-pharmacological therapies on hand function and the ability to perform daily activities in people with systemic sclerosis: A systematic review and meta-analysis of randomized control trials

BACKGROUND

Systemic sclerosis (SSc) is an autoimmune rheumatic disease. Individuals with a diagnosis of SSc describe repercussions on their activities of daily living and instrumental activities of daily living that affect their everyday functional capacity. The objective of this systematic review was to explore the effectiveness of non-pharmacological interventions to improve hand function and the ability to perform activities of daily living.

METHODS

A systematic review was conducted on the Cochrane Library, Medline/PubMed, OTseeker, PEDro, Scopus, Web of Science up to September 10, 2022. Inclusion criteria were defined following PICOS recommendations (Populations, Intervention, Comparison and Outcome measures). Methodological quality was assessed with the Downs and Black Scale and risk of bias was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). A meta-analysis of each outcome was performed.

RESULTS

A total of 8 studies met the inclusion criteria, providing data on 487 individuals with SSc. The non-pharmacological intervention applied the most was exercise. The effects of non-pharmacological interventions were better than those of the waiting list or no treatment control conditions in both outcomes - hand function (mean difference [MD] = -6.98; 95% CI [-11.45, - 2.50], P = 0.002, I²  = 0%) and performance of daily activities (MD = -0.19; 95% CI [-0.33, - 0.04], P = 0.01, I²  = 0%). Moderate risk of bias was found in the majority of the studies included.

CONCLUSION

There is emerging evidence that non-pharmacological interventions can improve hand function and performance of daily activities in individuals with a diagnosis of SSc. Given the moderate risk of bias found in the studies included, the results should be considered with caution.

Barriers and applied activity, quality of life and self-efficacy in prostate cancer survivors 1 year after completing radiotherapy

PURPOSE

The aims of the study were to assess self-reported physical activity (PA) levels, barriers to PA, quality of life and self-efficacy to manage chronic disease of prostate cancer survivor 1 year after radiotherapy treatment.

METHODS

A cross-sectional case-control study was performed. Prostate cancer survivor patients treated with radiotherapy were recruited from the Radiation Oncology Service of the "Complejo Hospitalario Universitario" (Granada) and compared with age-matched healthy men. Outcomes included were perception of benefits for physical activity and potential barriers (Exercise Benefits/Barriers Scale), physical activity levels assessed by the International Physical Activity Questionnaire (IPAQ), quality of life (EuroQol five-dimension three-levels) and self-efficacy (Self-Efficacy to Manage Chronic Disease).

RESULTS

A total of 120 patients were included in our study. Significant differences were found between groups with worse results for the prostate cancer patient group in the variable perception of the benefit of physical activity, potential barriers, and physical activity. Regarding quality of life and self-efficacy, significant differences were also observed between groups with a greater score in the control group.

CONCLUSION

In conclusion, the results of this study reveal that self-reported PA levels, as measured using the IPAQ, were low in prostate cancer survivors after treatment. Results also showed worse perception of benefits for PA and potential barriers by the cancer survivors. Similarly, the quality of life and self-efficacy to manage chronic disease of prostate cancer survivors was lower.

Relationship between patient functionality impairment and caregiver burden: is there a cut off point for the severe COPD patient?

BACKGROUND

Chronic obstructive pulmonary disease (COPD) patients experience a progressive limitation of their functionality accompanying their clinical evolution. Concretely, severe COPD patients usually require the figure of a caregiver. Caregiver burden has yet to be explored in other similar chronic diseases. The objective is to propose a cutoff point in different functional impairment aspects, to predict the presence of caregiver burden.

METHODS

Severe COPD patients were divided into two groups according to the caregiver burden, measured with the Zarit Burden Interview (ZBI). The patients were assessed with the London Chest Activity of Daily Living (LCADL) scale, the Functional Independence Measure (FIM), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0).

RESULTS

70 COPD patients and their caregivers were included in this cross-sectional study. The ROC curve indicated a cutoff point of 19 in the LCADL scale (AUC = 0.722). Dependence in daily life activities had a cutoff point of 123 in the FIM (AUC = 0.776). Social participation in activities of daily living had a cutoff point of 37 in the WHODAS 2.0 (AUC = 0.739).

CONCLUSION

Dyspnea related to functional status, dependence in daily life activities, and social participation in activities of daily living of severe COPD patients can predict caretaker burden.

Pain Experiences of People Diagnosed With Autism Spectrum Disorder: A Systematic Review of Case-Control Studies

IMPORTANCE

Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and is characterized by compromised social interactions, reduced verbal communication, stereotyped repetitive behaviors, restricted interests, and sensory abnormalities. Yet absent from the knowledge base is information about sensory abnormalities related to pain experiences. Exploring the pain experiences of people with ASD may provide occupational therapy practitioners with a baseline to determine areas of need and effective interventions.

OBJECTIVE

To conduct a systematic review of the literature to summarize current evidence from case-control studies comparing sensory abnormalities with regard to pain experiences of people diagnosed and not diagnosed with ASD.

DATA SOURCES

A systematic literature search of the CINAHL, Cochrane, MEDLINE (PubMed), OTseeker, and Web of Science databases, using MeSH terms and broad keywords.

STUDY SELECTION AND DATA COLLECTION

A search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of the included studies.

FINDINGS

A total of 27 case-control studies involving 865 people with ASD and 864 control participants were included. Several methods were used to explore pain experiences, such as threshold detection or pain threshold.

CONCLUSION AND RELEVANCE

The results indicate that people with ASD may have an abnormal sensory experience with regard to pain sensitivity. Occupational therapy practitioners should develop an intervention to focus on pain. What This Article Adds: This study adds to the body of literature indicating that people with ASD have sensory abnormalities with regard to pain experiences. Results highlight the need for occupational therapy interventions to focus on pain experiences.

Pain and Clinical Presentation: A Cross-Sectional Study of Patients with New-Onset Chronic Pain in Long-COVID-19 Syndrome

The aim of this study was to evaluate the characteristics of pain (i.e., pain intensity, pain interference, clinical presentation) in Long-COVID-19 patients and compare the location of pain between successfully recovered COVID-19 patients and healthy matched controls. A cross-sectional case-control study was carried out. Long-COVID-19 patients, age- and sex-matched patients with a history of COVID-19 who had successfully recovered, and healthy controls were included. Outcomes included were pain characteristics (Brief Pain Inventory and Short-Form McGill Pain Questionnaire) and clinical presentation (Widespread Pain Index and Euroqol-5 Dimensions 5 Levels Visual Analogue Scale). Sixty-nine patients with Long-COVID-19 syndrome, sixty-six successfully recovered COVID-19 patients, and sixty-seven healthy controls were evaluated. Patients with Long-COVID-19 syndrome showed greater pain intensity and interference. In addition, they showed worse quality of life and greater widespread pain, with the most frequent locations of pain being the neck, legs, and head. In conclusion, patients with Long-COVID-19 syndrome show a high prevalence of pain, characterized by widespread pain of moderate intensity and interference, with the most frequent locations being the neck, legs, and head, significantly affecting the quality of life of these patients.

Systematic review of self-management programs for prostate cancer patients, a quality of life and self-efficacy meta-analysis

OBJECTIVE

To investigate the efficacy of self-management interventions on quality of life and/or self-efficacy in patients diagnosed with prostate cancer through a systematic review with meta-analysis.

METHODS

A search was conducted from database inception to March 2022 across three databases. Randomized controlled trials were included. Two reviewers performed independent data extraction and methodologic quality assessment of the studies.

RESULTS

A total of fifteen studies were included in the study. Self-management interventions were identified by the Practical Reviews in Self-Management Support. The meta-analysis showed that self-management interventions have a significant effect on self-efficacy CONCLUSION: Self-management programs could have positive effects on quality of life and improve self-efficacy in prostate cancer patients.

PRACTICE IMPLICATIONS

Self-management components may be heterogeneous but show positive results in improving self-efficacy in prostate cancer survivors. Including self-management components in the rehabilitation of prostate survivors can improve their quality of life.

Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review

Background: Understanding the stomatognathic system disturbances is key to diagnosing them early and implementing rehabilitation approaches to promote functional recovery. The objective of this study was to systematically review all published data that examined the assessment and rehabilitation strategies for the stomatognathic system disturbances in patients with stroke. Methods: Five databases (i.e., PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and PEDro), were screened for manuscripts that included the assessment and rehabilitation strategies for stomatognathic system disturbances. The methodological quality was evaluated using the Mixed Methods Appraisal Tool. Results: Sixteen articles were included in this systematic review. The most frequently reported symptoms in patients with stroke included stiffness and thickness of the masseter muscle on the affected side and suprahyoid muscles; facial muscles' asymmetry and weakness; temporomandibular disorders; and a reduced maximum lip force, tongue pressure, and saliva flow rate. The rehabilitation strategies more frequently reported included exercises directed to the jaw, temporomandibular joint, tongue, and neck. The mean score for methodological quality was 85%. Conclusion: The stomatognathic system disturbances are frequently reported among patients with stroke, leading to dysfunction in masticatory performance or swallowing. More studies on interventions for stomatognathic system disturbances are required before conclusions may be drawn. Key Practitioner Message: This systematic review has clinical implications for rehabilitation practices, given that the results may help to develop early assessment and rehabilitation strategies for stomatognathic disturbances in patients with stroke.

Effectiveness of healthy lifestyle-based interventions in lung cancer survivors: a systematic review and meta-analysis

PURPOSE

To assess the effectiveness of healthy lifestyle-based interventions in lung cancer survivors.

METHODS

We performed a literature search using PubMed, Web of Science, and Science Direct (last search March 2022). Quality assessment and risk of bias were assessed using the Downs and Black scale and the Cochrane tool. A systematic review and meta-analysis of randomized controlled trials were performed. We included controlled trials testing the effect of healthy lifestyle-based interventions in lung cancer survivors versus a control intervention where lung cancer patients had no treatment, were receiving the usual care, or had not an active role in the intervention. The data were pooled and a meta-analysis was completed for quality of life, psychological distress, and cancer-related symptoms.

RESULTS

We selected 14 studies, which included 1519 patients with lung cancer. The treatment status of these patients was heterogeneous. Healthy lifestyle programs were applied isolated or in combination with usual care in most of the studies. The components of the healthy lifestyle programs were also heterogeneous. Results showed significant differences in favor of healthy lifestyle-based interventions in comparison to the control group for quality of life (p = 0.01), psychological distress (p = 0.05), and cancer-related symptoms (p = 0.03).

CONCLUSIONS

The findings indicated a beneficial effect of healthy lifestyle-based interventions for improving quality of life, psychological distress, and cancer-related symptoms in lung cancer patients. However, this review could not show any conclusion about the better treatment moment to apply healthy lifestyle-based interventions.

REVIEW REGISTRATION

PROSPERO Identifier: CRD42021292152.

REVIEW REGISTRATION DATE

19/12/2021.

Cross-sectional study of pain-related variables before and during the COVID-19 pandemic in patients with COPD

BACKGROUND

The impact of the COVID-19 pandemic influences of COPD patients. The worsening of their health status may contribute to a higher pain prevalence.

AIM

The aim of this study was to analyze the pain-related variables before and during the COVID-19 pandemic in patients with chronic obstructive pulmonary disease.

METHODS

In this cross-sectional case-control study, stable patients with chronic obstructive pulmonary disease without a COVID-19 diagnosis were evaluated before and during the pandemic. The main outcomes were the pronociceptive pain profile (general pain sensitivity, pain intensity, pain interference, and pressure pain sensitivity) and the psychological vulnerability (perceived health status, anxiety, and depression).

RESULTS

Our results showed that patients with chronic obstructive pulmonary disease during COVID-19 pandemic experienced higher general pain sensitivity and intensity with statistical differences in pain interference (p < .001), being the overall perceived health status lower than before the pandemic (p < .05).

CONCLUSIONS

We concluded that patients with chronic obstructive pulmonary disease during the COVID-19 pandemic showed a rise the pronociceptive pain profile accompanied by increased psychological vulnerability.

Relationship between Pain Intensity, Physical Factors, Pronociceptive Pain Modulation Profile and Psychological Vulnerability on Upper Limb Disability in Older Patients with Chronic Shoulder Pain

BACKGROUND

Chronic shoulder pain is a very prevalent condition causing disability and functional impairment. The purpose of the study was to evaluate the relationship between pain intensity, physical variables, psychological vulnerability, pronociceptive pain modulation profile and disability in older people with chronic shoulder pain.

METHODS

A cross-sectional study was carried out. A total of 56 participants with non-specific chronic shoulder pain of the "Complejo Hospitalario Universitario" (Granada) and 56 healthy controls were included. The outcomes evaluated were pain intensity (visual analogue scale), physical factors (dynamometry for grip strength), psychological vulnerability (Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia), pronociceptive pain modulation profile (pain pressure algometry) and disability (Quick Disability Arm Shoulder Hand questionnaire).

RESULTS

Disability showed a positive correlation with pain and psychological vulnerability (p < 0.05) and a negative correlation with pronociceptive pain variables and dynamometry (p < 0.001). Psychological vulnerability also presented a strong negative correlation with proprioceptive pain variables and dynamometry and a positive correlation with pain (p < 0.05). In regard to the pronociceptive pain modulation profile, a strong negative correlation with pain (p < 0.001) and a positive moderate correlation with dynamometry (p < 0.001) were shown.

CONCLUSIONS

Our results support a strong association between disability, psychological vulnerability and pronociceptive pain modulation profile in older adults with chronic shoulder pain.

Adaptation, validity, and reliability of the Interaction with Disabled Persons Scale in Spanish population

PURPOSE

To adapt the Interaction with Disabled Persons Scale (IDP) into Spanish and examine its factor structure.

METHODS

A forward and back translation of the IPD was performed by professional translators of scholarly articles. Spanish-speaking professional translators provided modifications in order to develop the final version of the scale. Participants filled in the Spanish version of the IDP, Positive and Negative Affect Schedule (PANAS), Multidimensional Attitudes Scale toward persons with disabilities (MAS), and Semantic Differential Technique (SDT).

RESULTS

A total of 523 persons (62.6% women), with a mean age of 29.22 (SD = 14.03) ranking from 18 to 81. The confirmatory factor analysis showed a reliable brief version of the IDP with adequate psychometric properties and two factors: (χ₍₁₉₎²=28.98, p < 0.001, CFI = 0.94, TLI = 0.91, RMSEA (90% IC)=0.05 (0.01, 0.08), SRMR = 0.06). The first factor solution was Coping/Succumbing Framework and the second factor was Discomfort in Social Interaction. The internal consistency reliability for the first factor was 0.63 and for the second 0.66.

CONCLUSIONS

Our findings provide evidence of the psychometric properties of the IDP as a brief measure of attitude toward individual with special needs in Spanish population.Implications for rehabilitationThe Interaction with Disabled Persons Scale (IDP) was successfully translated into Spanish language.The Spanish version of IDP Scale has a good acceptability, acceptable internal consistency, and high test-retest reliability.The Spanish version of IDP can been used to assist the clinicians, educators, and researchers in identifying the attitudes of the Spanish population toward persons with functional diversity in Spanish.Identifying the attitudes will permit to improve the inclusion polity and to design social programs toward greater inclusion.

Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis

Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = −1.26, 95% CI = −1.65, −0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.

Virtual Reality in the Treatment of Adults with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Virtual reality (VR) can present advantages in the treatment of chronic low back pain. The objective of this systematic review and meta-analysis was to analyze the effectiveness of VR in chronic low back pain. This review was designed according to PRISMA and registered in PROSPERO (CRD42020222129). Four databases (PubMed, Cinahl, Scopus, Web of Science) were searched up to August 2021. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale and the risk of bias with the Cochrane Risk of Bias Assessment Tool. Fourteen studies were included in the systematic review and eleven in the meta-analysis. Significant differences were found in favor of VR compared to no VR in pain intensity postintervention (11 trials; n = 569; SMD = −1.92; 95% CI = −2.73, −1.11; p < 0.00001) and followup (4 trials; n = 240; SDM = −6.34; 95% CI = −9.12, −3.56; p < 0.00001); and kinesiophobia postintervention (3 trials; n = 192; MD = −8.96; 95% CI = −17.52, −0.40; p = 0.04) and followup (2 trials; n = 149; MD = −12.04; 95% CI = −20.58, −3.49; p = 0.006). No significant differences were found in disability. In conclusion, VR can significantly reduce pain intensity and kinesiophobia in patients with chronic low back pain after the intervention and at followup. However, high heterogeneity exists and can influence the consistency of the results.

The Caregiver Burden Inventory as a Sleep Disturbance Screening Tool for Parents of Children with Autism Spectrum Disorder

PURPOSE

The study was conducted to explore the degree to which caregiver burden is associated with sleep quality in parents of children with autism spectrum disorder, and to determine a statistically valid cutoff score for the Caregiver Burden Inventory (CBI) in order to identify parents of risk of poor sleep quality.

DESIGN AND METHODS

We conducted a cross-sectional analysis. We assessed caregiver burden with the CBI, sleep quality with the Pittsburgh Sleep Quality Index, emotional status with the Hospital Anxiety and Depression Scale, and impact on family with the Impact on Family Scale. Caregiver burden was evaluated with a logistic regression analysis. The best fit model was used in a receiver operating characteristic analysis. Likelihood ratios and post-test probabilities were calculated.

RESULTS

A total of 116 parents were included in this study. Higher caregiver burden was associated with a reduction in sleep quality in the logistic regression analysis (p < 0.001). The area under the curve for the univariate burden test model (best fit) was 76.70 (p < 0.001). The cutoff score for poor sleep quality was caregiver burden ≥26.50. The post-test probability of poor sleep quality increased to 82.02% from a pre-test probability of 76.72%.

CONCLUSIONS

Our findings suggest that caregiver burden is associated with sleep quality among parents of children with autism spectrum disorder. The findings suggest that a CBI cutoff score of 26.50 may help to detect risk of poor sleep quality in parents of children with autism spectrum disorder.

Psychological distress prior to surgery is related to symptom burden and health status in lung cancer survivors

PURPOSE

Patients with lung cancer experience a variety of distressing symptoms which could adversely affect quality of life. The aim of this study was to determine whether psychological distress prior to surgery is associated to health status and symptom burden in lung cancer survivors.

METHODS

A longitudinal observational study with 1-year follow-up was carried out. Health status was measured by the WHO Disability Assessment Scale (WHO-DAS 2.0), the Euroqol-5 dimensions (EQ-5D) and the Pittsburgh Sleep Quality Index (PSQI). Symptoms severity included dyspnoea (Multidimensional Profile of Dyspnoea); pain (Brief Pain Inventory); fatigue (Fatigue Severity Scale); and cough (Leicester Cough Questionnaire).

RESULTS

One hundred seventy-four lung cancer patients were included. Patients in the group with psychological distress presented a worse self-perceived health status, functionality and sleep quality. The group with psychological distress also presented higher dyspnoea, fatigue and pain.

CONCLUSION

Patients with psychological distress prior surgery present with a greater symptom burden and a poorer self-perceived health status, lower functionality and sleep quality, than patients without distress 1 year after the lung resection.

Reduced exercise capacity and self-perceived health status in high-risk patients undergoing lung resection

BACKGROUND

Lung resection represents the main curative treatment modality of non-small cell lung cancer. Patients with high-risk to develop postoperative pulmonary complications have been classified as “high-risk patients.” Characterizing this population could be important to improve their approach and rehabilitation.

AIM

To identify the differences between high and low-risk patients in exercise capacity and self-perceived health status after hospitalization.

METHODS

A longitudinal observational prospective cohort study was carried out. Patients undergoing lung resection were recruited from the “Hospital Virgen de las Nieves” (Granada) and divided into two groups according to the risk profile criteria (age ≥ 70 years, forced expiratory volume in 1 s ≤ 70% predicted, carbon monoxide diffusion capacity ≤ 70% predicted or scheduled pneumonectomy). Outcomes included were exercise capacity (Fatigue Severity Scale, Unsupported Upper-Limb Exercise, handgrip dynamometry, Five Sit-to-stand test, and quadriceps hand-held dynamometry) and patient-reported outcome (Euroqol-5 dimensions 5 Levels Visual Analogue Scale).

RESULTS

In total, 115 participants were included in the study and divided into three groups: high-risk, low-risk and control group. At discharge high-risk patients presented a poorer exercise capacity and a worse self-perceived health status (P < 0.05). One month after discharge patients in the high-risk group maintained these differences compared to the other groups.

CONCLUSION

Our results show a poorer recovery in high-risk patients at discharge and 1 mo after surgery, with lower self-perceived health status and a poorer upper and lower limb exercise capacity. These results are important in the rehabilitation field.

[Prevalence and repercussions of the locomotor syndrome in patients with chronic obstructive pulmonary disease]

BACKGROUND

Patients with Chronic Obstructive Pulmonary Disease (COPD) suffer a progressive deterioration of functional status and a decrease in independence in activities of daily living. Locomotor Syndrome (SL) is the involvement of the musculoskeletal system due to the deterioration caused by age.

AIM

In patients with COPD, to evaluate the prevalence in LS and assess its impact on functional status and quality of life.

MATERIAL AND METHODS

Cross sectional assessment of 259 patients with COPD. LS was evaluated with the Geriatric Locomotive Function Scale (GFLS-25). Those with a score < 16 were classified as having LS. Functional status was evaluated with dynamometry, Five Times Sit-to-Stand test, and the Modified Baecke Physical Activity Questionnaire. Functional impairment was measured with the London Chest Activity of Daily Living, and the quality of life was evaluated with EuroQol-5D.

RESULTS

LS was found in 139 patients (53%). Activity levels and muscle strength were lower in these patients. Also, they had a higher frequency of functional impairment and a lower quality of life perception.

CONCLUSIONS

LS in patients with COPD impacts their functional status and quality of life.

A Feasibility and Efficacy Randomized Controlled Trial of Two Exercise Programs in Severe AECOPD Patients with Resting Hypoxemia

Resting hypoxemia is the most severe stage of Chronic Obstructive Pulmonary Disease (COPD). Due to their impairments during the exacerbation, these patients are limited to traditional exercise rehabilitation and are excluded from the majority of the studies. The aim of this study was to assess the feasibility and the efficacy of two exercise programs in Acute Exacerbation of COPD (AECOPD) patients with resting hypoxemia. In this randomized clinical trial, patients hospitalized due to an acute exacerbation of COPD with hypoxemia at rest were included. Patients were randomly assigned into three groups. A Control Group (pharmacological treatment), a Global Exercise Group (GEG), and a Functional Electrostimulation Group (FEG). Patients were treated during the hospitalization period. The main outcomes were lower limb strength (assessed by a dynamometer), balance (assessed by the one leg standing balance test), health related quality of life (assessed by the EQ-5D), adverse events and adherence. At the end of the intervention, there were significant differences in all the variables in favour of the experimental groups (p < 0.05). We concluded that conducting an exercise program is feasible and improves lower limb strength, balance, and health related quality of life in AECOPD patients with resting hypoxemia.

Physical Therapist Interventions for Infants With Nonsynostotic Positional Head Deformities: A Systematic Review

OBJECTIVE

This study sought to examine the methodological quality and summarize the evidence from clinical trials that examined the effectiveness of physical therapist interventions in the management of nonsynostotic positional head deformities in infants.

METHODS

The following electronic databases were searched: PubMed/MEDLINE, ScienceDirect, CINAHL, Scopus, PEDro, and Web of Science. Two different authors conducted the searches and completed the data extraction. Randomized and non-randomized clinical trials were included. The risk of bias was assessed using the Downs and Black Scale and the Cochrane Collaboration's tool.

RESULTS

Six articles were finally included. The main features of interventions included education to parents about positioning, manual therapy, and motor stimulation. The small sample sizes were not adequately powered and methodological quality showed a high risk of bias, mainly from a lack of blinding and limited external validity.

CONCLUSION

There are indicators that suggest that physical therapist interventions may be useful for infants with nonsynostotic head deformities at improving cranial asymmetries and motor development. However, the validity of such conclusion is limited because most trials included had a high risk of bias. More rigorous research on physical therapy, including randomized controlled trials with larger sample sizes, is required in this area.

IMPACT

The high prevalence and incidence of nonsynostotic positional head deformities in infants calls for the development of effective interventions. Physical therapists have a promising role in the improvement of cranial asymmetry and motor development. The most reported interventions involved educating parents about positioning and manual therapy. Some studies show that changes obtained after physical therapist intervention were comparable with those obtained after helmet therapy.

LAY SUMMARY

Early referral to physical therapy may help to prevent or reduce the severity of nonsynostotic positional head deformities. Education about positioning is important to prevent and improve the asymmetry of the baby's head when there is nonsynostotic positional head deformity. Physical therapist interventions can improve motor development in infants with nonsynostotic positional head deformity who have motor delays.

Impacts of tailored, rehabilitation nursing care on functional ability and quality of life in hospitalized elderly patients after rib fractures

OBJECTIVES

We aimed to analyze the effects of a tailored rehabilitation nursing care program on functional ability and quality of life in patients with conservative treatment for rib fractures.

DESIGN

Randomized controlled trial.

SETTING

Inpatient rehabilitation hospital.

SUBJECTS

Rib fracture patients treated conservatively were randomized into two groups (experimental and control group).

INTERVENTIONS

Patients in control group received Treatment as Usual (TAU) and patients included in experimental group received TAU and an added tailored rehabilitation nursing care program (RNT).

MAIN MEASURES

At baseline, and end of hospitalization treatment, the functional ability was assessed with the Barthel Index, and the quality of life was evaluated with the EuroQol-5D. Additionally, the outcomes were assessed at six-month follow-up.

RESULTS

A total of 80 patients were included in the study, whose mean age was 77.19 SD 7.71 in the RNT group and 75.55 SD 9.46 in the TAU group. Our data showed a significant difference in the post-treatment gains in overall quality of life (74.25 SD 20.62 vs 60.28 SD 20.54), and functional ability (71.79 SD 23.85 vs 69.41 SD 24.30) between the RNT group and the TAU group (P < 0.05). Compared to the TAU group, the RNT group also showed a significant improvement in functional ability and quality of life at six-month follow-up.

CONCLUSIONS

A tailored rehabilitation nursing care program added to the conservative treatment during hospitalization can improve the functional ability and quality of life of patients after rib fractures at discharge and at six-month follow-up.

TRIAL REGISTRATION

ClinicalTrial.gov Identifier: NCT04168996.

Results of a self-management program added to standard physical therapy in chronic neck pain

OBJECTIVE

To evaluate the effectiveness of a self-management treatment added to a physical therapy program compared to a physical therapy program in patients with chronic neck pain.

METHODS

Fifty-three patients with chronic neck pain were randomly allocated to a physical therapy intervention (control group) or an individualized self-management combined with physical therapy intervention (experimental group). Both interventions were developed over a four-week period. Outcome measures included were Disability, Fear-Avoidance Beliefs, Health-Related Quality of Life, Pain, and Anxiety and Depression. All outcomes were measured before and after the treatment and at three-month follow-up.

RESULTS

There were not significant differences between groups at baseline. After the intervention both groups obtained better results in the Neck Disability Index but there were not significant differences between them (p > 0.05). At follow-up, the self-management group obtained significant better results compared to the control group (95 % CI: -5.20(-6.8 to -1.5), p = 0.032).

CONCLUSIONS

An individualized self-management program added to a physical therapy program led to a greater improvement in disability at 3 months follow up compared to a physical therapy program alone. Catastrophizing, pain, and health-related quality of life improved significantly after the intervention and at follow-up compared to the standard care alone.

PRACTICAL IMPLICATIONS

This study indicates that physical therapy for patients with chronic neck pain preferably should include self-management education.

Respiratory disturbances in fibromyalgia: A systematic review and meta-analysis of case control studies

Background: Fibromyalgia is a debilitating syndrome characterized by diffuse and chronic musculoskeletal pain.Objective: To perform a systematic review and meta-analysis of case-control studies to explore the respiratory disturbances among persons with fibromyalgia.Study appraisal and synthesis method: This review was performed in accordance with PRISMA guidelines (PROSPERO; identification number CRD: 42,020,196,835). We systematically searched seven electronic databases for articles published before December 2020.Eligibility criteria: Case-control studies comparing adults with fibromyalgia syndrome and healthy individuals with regard to the respiratory disturbances.Results: A total of six studies were included in the quantitative analysis. Pooled analysis showed that persons with fibromyalgia reported reduced chest expansion (MD -0.72, 95% CI, -1.70 to 0.27, I² = 95%, p = 0.016), maximum expiratory pressure (MD -10.67, 95% CI, -18.62 to -2.72, I² = 77%, p = 0.009), maximum inspiratory pressure (MD 11.04, 95% CI, -14.45 to -7.62, I² = 0%, p < 0.001) and maximal voluntary ventilation (MD 11.79, 95% CI, -16.80 to -7.78, I² = 0%, p < 0.001).Conclusion: Persons with fibromyalgia experience respiratory disturbances, such as reduced chest expansion, maximum expiratory pressure, maximum inspiratory pressure, and maximal voluntary ventilation.

Ventilatory Impairments Associated with Parkinson's Disease: A Systematic Review and Meta-Analysis

BACKGROUND

The peripheral and central repercussions of Parkinson's disease (PD) affect the neuromuscular system producing a loss of muscle strength that can influence the respiratory system. Although several studies have examined various respiratory aspects of PD, to the best of our knowledge no study to date has systematically reviewed the existing data.

OBJECTIVES

To examine the available literature related to the respiratory impairment in PD patients.

METHODS

We used PRISMA guidelines when reporting this review. We searched Pubmed, Cinhal, SciELO, and Cochrane Library, from inception until August 2018. Main variables assessed were forced vital capacity percent predicted (FVC%) and forced expiratory volume in 1 s percent predicted (FEV1%) for PD patients.

RESULTS

Six studies were included in this systematic review and meta-analysis. The obtained results concluded that PD patients present poorer pulmonary function when compared to healthy controls. When PD patients were compared between ON and OFF states, the results reviewed are in favour of the ON state. In the meta-analysis performed for FVC% and FEV1%, the results fail to find significant differences between PD patients and controls (p = 0.336 and p = 0.281, respectively), and between PD ON and OFF states (p = 0.109 and p = 0.059, respectively).

CONCLUSIONS

We conclude that PD patients have impaired respiratory capacities that are related to the PD severity, time since diagnosis, and OFF state. Adequate follow-up of the respiratory function and studies focused on PD phenotypes have to be considered in future studies.

Exploring perceived occupational balance in women with fibromyalgia. A descriptive study

BACKGROUND

People with chronic pain conditions such as fibromyalgia may experience occupational limitations and imbalances in their basic and instrumental occupations of daily living, leisure, work, and social participation.

OBJECTIVE

To describe occupational balance in persons with fibromyalgia and to analyze whether it is associated with self-reported disability and self-efficacy to manage symptoms.

METHODS

A cross-sectional study was carried out. Individuals with fibromyalgia were invited to participate. Occupational balance was assessed with the Occupational Balance Questionnaire; self-reported disability was assessed with the World Health Organization Disability Assessment Schedule, WHODAS 2.0-12; and self-efficacy was evaluated with the 8-item version of the Arthritis Self-Efficacy Scale. Data were analyzed using multiple linear regression with a forward stepwise procedure.

RESULTS

One hundred women with fibromyalgia were included. Occupational balance was 26.96 ± 12.09; however, scores differed between the mild disability group and the moderate disability group (33.11 ± 9.99 vs. 20.29 ± 10.61, p < 0.001). Multiple linear regression analyses revealed that self-reported disability and self-reported pain management explained 58.1% of the variance in occupational balance.

CONCLUSION

Women with fibromyalgia showed low occupational balance. Self-reported disability and self-reported pain management were associated with occupational balance.

SIGNIFICANCE

Occupational therapy practitioners can design intervention programs focussing on occupational balance and self-efficacy to manage symptoms.

Speech and language therapy treatment on hypokinetic dysarthria in Parkinson disease: Systematic review and meta-analysis

OBJECTIVE

To assess the effect of speech and language therapy (SLT) on Hypokinetic dysarthria (HD) in Parkinson's disease.

DESIGN

Systematic review and meta-analysis of randomized controlled trials.

METHODS

We performed a literature search of randomized controlled trials using PubMed, Web of Science, Science Direct and Cochrane database (last search October 2020). Quality assessment and risk of bias were assessed using the Downs and Black scale and the Cochrane tool. The data were pooled and a meta-analysis was completed for sound pressure levels, perceptual intelligibility and inflection of voice fundamental frequency.

RESULTS

We selected 15 high to moderate quality studies, which included 619 patients with Parkinson's disease. After pooling the data, 7 studies, which compared different speech language therapies to no treatment, control groups and 3 of their variables, (sound pressure level, semitone standard deviation and perceptual intelligibility) were included in the analysis.Results showed significant differences in favor of SLT for sound pressure level sustained phonation tasks (standard mean difference = 1.79; 95% confidence interval = 0.86, 2.72; p ⩽ 0.0001). Significant results were also observed for sound pressure level and semitone standard deviation in reading tasks (standard mean difference = 1.32; 95% confidence interval = 1.03, 1.61; p ⩽ 0.0001). Additionally, sound pressure levels in monologue tasks showed similar results when SLT was compared to other treatments (standard mean difference = 0.87; 95% confidence interval = 0.46, 1.28; p ⩽ 0.0001).

CONCLUSION

This meta-analysis suggests a beneficial effect of SLT for reducing Hypokinetic Dysarthria in Parkinson's disease, improving perceptual intelligibility, sound pressure level and semitone standard deviation.

A systematic review of internet-based interventions for women with chronic pain

Introduction

To evaluate the effects of internet-based interventions on physical and psychosocial outcomes in women with chronic pain through a systematic review.

Method

A search of the following electronic databases: PubMed/MEDLINE, ScienceDirect, and Web of Science. Two different authors separately tabulated the indices selected in identical predetermined forms. The methodological quality of all randomised trials was assessed using the Cochrane Collaboration’s tool for assessing the risk of bias.

Results

Seven articles were finally included. The main features of interventions included online cognitive-behavioural and/or psychoeducation therapy to improve health with an interactive component. The methodological quality showed a high risk of bias, mainly from a lack of blinding.

Conclusion

There are indicators that suggest that internet-based interventions may be useful for women with chronic pain. However, the validity of such a conclusion is limited as most trials included had a high risk of bias. More rigorous research is required before stating that such interventions can overcome the current limitations of traditional face-to-face care.

Effects of an active intervention based on myofascial release and neurodynamics in patients with chronic neck pain: a randomized controlled trial

BACKGROUND

While neck pain can be severely disabling and costly, treatment options have shown moderate evidence of effectiveness.

OBJECTIVE

The objective of this study was to explore the effects of a 4-week active program based on myofascial release and neurodynamics on trigger point (TrP) examination, pain, and functionality in patients with chronic neck pain.

METHODS

Randomized controlled trial. A total of 40 patients with chronic neck pain were randomly allocated to an experimental or a control group (n = 20). The primary outcome measure was TrP examination. Secondary outcomes were pain, assessed with the Brief Pain Inventory and a visual analogue scale, and functionality, evaluated with the Neck Outcome Score.

RESULTS

A between-group analysis showed significant differences (p < .05) in the percentage of active TrPs in the following muscles: suboccipital (50 vs. 92.4% in the right muscle and 37.5 vs. 89.6% in the left muscle), left scalene and levator scapulae. Significant differences (p < .05) were also found in pain severity, average pain, and functionality (i.e. symptoms, sleep, and participation).

CONCLUSIONS

A 4-week self-administered program for patients with chronic neck pain was effective in reducing the presence of active TrPs. Pain severity, average pain, and some aspects of functionality also improved significantly after the intervention.

Deficits underlying handgrip performance in mildly affected chronic stroke persons

BACKGROUND

Knowledge of the deficits underlying handgrip performance is fundamental for the development of targeted interventions.

OBJECTIVES

The purpose of this study was to evaluate maximal handgrip strength, fatigue resistance, grip work, and muscle fatigue in mildly affected stroke persons.

METHODS

We conducted a prospective observational study. A total of 20 individuals after a first unilateral ischemic/hemorrhagic chronic stroke (months poststroke: mean 33.64 ± 19.60), mildly affected according to functional score (FIM: 112.71 ± 16.14) and with arm motor impairment (upper-extremity Fugl-Meyer score: mean 57.07 ± 7.82 on the contralesional side); and 20 sex and age-matched controls were included. The outcomes assessed were maximal handgrip strength evaluated through maximal voluntary contraction, fatigue resistance defined as the seconds during which grip strength dropped to 50% of its maximum and gripwork, which was calculated using the equation grip work = maximal grip strength * 0.75 * fatigue resistance. Muscle fatigue was assessed using surface electromyography during a sustained contraction over 50% of maximal voluntary contraction.

RESULTS

Persons with stroke demonstrated significantly reduced handgrip performance regarding maximal handgrip strength, resistance to fatigue, grip work, and muscle fatigue for the contralesional hand. In addition, a reduced grip resistance and muscle fatigue was shown for the ipsilesional hand compared with controls. We found no effect of the hemispheric side of the lesion on the grip performance measures assessed.

CONCLUSIONS

Our findings provide evidence that handgrip performance remain impaired after 6 months after stroke, and may serve as a target for interventions to improve these abilities after stroke.

Effects of a patient-centered program including the cumulative-complexity model in women with chronic pelvic pain: a randomized controlled trial

OBJECTIVES

To evaluate the effects of a patient-centered intervention including the cumulative-complexity model on quality of life related to health, coping behaviors, pain, self-perceived occupational performance and activity levels.

STUDY DESIGN

Randomized controlled trial. Forty-four women with a clinical diagnosis of chronic pelvic pain were randomized into two groups. Patients in the experimental group (n = 22) were included in a patient-centered intervention that involved relevant activities proposed by participants. Patients in the control group (n = 22) received a leaflet with information about chronic pelvic pain, physical activity, fear of movement, false beliefs, active lifestyle and behavioral advice.

MAIN OUTCOME MEASURES

The primary outcome measures were health-related quality of life assessed with the EuroQol-5D and coping behavior using the Coping Strategies Questionnaires. Secondary outcomes included severity of pain using a Visual Analogue Scale, self-perception of occupational performance using the Canadian Occupational Performance Measure and physical activity levels assessed by the International Physical Activity Questionnaire.

RESULTS

An analysis of variance with repeated measures showed, in the experimental group compared with the control group, significantly greater improvement from baseline to post-intervention in health-related quality of life (EuroQol-5D Visual Analog Scale values of 70.06 ± 16.44 vs. 57.38 ± 16.40, p = 0.026) and coping behavior (adaptive coping 113.00 ± 31.89 vs. 83.24 ± 16.69, p = 0.002). Pain, self-perception of performance and physical activity levels also significantly improved.

CONCLUSIONS

A patient-centered intervention considering the workload of patients and their capacity for performing health behaviors provides benefits regarding quality of life and coping behavior. Additionally, pain, self-perceived performance of relevant tasks and physical activity levels improved.

Effects of a core stabilization training program on balance ability in persons with Parkinson's disease: a randomized controlled trial

OBJECTIVE

To explore the effects of an eight-week core stability program on balance ability in persons with Parkinson's disease.

DESIGN

Randomized controlled trial.

SETTING

A local Parkinson's association.

SUBJECTS

A total of 44 participants with a clinical diagnosis of Parkinson's disease were randomly assigned to an experimental (n = 22) or control group (n = 22).

INTERVENTION

The experimental group received 24 sessions of core training, while the control group received an intervention including active joint mobilization, muscle stretching, and motor coordination exercises.

MAIN MEASURES

The primary outcome measure was dynamic balance evaluated using the Mini-Balance Evaluation Systems Test. Secondary outcomes included the balance confidence assessed with the Activities-specific Balance Confidence Scale and standing balance assessed by the maximal excursion of center of pressure during the Modified Clinical Test of Sensory Interaction on Balance and the Limits of Stability test.

RESULTS

After treatment, a significant between-group improvement in dynamic balance was observed in the experimental group compared to the control group (change, 2.75 ± 1.80 vs 0.38 ± 2.15, P = 0.002). The experimental group also showed a significant improvement in confidence (change, 16.48 ± 16.21 vs 3.05 ± 13.53, P = 0.047) and maximal excursion of center of pressure in forward (change, 0.86 ± 1.89 cm vs 0.17 ± 0.26 cm, P = 0.048), left (change, 0.88 ± 2.63 cm vs 0.07 ± 0.48 cm, P = 0.010), and right (change, 1.63 ± 2.82 cm vs 0.05 ± 0.17 cm, P = 0.046) directions of limits of stability compared to the control group.

CONCLUSION

A program based on core stability in comparison with non-specific exercise benefits dynamic balance and confidence and increases center of mass excursion in patients with Parkinson's disease.