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Zasadzka E, Tobis S, Trzmiel T, Marchewka R, Kozak D, Roksela A, Pieczyńska A, Hojan K. Application of an EMG-Rehabilitation Robot in Patients with Post-Coronavirus Fatigue Syndrome (COVID-19)-A Feasibility Study. Int J Environ Res Public Health 2022; 19:10398. [PMID: 36012033 PMCID: PMC9407702 DOI: 10.3390/ijerph191610398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/07/2022] [Accepted: 08/17/2022] [Indexed: 05/27/2023]
Abstract
This pilot study aimed to assess the safety and feasibility of an EMG-driven rehabilitation robot in patients with Post-Viral Fatigue (PVF) syndrome after COVID-19. The participants were randomly assigned to two groups (IG-intervention group and CG-control group) in an inpatient neurological rehabilitation unit. Both groups were assessed on admission and after six weeks of rehabilitation. Rehabilitation was carried out six days a week for six weeks. The patients in the IG performed additional training using an EMG rehabilitation robot. Muscle fatigue was assessed using an EMG rehabilitation robot; secondary outcomes were changes in hand grip strength, Fatigue Assessment Scale, and functional assessment scales (Functional Independence Measure, Barthel Index). Both groups improved in terms of the majority of measured parameters comparing pre- and post-intervention results, except muscle fatigue. Muscle fatigue scores presented non-significant improvement in the IG and non-significant deterioration in the CG. Using an EMG rehabilitation robot in patients with PVF can be feasible and safe. To ascertain the effectiveness of such interventions, more studies are needed, particularly involving a larger sample and also assessing the participants' cognitive performance.
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Affiliation(s)
- Ewa Zasadzka
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Sławomir Tobis
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Tomasz Trzmiel
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Renata Marchewka
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland
| | - Dominika Kozak
- Department of Physiotherapy, University of Health Science, 85-067 Bydgoszcz, Poland
- Egzotech sp. z o.o., 44-100 Gliwice, Poland
| | - Anna Roksela
- Egzotech sp. z o.o., 44-100 Gliwice, Poland
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Anna Pieczyńska
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Katarzyna Hojan
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland
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Arai M. Evaluating the usefulness of Ninjin'yoeito Kampo medicine in combination with rehabilitation therapy in patients with frailty complicated by intractable dizziness. Neuropeptides 2021; 90:102189. [PMID: 34481223 DOI: 10.1016/j.npep.2021.102189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/04/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
Patients with chronic intractable dizziness (henceforth referred to as "intractable dizziness") have a high risk of developing frailty complications. This warrants investigation of a combined treatment for intractable dizziness and frailty. Ninjin'yoeito (NYT), a traditional Japanese medicine (Kampo medicine), is reportedly effective in treating frailty and sarcopenia. Herein, we report on the results of a retrospective study that involved the combined application of NYT and dizziness rehabilitation therapy (henceforth referred to as "dizziness rehabilitation"). Of the 31 patients with intractable dizziness, 14 developed frailty, indicating a complication rate of 45.2%. This in turn was approximately 4 times higher than the previously reported rates. Eleven patients became non-frail after 6 months of the combined treatment, and their improvement rate was 78.6%. The aforementioned combination therapy not only improved dizziness but also improved frailty. Following 6 months of combined treatment, patients in the frailty group exhibited improvement in the Dizziness Handicap Inventory score, frailty symptoms, Kihon checklist score, and visual analog scale score (fatigue), and approached the pre-treatment values of those in the non-frailty group. Together, our results highlight the need to combine the treatment for intractable dizziness and frailty.
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Affiliation(s)
- Motohiro Arai
- Department of Dizziness and Balance Neurology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan; Department of Otorhinolarygology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan.
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Teranishi-Hashimoto C, Bantum EO, Conde F, Lee E, Yamada PM. Group-based Exercise Therapy Improves Psychosocial Health and Physical Fitness in Breast Cancer Patients in Hawai'i. Hawaii J Health Soc Welf 2021; 80:263-269. [PMID: 34765985 PMCID: PMC8571815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cancer diagnosis and treatment often negatively impact quality of life, worsening prognosis, and long-term survival in cancer patients. Rehabilitation is effective at reversing cancer-related effects, but these services are not standardized. An implementation study was conducted to determine the usability and efficacy of group-based exercise therapy delivered from an outpatient therapy clinic. Thirty breast cancer patients (mean age ± standard deviation [SD],= 55 ± 10 years) completed 36 90-minute group-based exercise sessions in small groups. Team-based exercises were used to foster peer interaction and social support. Usability was evaluated with participant feedback, adherence, and occurrence of adverse events. Effectiveness was measured with the Revised Piper Fatigue, the City of Hope Quality of Life (QOL), and the Beck Depression Inventories. Paired t-tests and 2-way ANOVAs were used to detect significance (P<.05); Cohen's d was used to measure effect size. Twenty-five patients completed the program; they reported that they liked the program design. One anticipated, moderate adverse event occurred. The intervention improved fatigue and QOL, where significant main effects of time were detected [Fatigue: (F(1,76)=29.78, P <.001); QOL: (F(1,80)=24.42, P<.0001)]. Improvements in the fatigue inventory's behavioral/security and sensory dimensions (Cohen's d=-0.43 and ȡ0.68, respectively) and the physical dimension of the QOL inventory were detected (Cohen's d=0.92). There were no significant changes in depression (P=.0735). Seven patients continued to participate in exercise classes for 2.5-years post-intervention, demonstrating achievability of program maintenance. Providing group-based exercise therapy services at an outpatient clinic is an effective and practical approach to improve cancer patients' QOL.
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Affiliation(s)
| | | | - Francisco Conde
- Department of Oncology, Straub Medical Center, Honolulu, HI (FC)
| | - Eugene Lee
- Rehabilitation Hospital of the Pacific, Honolulu, HI (CT, EL)
| | - Paulette M. Yamada
- Department of Kinesiology and Rehabilitative Services, University of Hawai‘i at Manoa, Honolulu, HI (PMY)
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Stefan M, Sharp M, Gheith R, Lowery R, Ottinger C, Wilson J, Durkee S, Bellamine A. L-Carnitine Tartrate Supplementation for 5 Weeks Improves Exercise Recovery in Men and Women: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2021; 13:3432. [PMID: 34684429 PMCID: PMC8541253 DOI: 10.3390/nu13103432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 01/18/2023] Open
Abstract
L-carnitine tartrate has been shown to improve relatively short-term recovery among athletes. However, there is a lack of research on the longer-term effects in the general population. OBJECTIVE The primary objectives of this randomized double-blind, placebo-controlled trial were to evaluate the effects of daily L-carnitine tartrate supplementation for 5 weeks on recovery and fatigue. METHOD In this study, eighty participants, 21- to 65-years-old, were recruited. Participants were split into two groups of forty participants each, a placebo, and a L-carnitine Tartrate group. Seventy-three participants completed a maintenance exercise training program that culminated in a high-volume exercise challenge. RESULTS Compared to placebo, L-carnitine tartrate supplementation was able to improve perceived recovery and soreness (p = 0.021), and lower serum creatine kinase (p = 0.016). In addition, L-carnitine tartrate supplementation was able to blunt declines in strength and power compared to placebo following an exercise challenge. Two sub-analyses indicated that these results were independent of gender and age. Interestingly, serum superoxide dismutase levels increased significantly among those supplementing with L-carnitine tartrate. CONCLUSIONS These findings agree with previous observations among healthy adult subjects and demonstrate that L-carnitine tartrate supplementation beyond 35 days is beneficial for improving recovery and reducing fatigue following exercise across gender and age.
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Affiliation(s)
- Matthew Stefan
- Applied Science & Performance Institute, Research Division, Tampa, FL 33607, USA; (M.S.); (R.G.); (R.L.); (C.O.); (J.W.)
| | - Matthew Sharp
- Applied Science & Performance Institute, Research Division, Tampa, FL 33607, USA; (M.S.); (R.G.); (R.L.); (C.O.); (J.W.)
| | - Raad Gheith
- Applied Science & Performance Institute, Research Division, Tampa, FL 33607, USA; (M.S.); (R.G.); (R.L.); (C.O.); (J.W.)
| | - Ryan Lowery
- Applied Science & Performance Institute, Research Division, Tampa, FL 33607, USA; (M.S.); (R.G.); (R.L.); (C.O.); (J.W.)
| | - Charlie Ottinger
- Applied Science & Performance Institute, Research Division, Tampa, FL 33607, USA; (M.S.); (R.G.); (R.L.); (C.O.); (J.W.)
| | - Jacob Wilson
- Applied Science & Performance Institute, Research Division, Tampa, FL 33607, USA; (M.S.); (R.G.); (R.L.); (C.O.); (J.W.)
| | - Shane Durkee
- Lonza Consumer Health Inc., Morristown, NJ 07960, USA;
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Qiu M, Zhang J. Exploring the perceived restorativeness of natural soundscapes under the global pandemic of COVID-19: A moderated mediation model. PLoS One 2021; 16:e0256855. [PMID: 34449825 PMCID: PMC8396716 DOI: 10.1371/journal.pone.0256855] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Although emerging studies have discussed the potential benefits of soundscape in mental restoration, few have investigated how soundscape renews and re-energizes people, especially in facing the current public challenge of the COVID-19 crisis. We established a moderated mediation model to examine the relationship of the four restorative components of soundscape: being away, compatibility, extent and fascination. The data were collected in Xixi Wetland National Park, China, before the outbreak of COVID-19 (n = 562) in October 2019 and post COVID-19 in October 2020 (n = 341). The results revealed that natural soundscapes have great restorative benefits for visitors. The inter relationships of the restorative components are moderated by the perceived stress level which show significant different before and after the COVID-19 pandemic. The post-COVID-19 visitors reported a higher level of stress while natural soundscapes had greater effects on their mental restoration. The direct effects of extent and fascination as well as the mediating effects of fascination were stronger among the post-COVID-19 group. However, the path coefficient from being away to compatibility were higher in the pre-COVID-19 group. This study improves the current understanding of the interactive mechanism among the restorative components of soundscape. Knowledge about natural soundscape encourages practitioners to consider it as a guideline for the creation of sustainable environments, especially under the COVID-19 crisis.
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Affiliation(s)
- Mengyuan Qiu
- College of Economics and Management, Nanjing Forestry University, Nanjing, Jiangsu, PR China
- * E-mail:
| | - Jie Zhang
- School of Geography and Ocean Science, Nanjing University, Nanjing, Jiangsu, PR China
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Fu JB, Ng AH, Molinares DM, Pingenot EA, Morishita S, Silver JK, Bruera E. Rehabilitation Utilization by Cancer Patients with Pathology-Confirmed Leptomeningeal Disease Receiving Intrathecal Chemotherapy. Am J Phys Med Rehabil 2021; 100:100-104. [PMID: 33534219 DOI: 10.1097/phm.0000000000001565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The incidence of leptomeningeal disease (LMD) is believed to be increasing in part because of more effective chemotherapy treatments allowing cancer progression behind the blood-brain barrier. However, little has been published about the rehabilitation of this growing patient population. In this study, impairments and rehabilitation utilization by cytology-proven LMD patients receiving intrathecal chemotherapy at a cancer center are described. A total of 109 consecutive patients with pathology-confirmed LMD who received an intrathecal chemotherapy infusion from January 1, 2017, through October 31, 2017, were retrospectively reviewed. Of the 109 patients, 103 (95%) had impairments described in their medical record that could impact physical function, including 74 of 109 (68%) who had deconditioning or fatigue. Kaplan-Meier median survival from initial LMD diagnosis was 13.1 mos. The median number of hospital admissions and intrathecal chemotherapy administrations was both 8. Of the 109 patients, 43 (39%) had magnetic resonance imaging radiology interpreted LMD. Most LMD patients used rehabilitation services (95/109, 87%) and most were able to forego post-acute inpatient rehabilitation facilities (96/109, 88%). Additional research and education for rehabilitation professionals about this increasingly common syndrome are needed.
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Affiliation(s)
- Jack B Fu
- From the Department of Palliative, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas (JBF, AHN, EB); Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine and Sylvester Comprehensive Cancer Center, Miami, Florida (DMM); College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Joplin, Missouri (EAP); Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan (SM); and Department of Physical Medicine & Rehabilitation, Harvard Medical School and Spaulding Rehabilitation Hospital, Boston, Massachusetts (JKS)
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Daynes E, Gerlis C, Chaplin E, Gardiner N, Singh SJ. Early experiences of rehabilitation for individuals post-COVID to improve fatigue, breathlessness exercise capacity and cognition - A cohort study. Chron Respir Dis 2021; 18:14799731211015691. [PMID: 33957805 PMCID: PMC8114752 DOI: 10.1177/14799731211015691] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/17/2022] Open
Abstract
Individuals with lasting symptoms of COVID-19 should be offered a comprehensive recovery programme. 30 individuals (mean[SD] age 58[16]) that completed a 6 week, twice supervised rehabilitation programme demonstrated statistically significant improvements in exercise capacity, respiratory symptoms, fatigue and cognition. Participants improved by 112 m on the Incremental Shuttle Walking Test and 544 seconds on the Endurance Shuttle Walking Test. There were no serious adverse events recorded, and there were no dropouts related to symptom worsening. COVID-19 rehabilitation appears feasible and significantly improves clinical outcomes.
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Affiliation(s)
- Enya Daynes
- Centre of Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Charlotte Gerlis
- Centre of Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester, Leicester, UK
| | - Emma Chaplin
- Centre of Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester, Leicester, UK
| | - Nikki Gardiner
- Centre of Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester, Leicester, UK
| | - Sally J Singh
- Centre of Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
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Hakimi A, Bergoin C, Mucci P. Immediate and 6-week after effects of a rehabilitation program for Ehlers-Danlos syndrome hypermobile type patients: A retrospective study. Am J Med Genet A 2020; 182:2263-2271. [PMID: 32738018 DOI: 10.1002/ajmg.a.61772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 12/21/2022]
Abstract
Ehlers-Danlos syndromes (EDS) are a group of inherited connective tissue disorders with an impaired quality of life in association with fatigue, pain, and kinesiophobia. A retrospective evaluation of the effects of an outpatient rehabilitation program (RP) was performed in Ehlers-Danlos syndrome hypermobile type (hEDS) patients. The 6-minute walk test (6MWT) was used to evaluate functional capacity. Kinesiophobia, fatigue, pain, and quality of life were self-evaluated at the start, at the end, and 6 weeks after the end of the RP. The retrospective analysis of patients' records showed significant improvement for the walked distance during the 6MWT (491.8 ± 72.5 vs. 439.4 ± 100.9 m) maintained at 6-week follow-up (p = .001), significant improvement for kinesiophobia (p = .033) and the impact of fatigue on activity (p = .01), and significant increase for quality of life with in particular improvements of vitality (p = .001). This retrospective study showed encouraging results of a RP for hEDS patients on functional capacity and quality of life, and prospective studies with long-term follow-up are needed to confirm them.
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Affiliation(s)
- Adrien Hakimi
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
- Clinique de la Mitterie, Lille, France
| | | | - Patrick Mucci
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
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Delrieu L, Anota A, Trédan O, Freyssenet D, Maire A, Canada B, Fournier B, Febvey-Combes O, Pilleul F, Bouhamama A, Caux C, Joly F, Fervers B, Pialoux V, Pérol D, Pérol O. Design and methods of a national, multicenter, randomized and controlled trial to assess the efficacy of a physical activity program to improve health-related quality of life and reduce fatigue in women with metastatic breast cancer: ABLE02 trial. BMC Cancer 2020; 20:622. [PMID: 32620149 PMCID: PMC7333295 DOI: 10.1186/s12885-020-07093-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with a metastatic breast cancer suffer from a deteriorated health-related quality of life and numerous symptoms such as pain, severe fatigue and a decrease of their physical fitness. As the feasibility of a physical activity program has been demonstrated in this population, ABLE02 aims to assess the efficacy of a 6 month-physical activity program using connected devices to improve health-related quality of life and to reduce fatigue in women with metastatic breast cancer. METHODS ABLE02 is a prospective, national, multicenter, randomized, controlled and open-label study. A total of 244 patients with a metastatic breast cancer, with at least one positive hormone receptor and a first-line chemotherapy planned, will be randomly assigned (1:1 ratio) to: (i) the intervention arm to receive physical activity recommendations, an activity tracker to wear 24 h a day during the whole intervention (6 months) with at least three weekly walking sessions and quizzes each week on physical activity and nutrition (ii) the control arm to receive physical activity recommendations only. Health-related quality of life will be assessed every 6 weeks and main assessments will be conducted at baseline, M3, M6, M12 and M18 to evaluate the clinical, physical, biological and psychological parameters and survival of participants. All questionnaires will be completed on a dedicated application. DISCUSSION An activity program based on a smartphone application linked to an activity tracker may help to improve quality of life and reduce fatigue of patients with a metastatic breast cancer. The growth of e-health offers the opportunity to get real-time data as well as improving patient empowerment in order to change long-term behaviors. TRIAL REGISTRATION NCT number: NCT04354233 .
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Affiliation(s)
- Lidia Delrieu
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
- Inter-University Laboratory of Human Movement Biology EA7424, University Claude Bernard Lyon 1, University of Lyon, Villeurbanne, France
| | - Amélie Anota
- Methodology and Quality of Life in Oncology unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
- RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, F-25000, Besançon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | - Olivier Trédan
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | - Damien Freyssenet
- Inter-University Laboratory of Human Movement Biology EA7424, Univ Lyon, University Jean Monnet Saint-Etienne, Saint-Etienne, France
| | - Aurélia Maire
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
| | - Brice Canada
- Laboratory on Vulnerabilities and Innovations in Sport, University Claude Bernard Lyon 1, University of Lyon, Villeurbanne, France
| | - Baptiste Fournier
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
| | - Olivia Febvey-Combes
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - Frank Pilleul
- Department of Interventional Radiology, Léon Bérard Cancer Center, Lyon, France
| | - Amine Bouhamama
- Department of Interventional Radiology, Léon Bérard Cancer Center, Lyon, France
| | - Christophe Caux
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Léon Bérard Cancer Center, Lyon, France
| | - Florence Joly
- Medical Oncology Department, Centre François Baclesse, Caen, France
- INSERM, U1086, ANTICIPE, Caen, France
- Cancer & Cognition, Platform, Ligue Contre le Cancer, CHU de Caen, Caen, France
| | - Béatrice Fervers
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
- INSERM UA8, Léon Bérard Cancer Center, Lyon, France
| | - Vincent Pialoux
- Inter-University Laboratory of Human Movement Biology EA7424, University Claude Bernard Lyon 1, University of Lyon, Villeurbanne, France
| | - David Pérol
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - Olivia Pérol
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France.
- INSERM UA8, Léon Bérard Cancer Center, Lyon, France.
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Pálsdóttir AM, Stigmar K, Norrving B, Petersson IF, Åström M, Pessah-Rasmussen H. The nature stroke study; NASTRU: A randomized controlled trial of nature-based post-stroke fatigue rehabilitation. J Rehabil Med 2020; 52:jrm00020. [PMID: 32105334 DOI: 10.2340/16501977-2652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine whether nature-based rehabilitation, as an add-on to standard care, has a long-term influence on post-stroke fatigue, perceived value of everyday occupations, disability, health-related quality of life, anxiety, and depression at follow-up 8 and 14 months after randomization. DESIGN Single-blinded, 2-armed, randomized controlled trial. METHODS Stroke survivors, identified through routine 3-month follow-up visit (sub-acute) or medical records (chronic stroke > 1 year previously), were randomized to standard care + nature-based rehabilitation (intervention group) or standard care alone (control group). Blinded evaluations were conducted at follow-up 8 and 14 months after randomization, for the following outcomes: post-stroke fatigue (Mental Fatigue Scale; MFS), perceived value of everyday occupations (Occupational value instrument with pre-defined items), disability (modified Rankin Scale; mRS), health-related quality of life (Euro-QoL-5 Demension Questionnaire), anxiety (Hospital Anxiety and Depression Scale; HAD) and depression (HAD). RESULTS Approximately one-quarter of the screened patients were eligible for inclusion in the study; of these, half agreed to participate; a final total of 101 patients were randomized (mean age 67 years, 60% female). The patients with sub-acute stroke were highly compliant with the intervention. The participants in both the intervention and control groups improved, However, no statistically significant differences in improvement were found between the intervention and control groups for any of the outcome measures. Fatigue decreased to a value below the suggested cut-off for mental fatigue (< 10.5) in the intervention group, but not in the control group. CONCLUSION Nature-based rehabilitation is feasible and well tolerated. A larger randomized controlled trial is warranted.
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Siengsukon CF, Alshehri M, Williams C, Drerup M, Lynch S. Feasibility and treatment effect of cognitive behavioral therapy for insomnia in individuals with multiple sclerosis: A pilot randomized controlled trial. Mult Scler Relat Disord 2020; 40:101958. [PMID: 32014809 DOI: 10.1016/j.msard.2020.101958] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/23/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND At least 40% of individuals with multiple sclerosis (MS) exercise chronic insomnia, and the prevalence is likely higher due to underdiagnosis. Poor sleep quality has been associated with increased fatigue, anxiety, depression, and risk of relapse in individuals with MS. While cognitive behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia, the treatment effect of CBT-I in people with MS is unclear. OBJECTIVE This pilot randomized control trial (RCT) assessed the feasibility and treatment effect of CBT-I to improve sleep quality and fatigue in individuals with MS with symptoms of insomnia. METHODS Thirty-three individuals with MS (30 females, 3 males; 30 relapsing-remitting; 3 secondary-progressive; 53.0 ± 9.4 years old) with symptoms of insomnia were randomized into one of three arms: 1. 6-week CBT-I program, 2. 6-week active control, or 3. Single session of sleep education. Participants completed surveys to assess sleep quality, fatigue, sleep self-efficacy, depression, and anxiety. RESULTS CBT-I in individuals with MS is feasible with high retention and adherence rate. All groups experienced a large magnitude of improvement in insomnia symptoms. The CBT-I and brief education groups experienced a large magnitude of improvement in sleep quality and fatigue. Only the CBT-I group demonstrated a large magnitude of improvement in sleep self-efficacy and depression. CONCLUSION This is the first study to prospectively demonstrates that CBT-I is feasible in people with MS and produces promising improvements in insomnia severity, sleep quality, sleep self-efficacy and comorbid symptoms of fatigue, depression, and anxiety. Future studies are needed to determine mechanisms for these improvements and expand the scope of individuals with MS who may benefit from CBT-I. Furthermore, considering the moderate to large improvements experienced by the brief education group and the limited number of CBT-I providers, a stepped-care approach warrants consideration.
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Affiliation(s)
- Catherine F Siengsukon
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States.
| | - Mohammed Alshehri
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Cierra Williams
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Michelle Drerup
- Sleep Disorders Clinic, Cleveland Clinic, Cleveland, OH, United States
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
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12
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Kudubes AA, Bektas M, Mutafoğlu K. The Effect of Fatigue-Related Education on Pediatric Oncology Patients' Fatigue and Quality of Life. J Cancer Educ 2019; 34:1130-1141. [PMID: 30132265 DOI: 10.1007/s13187-018-1419-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The identification of cancer-related fatigue as a clinical problem in pediatric oncology is an important phenomenon, and there are limited number of studies about raising the awareness of pediatric oncology patients and their parents. Fatigue-related education for patients and their parents before and during cancer treatment reduces the fatigue levels of patients. This study aims to analyze the effect of fatigue-related education for pediatric oncology patients aged 7-12 and their parents on their fatigue and quality of life. This study was conducted with 80 children with cancer and their parents who were assigned to either the control group (n = 40) or the experimental group (n = 40). The experimental group received a fatigue-related educational program. The data were collected three times: prior to the program, 3 months later, and 6 months afterwards. Multidimensional variance analysis, the Bonferroni adjusted t test and regression analysis were used to analyze the data. A significant difference was found among the experimental and the control group for total mean scores and the mean scores of subdimensions of the Scale for the Assessment of Fatigue-Child Form in terms of the interactions of group, time, and group*time (p < 0.05). Significant differences were found among the experimental and control groups' mean scores on the Scale for the Quality of Life-Child and Parents Form in terms of the interactions of group, time, and group*time (p < 0.05). Fatigue-related education is an effective education model as a way to reduce fatigue and increase the quality of life of children with cancer. The use of fatigue-related education by nurses in pediatric oncology clinics will have positive effects on children and their parents.
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Affiliation(s)
- Aslı Akdeniz Kudubes
- Department of Pediatric Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, 35340, Izmir, Turkey.
| | - Murat Bektas
- Department of Pediatric Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, 35340, Izmir, Turkey
| | - Kamer Mutafoğlu
- Department of Pediatrics, Izmir University of Economics Faculty of Medicine, Izmir, Turkey
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Høeg BL, Bidstrup PE, Karlsen RV, Friberg AS, Albieri V, Dalton SO, Saltbæk L, Andersen KK, Horsboel TA, Johansen C. Follow-up strategies following completion of primary cancer treatment in adult cancer survivors. Cochrane Database Syst Rev 2019; 2019:CD012425. [PMID: 31750936 PMCID: PMC6870787 DOI: 10.1002/14651858.cd012425.pub2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Most cancer survivors receive follow-up care after completion of treatment with the primary aim of detecting recurrence. Traditional follow-up consisting of fixed visits to a cancer specialist for examinations and tests are expensive and may be burdensome for the patient. Follow-up strategies involving non-specialist care providers, different intensity of procedures, or addition of survivorship care packages have been developed and tested, however their effectiveness remains unclear. OBJECTIVES The objective of this review is to compare the effect of different follow-up strategies in adult cancer survivors, following completion of primary cancer treatment, on the primary outcomes of overall survival and time to detection of recurrence. Secondary outcomes are health-related quality of life, anxiety (including fear of recurrence), depression and cost. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, four other databases and two trials registries on 11 December 2018 together with reference checking, citation searching and contact with study authors to identify additional studies. SELECTION CRITERIA We included all randomised trials comparing different follow-up strategies for adult cancer survivors following completion of curatively-intended primary cancer treatment, which included at least one of the outcomes listed above. We compared the effectiveness of: 1) non-specialist-led follow-up (i.e. general practitioner (GP)-led, nurse-led, patient-initiated or shared care) versus specialist-led follow-up; 2) less intensive versus more intensive follow-up (based on clinical visits, examinations and diagnostic procedures) and 3) follow-up integrating additional care components relevant for detection of recurrence (e.g. patient symptom education or monitoring, or survivorship care plans) versus usual care. DATA COLLECTION AND ANALYSIS We used the standard methodological guidelines by Cochrane and Cochrane Effective Practice and Organisation of Care (EPOC). We assessed the certainty of the evidence using the GRADE approach. For each comparison, we present synthesised findings for overall survival and time to detection of recurrence as hazard ratios (HR) and for health-related quality of life, anxiety and depression as mean differences (MD), with 95% confidence intervals (CI). When meta-analysis was not possible, we reported the results from individual studies. For survival and recurrence, we used meta-regression analysis where possible to investigate whether the effects varied with regards to cancer site, publication year and study quality. MAIN RESULTS We included 53 trials involving 20,832 participants across 12 cancer sites and 15 countries, mainly in Europe, North America and Australia. All the studies were carried out in either a hospital or general practice setting. Seventeen studies compared non-specialist-led follow-up with specialist-led follow-up, 24 studies compared intensity of follow-up and 12 studies compared patient symptom education or monitoring, or survivorship care plans with usual care. Risk of bias was generally low or unclear in most of the studies, with a higher risk of bias in the smaller trials. Non-specialist-led follow-up compared with specialist-led follow-up It is uncertain how this strategy affects overall survival (HR 1.21, 95% CI 0.68 to 2.15; 2 studies; 603 participants), time to detection of recurrence (4 studies, 1691 participants) or cost (8 studies, 1756 participants) because the certainty of the evidence is very low. Non-specialist- versus specialist-led follow up may make little or no difference to health-related quality of life at 12 months (MD 1.06, 95% CI -1.83 to 3.95; 4 studies; 605 participants; low-certainty evidence); and probably makes little or no difference to anxiety at 12 months (MD -0.03, 95% CI -0.73 to 0.67; 5 studies; 1266 participants; moderate-certainty evidence). We are more certain that it has little or no effect on depression at 12 months (MD 0.03, 95% CI -0.35 to 0.42; 5 studies; 1266 participants; high-certainty evidence). Less intensive follow-up compared with more intensive follow-up Less intensive versus more intensive follow-up may make little or no difference to overall survival (HR 1.05, 95% CI 0.96 to 1.14; 13 studies; 10,726 participants; low-certainty evidence) and probably increases time to detection of recurrence (HR 0.85, 95% CI 0.79 to 0.92; 12 studies; 11,276 participants; moderate-certainty evidence). Meta-regression analysis showed little or no difference in the intervention effects by cancer site, publication year or study quality. It is uncertain whether this strategy has an effect on health-related quality of life (3 studies, 2742 participants), anxiety (1 study, 180 participants) or cost (6 studies, 1412 participants) because the certainty of evidence is very low. None of the studies reported on depression. Follow-up strategies integrating additional patient symptom education or monitoring, or survivorship care plans compared with usual care: None of the studies reported on overall survival or time to detection of recurrence. It is uncertain whether this strategy makes a difference to health-related quality of life (12 studies, 2846 participants), anxiety (1 study, 470 participants), depression (8 studies, 2351 participants) or cost (1 studies, 408 participants), as the certainty of evidence is very low. AUTHORS' CONCLUSIONS Evidence regarding the effectiveness of the different follow-up strategies varies substantially. Less intensive follow-up may make little or no difference to overall survival but probably delays detection of recurrence. However, as we did not analyse the two outcomes together, we cannot make direct conclusions about the effect of interventions on survival after detection of recurrence. The effects of non-specialist-led follow-up on survival and detection of recurrence, and how intensity of follow-up affects health-related quality of life, anxiety and depression, are uncertain. There was little evidence for the effects of follow-up integrating additional patient symptom education/monitoring and survivorship care plans.
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Affiliation(s)
- Beverley L Høeg
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
| | - Pernille E Bidstrup
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
| | - Randi V Karlsen
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
| | - Anne Sofie Friberg
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
- Rigshospitalet, Copenhagen University HospitalDepartment of OncologyCopenhagenDenmark
| | - Vanna Albieri
- Danish Cancer Society Research CenterStatistics and Pharmaco‐Epidemiology UnitStrandboulevarden 49CopenhagenDenmark
| | - Susanne O Dalton
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
- Zealand University HospitalDepartment of OncologyNæstvedDenmark
| | - Lena Saltbæk
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
- Zealand University HospitalDepartment of OncologyNæstvedDenmark
| | - Klaus Kaae Andersen
- Danish Cancer Society Research CenterStatistics and Pharmaco‐Epidemiology UnitStrandboulevarden 49CopenhagenDenmark
| | - Trine Allerslev Horsboel
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
| | - Christoffer Johansen
- Danish Cancer Society Research CenterSurvivorship UnitStrandboulevarden 49CopenhagenCentral Denmark RegionDenmark2100
- Rigshospitalet, Copenhagen University HospitalDepartment of OncologyCopenhagenDenmark
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14
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Bolam KA, Mijwel S, Rundqvist H, Wengström Y. Two-year follow-up of the OptiTrain randomised controlled exercise trial. Breast Cancer Res Treat 2019; 175:637-648. [PMID: 30915663 PMCID: PMC6534518 DOI: 10.1007/s10549-019-05204-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 03/14/2019] [Indexed: 12/24/2022]
Abstract
Purpose The aim of this study was to determine if there were any differences in health-related outcomes and physical activity (PA) between the two OptiTrain exercise groups and usual care (UC), 2 years post-baseline. Methods The OptiTrain study was a three-arm randomised controlled trial comparing 16 weeks of concurrent aerobic high-intensity interval training (HIIT) and progressive resistance exercise (RT-HIIT) or concurrent HIIT and continuous moderate-intensity aerobic exercise (AT-HIIT) to UC in 206 patients with breast cancer undergoing chemotherapy. Eligible participants were approached 2 years following baseline to assess cancer-related fatigue, quality of life, symptoms, muscle strength, cardiorespiratory fitness, body mass, PA, sedentary behaviour, and sick leave. Results The RT-HIIT group reported lower total cancer-related fatigue, (− 1.37, 95% CI − 2.70, − 0.04, ES = − 0.06) and cognitive cancer-related fatigue (− 1.47, 95% CI − 2.75, − 0.18, ES = − 0.28), and had higher lower limb muscle strength (12.09, 95% CI 3.77, 20.40, ES = 0.52) than UC at 2 years. The AT-HIIT group reported lower total symptoms (− 0.23, 95% CI − 0.42, − 0.03, ES = − 0.15), symptom burden (− 0.30, 95% CI − 0.60, − 0.01, ES = − 0.19), and body mass − 2.15 (− 3.71, − 0.60, ES = − 0.28) than UC at 2 years. Conclusion At 2 years, the exercise groups were generally experiencing positive differences in cancer-related fatigue (RT-HIIT), symptoms (AT-HIIT), and muscle strength (RT-HIIT) to UC. The findings provide novel evidence that being involved in an exercise program during chemotherapy can have long-term benefits for women with breast cancer, but that strategies are needed to create better pathways to support patients to maintain physical activity levels. Trial registration Clinicaltrials.gov registration number: NCT02522260. Trial registered on 9 June 2015. https://clinicaltrials.gov/ct2/show/NCT02522260. Retrospectively registered.
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Affiliation(s)
- Kate A Bolam
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 23, 14183, Stockholm, Sweden.
| | - Sara Mijwel
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 23, 14183, Stockholm, Sweden
- Cancer Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Helene Rundqvist
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 23, 14183, Stockholm, Sweden
- Cancer Theme, Karolinska University Hospital, Stockholm, Sweden
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15
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Okkersen K, Jimenez-Moreno C, Wenninger S, Daidj F, Glennon J, Cumming S, Littleford R, Monckton DG, Lochmüller H, Catt M, Faber CG, Hapca A, Donnan PT, Gorman G, Bassez G, Schoser B, Knoop H, Treweek S, van Engelen BGM. Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial. Lancet Neurol 2018; 17:671-680. [PMID: 29934199 DOI: 10.1016/s1474-4422(18)30203-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/08/2018] [Accepted: 05/16/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Myotonic dystrophy type 1 is the most common form of muscular dystrophy in adults and leads to severe fatigue, substantial physical functional impairment, and restricted social participation. In this study, we aimed to determine whether cognitive behavioural therapy optionally combined with graded exercise compared with standard care alone improved the health status of patients with myotonic dystrophy type 1. METHODS We did a multicentre, single-blind, randomised trial, at four neuromuscular referral centres with experience in treating patients with myotonic dystrophy type 1 located in Paris (France), Munich (Germany), Nijmegen (Netherlands), and Newcastle (UK). Eligible participants were patients aged 18 years and older with a confirmed genetic diagnosis of myotonic dystrophy type 1, who were severely fatigued (ie, a score of ≥35 on the checklist-individual strength, subscale fatigue). We randomly assigned participants (1:1) to either cognitive behavioural therapy plus standard care and optional graded exercise or standard care alone. Randomisation was done via a central web-based system, stratified by study site. Cognitive behavioural therapy focused on addressing reduced patient initiative, increasing physical activity, optimising social interaction, regulating sleep-wake patterns, coping with pain, and addressing beliefs about fatigue and myotonic dystrophy type 1. Cognitive behavioural therapy was delivered over a 10-month period in 10-14 sessions. A graded exercise module could be added to cognitive behavioural therapy in Nijmegen and Newcastle. The primary outcome was the 10-month change from baseline in scores on the DM1-Activ-c scale, a measure of capacity for activity and social participation (score range 0-100). Statistical analysis of the primary outcome included all participants for whom data were available, using mixed-effects linear regression models with baseline scores as a covariate. Safety data were presented as descriptives. This trial is registered with ClinicalTrials.gov, number NCT02118779. FINDINGS Between April 2, 2014, and May 29, 2015, we randomly assigned 255 patients to treatment: 128 to cognitive behavioural therapy plus standard care and 127 to standard care alone. 33 (26%) of 128 assigned to cognitive behavioural therapy also received the graded exercise module. Follow-up continued until Oct 17, 2016. The DM1-Activ-c score increased from a mean (SD) of 61·22 (17·35) points at baseline to 63·92 (17·41) at month 10 in the cognitive behavioural therapy group (adjusted mean difference 1·53, 95% CI -0·14 to 3·20), and decreased from 63·00 (17·35) to 60·79 (18·49) in the standard care group (-2·02, -4·02 to -0·01), with a mean difference between groups of 3·27 points (95% CI 0·93 to 5·62, p=0·007). 244 adverse events occurred in 65 (51%) patients in the cognitive behavioural therapy group and 155 in 63 (50%) patients in the standard care alone group, the most common of which were falls (155 events in 40 [31%] patients in the cognitive behavioural therapy group and 71 in 33 [26%] patients in the standard care alone group). 24 serious adverse events were recorded in 19 (15%) patients in the cognitive behavioural therapy group and 23 in 15 (12%) patients in the standard care alone group, the most common of which were gastrointestinal and cardiac. INTERPRETATION Cognitive behavioural therapy increased the capacity for activity and social participation in patients with myotonic dystrophy type 1 at 10 months. With no curative treatment and few symptomatic treatments, cognitive behavioural therapy could be considered for use in severely fatigued patients with myotonic dystrophy type 1. FUNDING The European Union Seventh Framework Programme.
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Affiliation(s)
- Kees Okkersen
- Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands.
| | | | - Stephan Wenninger
- Friedrich-Baur-Institute, Department of Neurology, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ferroudja Daidj
- Neuromuscular Reference Centre, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jeffrey Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Sarah Cumming
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Darren G Monckton
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Hanns Lochmüller
- Institute of Genetic Medicine, University of Newcastle, Newcastle, UK; Department of Neuropediatrics and Muscle Disorders, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany; Centro Nacional de Análisis Genómico, Center for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Catalonia, Spain
| | - Michael Catt
- National Innovation Centre for Ageing, University of Newcastle, Newcastle, UK; Catt-Sci, Wellingborough, UK
| | - Catharina G Faber
- Department of Neurology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Adrian Hapca
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Peter T Donnan
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Gráinne Gorman
- Institute of Neuroscience, University of Newcastle, Newcastle, UK
| | - Guillaume Bassez
- Neuromuscular Reference Centre, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Hans Knoop
- Academic Medical Center, University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
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16
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Figueiredo PHS, Lima MMO, Costa HS, Martins JB, Flecha OD, Gonçalves PF, Alves FL, Rodrigues VGB, Maciel EHB, Mendonça VA, Lacerda ACR, Vieira ÉLM, Teixeira AL, de Paula F, Balthazar CH. Effects of the inspiratory muscle training and aerobic training on respiratory and functional parameters, inflammatory biomarkers, redox status and quality of life in hemodialysis patients: A randomized clinical trial. PLoS One 2018; 13:e0200727. [PMID: 30048473 PMCID: PMC6061993 DOI: 10.1371/journal.pone.0200727] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/23/2018] [Indexed: 01/19/2023] Open
Abstract
Objective Evaluate and compare the isolated and combined effects of Inspiratory Muscle Training (IMT) and Aerobic Training (AT) on respiratory and functional parameters, inflamatory biomarkers, redox status and health-related quality of life (HRQoL) in hemodialysis patients. Methods A randomised controlled trial with factorial allocation and intention-to-treat analysis was performed in hemodialysis patients. Volunteers were randomly assigned to performe 8-weeks of IMT at 50% of maximal inspiratory pressure (MIP), low intensity AT or combined training (CT). Before the interventions, all the volunteers went 8-weeks through a control period (without training). Measures are taken at baseline, 8-week (after control period) and 16-week (after the interventions). Primary outcomes were functional capacity (incremental shuttle walk test), MIP and lower limbs strength (Sit-to-Stand test of 30 seconds). Plasma levels of interleukin-6 (IL-6), soluble tumor necrosis factor receptor 1 (sTNFR1) and 2 (sTNFR2), adiponectin, resistin and leptin, redox status parameters and HRQoL (KDQOL-SF questionnaire) were the scondary outcomes. Data analyses were performed by two-way repeated measurements ANOVA. Results 37 hemodialysis patients aged 48.2 years old (IC95% 43.2–54.7) were randomized. Increase of MIP, functional capacity, lower limbs strength and resistin levels, and reduction of sTNFR2 levels in 16-week, compared to baseline and 8-week, were observed in all the groups (p<0.001). IMT improved functional capacity, MIP and lower limbs strength in 96.7m (IC95% 5.6–189.9), 34.5cmH2O (IC95% 22.4–46.7) and 2.2repetitions (IC95% 1.1–3.2) respectively. Increase in resistin leves and reduction in sTNFR2 leves after IMT was 0.8ng/dL (IC95% 0.5–1.1) and 0.8ng/dL (IC95% 0.3–1.3), respectively, without between-group differences. Compared to baseline and 8-week, adiponectin levels (p<0.001) and fatigue domain of the HRQoL (p<0.05) increased in 16-week only in CT. Conclusion IMT, AT and CT improved functional parameters and modulated inflammatory biomarkers, in addition, IMT provoked a similar response to low intensity AT in hemodialysis patients. Trial registration Registro Brasileiro de Ensaios clínicos RBR-4hv9rs.
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Affiliation(s)
- Pedro Henrique Scheidt Figueiredo
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- * E-mail:
| | - Márcia Maria Oliveira Lima
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Henrique Silveira Costa
- Medical School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Jeanne Brenda Martins
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Olga Dumont Flecha
- Dentistry School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Patrícia Furtado Gonçalves
- Dentistry School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Frederico Lopes Alves
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
- Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Vanessa Gomes Brandão Rodrigues
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
- Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Emílio Henrique Barroso Maciel
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
- Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Vanessa Amaral Mendonça
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | | | - Antônio Lúcio Teixeira
- Medical School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Fabrício de Paula
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina Hospital, Diamantina, Minas Gerais, Brazil
| | - Cláudio Heitor Balthazar
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas-PMPGCF, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Physical Therapy School, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
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17
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Malmberg Gavelin H, Eskilsson T, Boraxbekk CJ, Josefsson M, Stigsdotter Neely A, Slunga Järvholm L. Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO - a randomized clinical trial. Stress 2018; 21:279-291. [PMID: 29693483 DOI: 10.1080/10253890.2018.1461833] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity, and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.
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Affiliation(s)
| | - Therese Eskilsson
- b Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden
| | - Carl-Johan Boraxbekk
- c Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
- d Centre for Demographic and Aging Research (CEDAR) , Umeå University , Umeå , Sweden
| | - Maria Josefsson
- d Centre for Demographic and Aging Research (CEDAR) , Umeå University , Umeå , Sweden
| | - Anna Stigsdotter Neely
- a Department of Psychology , Umeå University , Umeå , Sweden
- e Department of Social and Psychological Studies , Karlstad University , Karlstad , Sweden
| | - Lisbeth Slunga Järvholm
- f Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine , Umeå University , Umeå , Sweden
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Kapila AK, Hamdi M, Patel A. Clinicians Should Actively Promote Exercise in Survivors of Breast Cancer. Clin Breast Cancer 2018; 18:e747-e749. [PMID: 30417830 DOI: 10.1016/j.clbc.2018.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/01/2018] [Accepted: 06/11/2018] [Indexed: 12/18/2022]
Abstract
Breast cancer is the most common cancer affecting women, causing 29% of all female cancers and afflicting 14% of all female cancer-related deaths worldwide. It remains a significant clinical, psychological, and financial burden. Exercise has been suggested to reduce cancer recurrence and cancer-related mortality from research in the past decade. Recent American and European guidelines advise on exercise for breast cancer survivors, not only to improve quality of life and decrease fatigue, but also to aid in decreasing recurrence and improve breast cancer related mortality. Nonetheless, adherence to guidelines remains low, with lack of awareness and fatigue related to chemotherapy as the most common barriers. It remains to be elucidated whether a particular type of exercise, or whether group or individualized activity is most effective. The importance of exercise in avoiding recurrence and improving quality of life needs to be recognized and taken into account in the management of breast cancer survivors. Further patient awareness and education is essential towards this goal, and the role of group exercise should be further explored.
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Affiliation(s)
- Ayush K Kapila
- The Breast Unit, Princess Alexandra Hospital, Harlow, United Kingdom; Department of Plastic Surgery, University Hospitals Brussels, University of Brussels, Brussels, Belgium.
| | - Moustapha Hamdi
- Department of Plastic Surgery, University Hospitals Brussels, University of Brussels, Brussels, Belgium
| | - Ashraf Patel
- The Breast Unit, Princess Alexandra Hospital, Harlow, United Kingdom
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Hammer NM, Midtgaard J, Hetland ML, Krogh NS, Esbensen BA. Physical activity behaviour in men with inflammatory joint disease: a cross-sectional register-based study. Rheumatology (Oxford) 2018; 57:803-812. [PMID: 29390089 DOI: 10.1093/rheumatology/kex498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Indexed: 12/15/2022] Open
Abstract
Objectives Physical activity is recommended as an essential part of the non-pharmacological management of inflammatory joint disease, but previous research in this area has predominantly included women. The aim of this study was to examine physical activity behaviour in men with inflammatory joint disease. Methods The study was conducted as a cross-sectional register-based study. Data on physical activity behaviour in men with RA, PsA and AS were matched with sociodemographic and clinical variables extracted from the DANBIO registry. Logistic regression analyses using multiple imputations were performed to investigate demographic and clinical variables associated with regular engagement in physical activity (moderate-vigorous ⩾2 h/week). Descriptive statistics were applied to explore motivation, barriers and preferences for physical activity. Results A total of 325 men were included of whom 129 (40%) engaged in regular physical activity. In univariate analyses, higher age, visual analogue scale (VAS) for pain, VAS fatigue, VAS patient's global, CRP level, disease activity, functional disability and current smoking were negatively associated with regular engagement in physical activity. In the final multivariable regression model only a high VAS fatigue score (⩾61 mm) (OR = 0.228; CI: 0.119, 0.436) remained significantly independently associated with regular physical activity. Conclusion A majority of men with inflammatory joint disease do not meet the recommendations of regular physical activity. Both sociodemographic and clinical parameters were associated with engagement in physical activity, and fatigue especially seems to play a pivotal role in explaining suboptimal physical activity behaviour in this patient group.
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Affiliation(s)
- Nanna Maria Hammer
- The DANBIO Registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Julie Midtgaard
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Social Medicine, Copenhagen, Denmark
| | - Merete Lund Hetland
- The DANBIO Registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Bente Appel Esbensen
- The DANBIO Registry and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Hara KW, Bjørngaard JH, Brage S, Borchgrevink PC, Halsteinli V, Stiles TC, Johnsen R, Woodhouse A. Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation. J Occup Rehabil 2018; 28:265-278. [PMID: 28597308 PMCID: PMC5978834 DOI: 10.1007/s10926-017-9711-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Purpose Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3½ weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work ≥1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were mental disorders (38%) and musculoskeletal disorders (30%). One year after discharge the intervention group had 87% increased odds (OR 1.87, 95% confidence interval 1.06-3.31, p = 0.031), of (re)entry to competitive work ≥1 day per week compared with the controls, with similar positive results for sensitivity analysis of participation half time (≥2.5 days per week). The cost of boosted follow-up was 390.5 EUR per participant. Conclusion Participants receiving boosted RTW follow-up had higher (re)entry to competitive work ≥1 day per week at 1 year when compared to the control group. Adding low-cost boosted follow-up by telephone after completing an occupational rehabilitation program augmented the effect on return-to-work.
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Affiliation(s)
- Karen Walseth Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway.
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- The Norwegian Labour and Welfare Service of Sør-Trøndelag, Trondheim, Norway.
| | - Johan Håkon Bjørngaard
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Forensic Department and Research Centre Brøset, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Søren Brage
- The Norwegian Directorate for Labour and Welfare, Oslo, Norway
| | - Petter Christian Borchgrevink
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Hysnes Rehabilitation Center, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Vidar Halsteinli
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Centre for Health Care Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tore Charles Stiles
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
| | - Astrid Woodhouse
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Abstract
BACKGROUND The differential effects of bilateral and unilateral training on upper extremity (UE) function remain unclear. OBJECTIVE To compare the effectiveness of bilateral and unilateral training on UE function and activities of daily living (ADL) after stroke. METHODS Randomized controlled trials (RCTs) were selected for inclusion by two reviewers after searching the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and KoreaMed. Methodological qualities were assessed using the PEDro scale. Effect size was estimated by calculating the standardized mean difference (SMD). RESULTS Eleven RCTs of sufficient quality were included in our meta-analysis. The effect size on UE capacity was statistically significant in favor of the Constraint-Induced Movement Therapy (CIMT) groups (SMD [fixed], g: - 0.34; 95% CI: - 0.59-0.08; p = 0.01; I2 = 0%). No other SMDs were significant. CONCLUSION The CIMT tasks were more effective than bilateral training with regard to increased UE capacity; however, this result should be cautiously interpreted since the evaluation tools were designed for assessment of unilateral UE function, not bilateral UE function. Further, the effect of the CIMT tasks on UE capacity was not translated into ADL. Considering the disadvantages of CIMT such as fatigue, bilateral training may be more appropriate for improving ADL.
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Abstract
BACKGROUND The prognosis and survival rate of women with breast cancer have significantly improved worldwide. Effective home-based multidimensional programmes for breast cancer survivors have gained an ever greater emphasis in survivorship care to maximise women's quality of life for their successful transition to rehabilitation and normal life. It is important to summarise the best available evidence to evaluate the effects of home-based multidimensional survivorship programmes on quality of life in women within 10 years of the completion of surgery or adjuvant cancer therapy for breast cancer, or both. OBJECTIVES To assess the effects of home-based, multidimensional survivorship (HBMS) programmes on maintaining or improving the quality of life in breast cancer survivors. SEARCH METHODS In April 2016 we searched the Cochrane Breast Cancer Specialised Register, CENTRAL, PubMed, Embase, CINAHL Plus, PsycINFO, Web of Science, and the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov. We also screened reference lists of all identified studies and contacted study authors. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs assessing the effects of HBMS programmes in maintaining or improving quality of life in women with stages 0 to 3 breast cancer who completed primary cancer treatment (surgery or adjuvant cancer therapy, or both) up to 10 years earlier. We considered studies where the interventions included more than one of the following listed components: educational (such as information provision and self-management advice), physical (such as exercise training and resistance training) and psychological (such as counselling and cognitive therapies), to constitute a multidimensional programme. Interventions had to be allowed to be carried out at home. DATA COLLECTION AND ANALYSIS Two authors independently assessed eligible studies for inclusion, and performed quality assessment and extracted relevant data of the included studies. Quality of life was the primary outcome of the review. MAIN RESULTS We included 22 RCTs and four quasi-RCTs on 2272 participants. We categorised the intervention components into four groups: educational and psychological; educational and physical; physical and psychological; and educational, physical and psychological. Most of the studies used usual care (routine medical follow-up services) as the comparator. A few studies used a lower level or different type of intervention (e.g. stress management or exercise) or attention control as the comparator.We used the Functional Assessment of Cancer Therapy-Breast (FACT B), European Organisation for Research and Treatment of Cancer Quality of Life C30 (EORTC C30), Quality of Life (QoL) Breast Cancer, and SF36 questionnaires to assess quality of life. HBMS programmes may increase breast cancer-specific quality of life and global quality of life immediately after the intervention, as measured by FACT-B and EORTC C30 (FACT-B: mean difference (MD) 4.55, 95% confidence interval (CI) 2.33 to 6.78, 7 studies, 764 participants; EORTC: MD 4.38, 95% CI 0.11 to 8.64, 6 studies; 299 participants; moderate-quality evidence). There was no evidence of a difference in quality of life as measured by QoL-Breast Cancer or SF-36 (QoL-Breast Cancer: MD 0.42, 95% CI -0.02 to 0.85, 2 studies, 111 participants, very low-quality evidence; physical composite score SF36: MD 0.55, 95% CI -3.52 to 4.63, 2 studies, 308 participants, low-quality evidence).We observed a similar pattern at one to three months after the intervention: FACT-B (MD 6.10, 95% CI 2.48 to 9.72, 2 studies, 426 participants), EORTC-C30 (MD 6.32, 95% CI 0.61 to 12.04, 2 studies; 172 participants) and QoL-Breast Cancer (MD 0.45, 95% CI -0.19 to 1.09, 1 study, 61 participants). At four to six months and 12 months, there was no evidence of a difference in quality of life between groups (four to six months: EORTC - MD 0.08, 95% CI -7.28 to 7.44, 2 studies; 117 participants; SF-36 - MD -1.05, 95% CI -5.60 to 3.51, 2 studies, 308 participants; 12 months: EORTC - MD 2.04, 95% CI -9.91 to 13.99, 1 study; 57 participants).Functional status was incorporated into the quality of life subscale findings. HBMS programmes may decrease anxiety (MD of Hospital Anxiety and Depression Scale (HADS) -1.01, 95% CI -1.94 to -0.08, 5 studies, 253 participants, low-quality evidence) compared to control immediately after the intervention but the effect did not persist at four to six months. There was no evidence of improvements in depression immediately after HBMS (MD of HADS -1.36, 95% CI -2.94 to 0.22, 4 studies, 213 participants, low-quality evidence) or at follow-up. HBMS programmes may also decrease fatigue (MD -1.11, 95% CI -1.78 to -0.45, 3 studies, 127 participants; low-quality evidence) and insomnia (MD -1.81, 95% CI -3.34 to -0.27, 3 studies, 185 participants, low-quality evidence).None of the included studies reported service needs and utilisation and cost of care, and therefore the effect of HBMS programmes on healthcare utilisation and cost is unknown. Due to the variations in assessment methods of adherence among the eight studies, we could not combine the results for meta-analysis. We synthesised the results narratively, with the reported adherence rates of 58% to 100%. AUTHORS' CONCLUSIONS The results of this systematic review and meta-analysis revealed that HBMS programmes in breast cancer survivors appear to have a short-term beneficial effect of improving breast cancer-specific quality of life and global quality of life as measured by FACT-B and EORTC-C30, respectively. In addition, HBMS programmes are associated with a reduction in anxiety, fatigue and insomnia immediately after the intervention. We assessed the quality of evidence across studies as moderate for some outcomes, meaning that we are fairly confident about the results, while we assessed other outcomes as being low-quality, meaning that we are uncertain about the result.
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Affiliation(s)
- Karis Kin Fong Cheng
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
| | - Yee Ting Ethel Lim
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
| | - Zhi Min Koh
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
| | - Wilson Wai San Tam
- National University of Singapore, National University Health SystemAlice Lee Centre for Nursing StudiesSingaporeSingapore
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Leensen MCJ, Groeneveld IF, van der Heide I, Rejda T, van Veldhoven PLJ, van Berkel S, Snoek A, van Harten W, Frings-Dresen MHW, de Boer AGEM. Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands. BMJ Open 2017; 7:e014746. [PMID: 28619770 PMCID: PMC5623345 DOI: 10.1136/bmjopen-2016-014746] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes. DESIGN Longitudinal prospective intervention study using a one-group design. SETTING Two hospitals in the Netherlands. PARTICIPANTS Of the eligible patients, 56% participated; 93 patients with a primary diagnosis of cancer receiving chemotherapy and on sick leave were included. Patients completed questionnaires on RTW, the importance of work, work ability (WAI), RTW self-efficacy, fatigue (MFI), and quality of life (EORTC QLQ C-30) at baseline and 6, 12 and 18 months follow-up. Before and after the exercise programme 1-repetition maximum (1RM) muscle strength and cardiorespiratory fitness (VO2 peak) were assessed. RESULTS Six months after the start of a multidisciplinary rehabilitation programme that combined occupational counselling with a supervised physical exercise programme, 59% of the cancer patients returned to work, 86% at 12 months and 83% at 18 months. In addition, significant improvements (p<0.05) in the importance of work, work ability, RTW self-efficacy, and quality of life were observed, whereas fatigue levels were significantly reduced. After completing the exercise programme, 1RM muscle strength was significantly increased but there was no improvement in VO2 peak level. CONCLUSIONS RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme. A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW, reduced fatigue and increased importance of work, work ability, and quality of life.
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Affiliation(s)
- Monique C J Leensen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | | | - Iris van der Heide
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Tomas Rejda
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - Sietske van Berkel
- Department of Sports Medicine, Isala Medical Center, Zwolle, The Netherlands
| | - Aernout Snoek
- Department of Sports Medicine, Isala Medical Center, Zwolle, The Netherlands
| | - Wim van Harten
- University Twente, Enschede, The Netherlands
- Rijnstate Hospital, Arnhem, The Netherlands
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Vugts MAP, Joosen MCW, Mert A, Zedlitz A, Vrijhoef HJM. Serious gaming during multidisciplinary rehabilitation for patients with complex chronic pain or fatigue complaints: study protocol for a controlled trial and process evaluation. BMJ Open 2017; 7:e016394. [PMID: 28600377 PMCID: PMC5726107 DOI: 10.1136/bmjopen-2017-016394] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Many individuals suffer from chronic pain or functional somatic syndromes and face boundaries for diminishing functional limitations by means of biopsychosocial interventions. Serious gaming could complement multidisciplinary interventions through enjoyment and independent accessibility. A study protocol is presented for studying whether, how, for which patients and under what circumstances, serious gaming improves patient health outcomes during regular multidisciplinary rehabilitation. METHODS AND ANALYSIS A mixed-methods design is described that prioritises a two-armed naturalistic quasi-experiment. An experimental group is composed of patients who follow serious gaming during an outpatient multidisciplinary programme at two sites of a Dutch rehabilitation centre. Control group patients follow the same programme without serious gaming in two similar sites. Multivariate mixed-modelling analysis is planned for assessing how much variance in 250 patient records of routinely monitored pain intensity, pain coping and cognition, fatigue and psychopathology outcomes is attributable to serious gaming. Embedded qualitative methods include unobtrusive collection and analyses of stakeholder focus group interviews, participant feedback and semistructured patient interviews. Process analyses are carried out by a systematic approach of mixing qualitative and quantitative methods at various stages of the research. ETHICS AND DISSEMINATION The Ethics Committee of the Tilburg School of Social and Behavioural Sciences approved the research after reviewing the protocol for the protection of patients' interests in conformity to the letter and rationale of the applicable laws and research practice (EC 2016.25t). Findings will be presented in research articles and international scientific conferences. TRIAL REGISTRATION NUMBER A prospective research protocol for the naturalistic quasi-experimental outcome evaluation was entered in the Dutch trial register (registration number: NTR6020; Pre-results).
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Affiliation(s)
- Miel A P Vugts
- Department of Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
- Ciran Rehabilitation Centres, Venlo, The Netherlands
| | - Margot C W Joosen
- Department of Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Agali Mert
- Ciran Rehabilitation Centres, Venlo, The Netherlands
| | - Aglaia Zedlitz
- Department of Health Medical and Neuropsychology, Leiden University, Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Hubertus J M Vrijhoef
- Department of Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Patient and Care, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Family Medicine, Vrije Universiteit Brussels, Brussels, Belgium
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25
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Abstract
BACKGROUND A huge clinical research database on adjuvant cancer treatment has verified improvements in breast cancer outcomes such as recurrence and mortality rates. On the other hand, adjuvant and neoadjuvant therapy with chemotherapy and radiotherapy impacts on quality of life due to substantial short- and long-term side effects. A number of studies have evaluated the effect of exercise interventions on those side effects. This is an updated version of the original Cochrane review published in 2006. The original review identified some benefits of physical activity on physical fitness and the resulting capacity for performing activities of daily life. It also identified a lack of evidence for other outcomes, providing clear justification for an updated review. OBJECTIVES To assess the effect of aerobic or resistance exercise interventions during adjuvant treatment for breast cancer on treatment-related side effects such as physical deterioration, fatigue, diminished quality of life, depression, and cognitive dysfunction. SEARCH METHODS We carried out an updated search in the Cochrane Breast Cancer Group Specialised Register (30 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2015), MEDLINE (1966 to 30 March 2015), and EMBASE (1966 to 30 March 2015). We did not update the original searches in CINAHL (1982 to 2004), SPORTDiscus (1975 to 2004), PsycINFO (1872 to 2003), SIGLE (1880 to 2004), and ProQuest Digital Dissertations (1861 to 2004). We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov for ongoing trials on 30 March 2015. We screened references in relevant reviews and published clinical trials. SELECTION CRITERIA We included randomised controlled trials that examined aerobic or resistance exercise or both in women undergoing adjuvant treatment for breast cancer. Published and unpublished trials were eligible. DATA COLLECTION AND ANALYSIS Two review authors independently performed data extraction, assessed trials, and graded the methodological quality using Cochrane's 'Risk of bias' tool. Any disagreements were resolved through discussion or by consulting the third review author. We entered data into Review Manager for analysis. For outcomes assessed with a variety of instruments, we used the standardised mean difference (SMD) as a summary statistic for meta-analysis; for those assessed with the same instrument, we used the mean difference (MD). MAIN RESULTS For this 2015 update we included a total of 32 studies with 2626 randomised women, 8 studies from the original search and 24 studies from the updated search. We found evidence that physical exercise during adjuvant treatment for breast cancer probably improves physical fitness (SMD 0.42, 95% confidence interval (CI) 0.25 to 0.59; 15 studies; 1310 women; moderate-quality evidence) and slightly reduces fatigue (SMD -0.28, 95% CI -0.41 to -0.16; 19 studies; 1698 women; moderate-quality evidence). Exercise may lead to little or no improvement in health-related quality of life (MD 1.10, 95% CI -5.28 to 7.48; 1 study; 68 women; low-quality evidence), a slight improvement in cancer site-specific quality of life (MD 4.24, 95% CI -1.81 to 10.29; 4 studies; 262 women; low-quality evidence), and an improvement in cognitive function (MD -11.55, 95% CI -22.06 to -1.05; 2 studies; 213 women; low-quality evidence). Exercise probably leads to little or no difference in cancer-specific quality of life (SMD 0.12, 95% CI 0.00 to 0.25; 12 studies; 1012 women; moderate-quality evidence) and little or no difference in depression (SMD -0.15, 95% CI -0.30 to 0.01; 5 studies; 674 women; moderate-quality evidence). Evidence for other outcomes ranged from low to moderate quality. Seven trials reported a very small number of adverse events. AUTHORS' CONCLUSIONS Exercise during adjuvant treatment for breast cancer can be regarded as a supportive self care intervention that probably results in less fatigue, improved physical fitness, and little or no difference in cancer-specific quality of life and depression. Exercise may also slightly improve cancer site-specific quality of life and cognitive function, while it may result in little or no difference in health-related quality of life. This review is based on trials with a considerable degree of clinical heterogeneity regarding adjuvant cancer treatments and exercise interventions. Due to the difficulty of blinding exercise trials, all included trials were at high risk for performance bias. Furthermore, the majority of trials were at high risk for detection bias, largely due to most outcomes being self reported.The findings of the updated review have enabled us to make a more precise conclusion that both aerobic and resistance exercise can be regarded as beneficial for individuals with adjuvant therapy-related side effects. Further research is required to determine the optimal type, intensity, and timing of an exercise intervention. Furthermore, long-term evaluation is required due to possible long-term side effects of adjuvant treatment.
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Affiliation(s)
- Anna C Furmaniak
- Technische Universität MünchenDepartment of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der IsarMunichGermany
- University of BonnDepartment of Psychosomatic Medicine and PsychotherapyBonnGermany
| | - Matthias Menig
- Health and Accident Insurance DirectorateFederal Office of Public Health FOPHBernSwitzerland
| | - Martina H Markes
- Institute for Quality and Efficiency in Health Care (IQWiG)Department Non‐Drug InterventionsIm Mediapark 8KölnGermany50670
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Nedeljkovic U, Raspopovic ED, Ilic N, Vujadinovic ST, Soldatovic I, Drulovic J. Effectiveness of rehabilitation in multiple sclerosis relapse on fatigue, self-efficacy and physical activity. Acta Neurol Belg 2016; 116:309-15. [PMID: 26563405 DOI: 10.1007/s13760-015-0563-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
Relapse of disease is one of the most prominent characteristics of multiple sclerosis. Effectiveness of rehabilitation programmes on fatigue, self-efficacy (SE) and physical activity (PA) has not been investigated so far in context of relapse. The aim of our study was to examine if rehabilitation programme in addition to high-dose methylprednisolone (HDMP) during relapse of disease can influence fatigue, SE and PA more than corticosteroid therapy alone. Patients were randomized in control group receiving only HDMP and experimental group which was in addition included in rehabilitation programme. Outcome measures used were Fatigue Severity Scale (FSS), Multiple Sclerosis Self- Efficacy scale (MSSES), Godin Leisure-Time Exercise Questionnaire (GLTEQ), completed on baseline, 1 and 3 months later. There was no significant change in FSS in both time points, despite different trend seen between groups. The mean MSSES for function and control improved significantly in treatment group after 1 month (807.1 ± 96.8, p = 0.005; 665.3 ± 145.1, p = 0.05) and 3 months (820 ± 83.5, p = 0.004; 720.0 ± 198.2, p = 0.016.) compared to baseline values. The mean GLTEQ score was significantly higher in the treatment group compared to the control at both follow-up time points (45.7 ± 7.6, p < 0.001; 34.3 ± 22.4, p < 0.01). Rehabilitation started along with corticosteroid treatment induced significant improvement in PA compared to HDMP therapy alone. It also influenced noticeable changes in self-efficacy, but effect on fatigue was insufficient.
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Affiliation(s)
- Una Nedeljkovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia.
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia.
| | - Emilija Dubljanin Raspopovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Nela Ilic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Sanja Tomanovic Vujadinovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Ivan Soldatovic
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Jelena Drulovic
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
- Neurology Clinic, Clinical Centre of Serbia, Doktora Subotica 6, 11000, Belgrade, Serbia
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Hojan K, Kwiatkowska-Borowczyk E, Leporowska E, Górecki M, Ozga-Majchrzak O, Milecki T, Milecki P. Physical exercise for functional capacity, blood immune function, fatigue, and quality of life in high-risk prostate cancer patients during radiotherapy: a prospective, randomized clinical study. Eur J Phys Rehabil Med 2016; 52:489-501. [PMID: 26761561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND During radiotherapy (RT), prostate cancer (PCa) patients may report cancer related fatigue (CRF), which impairs functional capacity, psychological status, and quality of life (QoL). RT can induce cytokine responses that could play a role in mediating radiation toxicity by increasing inflammation. While it is known that physical exercise plays an important anti-inflammatory role in healthy adults, its specific anti-inflammatory effects in PCa patients with CRF have not yet been determined. AIM Previous studies have shown that physical exercise in cancer patients undergoing RT improves cardiac fitness, muscle strength, and QoL, however it is still unknown how physical exercise affects inflammation and its specific consequences in PCa patients. Therefore, the purpose of this trial was to examine the effect of supervised physical exercise on inflammatory blood markers, as well as the relationship of these parameters with functional capacity, fatigue, and QoL in high-risk PCa patients undergoing RT. DESIGN This was a prospective, two-arm randomized controlled clinical trial. SETTING The study was performed in our outpatients center. POPULATION Fifty-four high-risk PCa men were randomly allocated to two groups prior to undergoing RT. METHODS Twenty-seven patients performed supervised, moderate-intensity physical exercise (exercise group; EG) and the other 27 formed a control group that carried out normal daily physical activity (usual group; UG). The following parameters were assessed before and after RT: functional capacity, changes in blood count variables and production of pro-inflammatory cytokines (interleukin [IL]-1β, IL-6, tumor necrosis factor [TNF]-α), fatigue, and QoL (using FACT-F score and EORTC questionnaires). RESULTS No significant differences existed between the study groups at baseline assessment. After RT, there was a significant improvement in functional capacity (P<0.05) and a decrease in pro-inflammatory cytokine levels (P>0.05) and fatigue (P<0.05) in the EG compared to the UG. Fatigue level was significantly higher in the UG (F[2.126]; P<0.05) after RT than before. Physical exercise had no effect on the correlation between inflammatory blood markers and functional capacity and fatigue scores provided by study participants. CONCLUSIONS Regular, moderate-intensity physical exercise improves functional capacity, decreases the production of inflammatory markers and fatigue, and has a positive influence on QoL in high-risk PCa patients during RT. CLINICAL REHABILITATION IMPACT This is one of the first studies to examine the effects of supervised exercise training on pro-inflammatory cytokine levels during RT in PCa patients by measuring functional capacity, fatigue, and QoL.
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Affiliation(s)
- Katarzyna Hojan
- Department of Rehabilitation, Greater Poland Cancer Centre, Poznan, Poland -
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Chen YW, Coxson HO, Reid WD. Reliability and Validity of the Brief Fatigue Inventory and Dyspnea Inventory in People With Chronic Obstructive Pulmonary Disease. J Pain Symptom Manage 2016; 52:298-304. [PMID: 27233134 DOI: 10.1016/j.jpainsymman.2016.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 02/02/2016] [Accepted: 02/26/2016] [Indexed: 11/28/2022]
Abstract
CONTEXT Dyspnea, fatigue, and pain are common in individuals with chronic obstructive pulmonary disease (COPD). However, questionnaires with a similar format are not available to assess their relative severity and interference. OBJECTIVES To determine the reliability and validity of the Brief Fatigue Inventory (BFI) and Dyspnea Inventory (DI) in COPD patients who attend pulmonary rehabilitation programs. METHODS Participants were recruited from four pulmonary rehabilitation programs to complete a survey package containing: the Chronic Respiratory Questionnaire (CRQ), BFI, and DI; and one week later, to complete the BFI and DI. Retrospective data of the CRQ, BFI, and DI were retrieved from one of the programs. RESULTS For the prospective component, there was an 85% response rate (n = 91) for the first package and 83.5% response rate (n = 76) for the second package. Retrospectively, CRQ, BFI, and DI data were retrieved from 48 charts. The BFI and DI demonstrated excellent internal consistency (Cronbach alpha = 0.96 both), and high test-retest reliability (intraclass correlation3,1 = 0.86 and 0.91, respectively). By comparison to the fatigue and dyspnea domains of the CRQ, the BFI showed high concurrent validity (ρ = -0.83), whereas the DI showed moderate (ρ = -0.57) to high (ρ = -0.78) concurrent validity. Factor analysis provided evidence that the items in the BFI and DI measured the intended constructs. CONCLUSION The BFI and DI are valid and reliable measures to evaluate fatigue and dyspnea in COPD patients and could be used concurrently with the Brief Pain Inventory to inform the relative severity and interference of these common symptoms in COPD.
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Affiliation(s)
- Yi-Wen Chen
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Harvey O Coxson
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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Mathiowetz VG, Finlayson ML, Matuska KM, Chen HY, Luo P. Randomized controlled trial of an energy conservation course for persons with multiple sclerosis. Mult Scler 2016; 11:592-601. [PMID: 16193899 DOI: 10.1191/1352458505ms1198oa] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the short-term efficacy and effectiveness of a six-week energy conservation course on fatigue impact, quality of life and self-efficacy for persons with multiple sclerosis (MS). Methods: In this randomized controlled trial, we randomly assigned 169 persons with MS to an immediate intervention group or a delayed control group using a crossover design. The outcome measures: Fatigue Impact Scale, SF-36 Health Survey and Self-Efficacy for Performing Energy Conservation Strategies were measured before and after courses and no intervention control periods. We performed intent-to-treat analysis and compliers-only analyses using mixed effects analysis of variance models. Results: Taking the energy conservation course had significant effects on reducing the physical and social subscales of Fatigue Impact Scale and on increasing the Vitality subscale of the SF-36 scores compared with not taking the course. Additional subscales were significant depending on methods of analyses. Self-Efficacy for Performing Energy Conservation Strategies Assessment increased significantly (p<0.05) postcourse compared to precourse. Conclusions: Results support the efficacy and effectiveness of the energy conservation course to decrease fatigue impact, and to increase self-efficacy and some aspects of quality of life.
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Affiliation(s)
- Virgil G Mathiowetz
- Program in Occupational Therapy, University of Minnesota, MMC 388, 420 Delaware St. SE, Minneapolis, MN 55455, USA.
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Mostert S, Kesselring J. Effect of pulsed magnetic field therapy on the level of fatigue in patients with multiple sclerosis - a randomized controlled trial. Mult Scler 2016; 11:302-5. [PMID: 15957511 DOI: 10.1191/1352458505ms1156oa] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Twenty-five multiple sclerosis patients, taking part in a rehabilitation program, were randomly assigned to treatment with pulsed magnetic field therapy (PMFT) or to sham therapy in order to study the additional effect of PMFTas part of a multimodal neurological rehabilitation program on fatigue. Patients demographic and disease specific characteristics were recorded. Level of fatigue was measured by fatigue sverity scale (FSS) at entrance and discharge and with a visual analog scale (VAS) immediate before and after a single treatment session. The ‘Magnetic Cell Regeneration’ system by Santerra was used for PMFT. A single treatment lasted 16 minutes twice daily over 3-4 weeks and consisted of relaxed lying on a PMF mattress. Sham intervention was conducted in an identical manner with the PMF-device off. Patients and statistics were blinded. Level of fatigue measured by FSS was high at entrance in both treatment group (TG) and control group (CG) (5.6 versus 5.5). Over time of rehabilitation fatigue was reduced by 18% in TG and 7% in CG which was statistically not significant. There was a statistically significant immediate effect of the single treatment session witch 18% reduction of fatigue measured by VAS in TG versus 11% in CG. Because of a high ‘placebo effect’ of simple bed rest, a only small and short lasting additional effect of PMFT and high costs of a PMF-device, we cannot recommend PMFTas an additional feature of a multimodal neurological rehabilitation program in order to reduce fatigue level of MS-patients.
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Affiliation(s)
- Stefan Mostert
- Department of Neurology, Rehabilitation Centre, CH 7317 Valens, Switzerland
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Newman MA, Dawes H, van den Berg M, Wade DT, Burridge J, Izadi H. Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study. Mult Scler 2016; 13:113-9. [PMID: 17294619 DOI: 10.1177/1352458506071169] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Impaired mobility in multiple sclerosis (MS) is associated with high-energy costs and effort when walking, gait abnormalities, poor endurance and fatigue. This repeated measures trial with blinded assessments investigated the effect of treadmill walking at an aerobic training intensity in 16 adults with MS. The intervention consisted of 12 sessions of up to 30 minutes treadmill training (TT), at 55–85% of age-predicted maximum heart rate. The primary outcome measure was walking effort, measured by oxygen consumption (mL/kg per metre), during treadmill walking at comfortable walking speed (CWS). Associated changes in gait parameters using the ‘Gait-Rite’ mat, 10-m time and 2-minute distance, and Fatigue Severity Scale were examined. Following training, oxygen consumption decreased at rest (P = 0.008), CWS increased (P = 0.002), and 10-m times (P = 0.032) and walking endurance (P = 0.020) increased. At increased CWS, oxygen consumption decreased (P = 0.020), with a decreased time spent in stance in the weaker leg (P = 0.034), and a greater stride distance with the stronger leg (P = 0.044). Reported fatigue levels remained the same. Aerobic TT presents the opportunity to alter a motor skill and reduce the effort of walking, whilst addressing cardiovascular de-conditioning, thereby, potentially reducing effort and fatigue for some people with MS.
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Affiliation(s)
- M A Newman
- Physiotherapy Research Unit, NOC NHS Trust, Oxford OX3 7LD, UK
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Abstract
Physical therapists often treat older adults with marked deficits in physical function secondary to an acute hospitalization. These deficits are often collectively defined as hospital-associated deconditioning (HAD). However, there is a paucity of evidence that objectively demonstrates the efficacy of physical therapy for older adults with HAD. Older adults with HAD represent a highly variable and complex population and thus may be difficult to study and develop effective interventions for using our current rehabilitation strategies. This perspective article outlines an innovative framework to operationalize and treat older adults with HAD. This framework may help therapists apply emerging exercise strategies to this population and facilitate additional research to support the total value of physical therapy for older adults in postacute care settings-with value measured not only by improvements in physical performance but perhaps also by reduced rates of disability development, rehospitalization, and institutionalization.
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Affiliation(s)
- Jason R Falvey
- J.R. Falvey, PT, DPT, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Mail Stop C244, 13121 East 17th Ave, Room 3116, Aurora, CO 80045 (USA).
| | - Kathleen K Mangione
- K.K. Mangione, PT, PhD, FAPTA, Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania
| | - Jennifer E Stevens-Lapsley
- J.E. Stevens-Lapsley, PT, PhD, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado
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Liseenko AN, Artemenko ES, Demeev YA, Shchur MS. [Problematic medical and psychological issues concerning rehabilitation of crews during the after-sea-dutymen period]. Voen Med Zh 2015; 336:45-48. [PMID: 26827519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The analysis of the causes of lack of effective functioning of the medical and psychological rehabilitation of crew of the Navy in the Pacific Fleet is performed. Possible ways of solving existing problematic issues are suggested. For determination of fatigue and overwork it was suggested to undertake mandatory initial medical and psychological screening examination of crews immediately before the return to the naval base, using a simple and affordable methods of testing. Medical and psychological rehabilitation of soldiers after the long sea voyages proposed to take immediate military sanatorium of the Ministry of Defense of the Russian Federation (on the territorial principle).
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Abstract
CONCLUSION The frequency of headaches in patients complaining of chronic dizziness is closely related to the severity of the dizziness impairments and mood states, such as anxiety. It is, therefore, important to treat co-morbid headache in patients with chronic dizziness. The severity of the dizziness impairments and other mood states, including anxiety, did not differ between patients with migraine or non-migraine headaches. OBJECTIVES Patients with chronic dizziness often complain of headaches or general fatigue. This study investigated the influence of the frequency of headaches on dizziness impairments, anxiety, quality-of-life, and other mood states in patients with chronic dizziness. METHOD The subjects consisted of 100 consecutive patients with intractable dizziness. Several types of questionnaires were used in the investigations. RESULTS Of the 85 patients, 51 had either type of headache (tension headache, 38; migraine, 13). The total score on the Dizziness Handicap Inventory correlated linearly with general fatigue (R = 0.39, p < 0.001) and headache (R = 0.25, p < 0.05). The patients with any type of headache had a significantly more positive family history of headache (p < 0.05).
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Affiliation(s)
- Fumiyuki Goto
- a 1 Department of Otolaryngology, National Hospital Organization Tokyo Medical Center , Meguro, Tokyo, Japan
| | - Miki Arai
- a 1 Department of Otolaryngology, National Hospital Organization Tokyo Medical Center , Meguro, Tokyo, Japan
| | - Motohiro Arai
- b 2 Department of Otolaryngology, Yokohama City Minato Red Cross Hospital , Kanagawa, Japan
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Abstract
BACKGROUND Sarcoidosis patients suffer from fatigue and exercise limitation. The aim of this study was to establish whether a physical training program improves these and other outcomes important to sarcoidosis patients. METHODS From 11/2012 to 9/2014, 201 sarcoidosis patients were referred to the ild care expertise team, Ede, the Netherlands. In our center, all patients are routinely recommended to undergo testing at baseline to determine their physical functioning and encouraged to complete a 12-week, supervised physical training program. Ninety patients underwent baseline testing and returned for repeat testing at 3 months in the interim, 49 completed the training program (Group I) and 41 chose not to participate (Group II). Change over time (from baseline to 3 months) in fatigue, exercise capacity, and skeletal muscle strength were assessed between the two groups. RESULTS At baseline, there were no between-group differences for fatigue, DLCO%, FVC%, or exercise capacity [assessed by percent predicted six-minute walk distance (6MWD%) and Steep Ramp Test (SRT)]. The 6MWD for Group I improved between baseline and 3 months, while the 6MWD remained the same in Group II (F = 72.2, p < 0.001). Group I showed a significantly larger decrease of fatigue compared with Group II (F = 6.27, p = 0.014). Lung function tests did not change in either group. CONCLUSION A supervised physical training program improves exercise capacity and fatigue among sarcoidosis patients and should be included in their management regimen.
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Affiliation(s)
- Bert Strookappe
- Department of Physical Therapy, Hospital Gelderse Vallei (ZGV), Ede, The Netherlands
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands
| | - Jeff Swigris
- Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
| | - Jolanda De Vries
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands
- Department of Medical Psychology, St. Elisabeth Hospital Tilburg and Department of Medical and Clinical Psychology, CoRPS, Tilburg University, Tilburg, The Netherlands
| | - Marjon Elfferich
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands
| | - Ton Knevel
- Department of Physical Therapy, Hospital Gelderse Vallei (ZGV), Ede, The Netherlands
| | - Marjolein Drent
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands.
- Center of Interstitial Lung Diseases, St. Antonius Hospital, Nieuwegein, The Netherlands.
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.
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Abstract
Fatigue is one of the most common symptoms experienced by people with multiple sclerosis (MS) and has a significant effect on all aspects of daily living and on quality of life. It is important for healthcare professionals working with patients with MS to identify fatigue where present and to be able to offer clinically effective treatment options. This article explores assessment and measurement of fatigue, evidence-based pharmacological and non-pharmacological treatments for managing fatigue and the role of MS specialist nurses and therapists.
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Marcellis R, Van der Veeke M, Mesters I, Drent M, De Bie R, De Vries G, Lenssen A. Does physical training reduce fatigue in sarcoidosis? Sarcoidosis Vasc Diffuse Lung Dis 2015; 32:53-62. [PMID: 26237356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/05/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Sarcoidosis patients frequently experience fatigue, exercise intolerance and muscle weakness, resulting in reduced quality of life (QOL). Scientific studies on the benefits of physical training in sarcoidosis have been scarce, so the aim of this pilot study was to examine the impact of a 13-week physical training program on fatigue, physical functions and QOL in fatigued sarcoidosis patients and/or patients with exercise intolerance. METHODS 18 sarcoidosis patients participated in a 13-week physical training program. The Fatigue Assessment Scale (FAS), World Health Organization Quality of Life-BREF assessment instrument (WHOQOL-BREF),Medical Research Council (MRC) dyspnea scale, Visual Analogue Scale (VAS), six-minute walk test (6MWT), submaximal bicycle test and muscle strength of the quadriceps and elbow flexors were assessed at baseline and after the program. RESULTS FAS scores had decreased (mean difference -2.7 points, 95% CI -4.4 to -1.1) after completion of the training program, along with improvements in WHOQOLBREF psychological health domain (mean difference 0.9 points, 95% CI 0.2 to 1.7) and MRC dyspnea score (mean difference -0.4 points, 95% CI -0.8 to -0.1). 6MWD improved by 34.6 m (95% CI 20.3 to 49.0) and mean heart rate on the bicycle test improved (mean difference 8.4 beats/minute, 95% CI -13.8 to -3.0), as did quadriceps strength (mean difference 10.7 kg, 95% CI 5.5 to 15.9). CONCLUSION Fatigue reduced after a period of physical training in sarcoidosis patients. Moreover, psychological health and physical functions improved. Future studies are warranted to assess the benefits of physical training in sarcoidosis.
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Affiliation(s)
- Rik Marcellis
- Department of Physical Therapy Maastricht University Medical Centre (MUMC) Maastricht The Netherlands.
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Kapsner-Smith MR, Hunter EJ, Kirkham K, Cox K, Titze IR. A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols. J Speech Lang Hear Res 2015; 58:535-49. [PMID: 25675335 PMCID: PMC4610291 DOI: 10.1044/2015_jslhr-s-13-0231] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 12/28/2014] [Indexed: 05/13/2023]
Abstract
PURPOSE Although there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal Function Exercises (VFE), an established set of exercises that utilize oral semi-occlusions. METHOD Twenty subjects (16 women, 4 men) with dysphonia and/or vocal fatigue were randomly assigned to 1 of 4 treatment conditions: (a) immediate FRT therapy, (b) immediate VFE therapy, (c) delayed FRT therapy, or (d) delayed VFE therapy. Subjects receiving delayed therapy served as a no-treatment control group. RESULTS Voice Handicap Index (Jacobson et al., 1997) scores showed significant improvement for both treatment groups relative to the no-treatment group. Comparison of the effect sizes suggests FRT therapy is noninferior to VFE in terms of reduction in Voice Handicap Index scores. Significant reductions in Roughness on the Consensus Auditory-Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were found for the FRT subjects, with no other significant voice quality findings. CONCLUSIONS VFE and FRT therapy may improve voice quality of life in some individuals with dysphonia. FRT therapy was noninferior to VFE in improving voice quality of life in this study.
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Affiliation(s)
- Mara R. Kapsner-Smith
- National Center for Voice and Speech, University of Utah, Salt Lake City
- University of Washington, Seattle
| | - Eric J. Hunter
- National Center for Voice and Speech, University of Utah, Salt Lake City
- Michigan State University, East Lansing
| | - Kimberly Kirkham
- National Center for Voice and Speech, University of Utah, Salt Lake City
| | - Karin Cox
- National Center for Voice and Speech, University of Utah, Salt Lake City
| | - Ingo R. Titze
- National Center for Voice and Speech, University of Utah, Salt Lake City
- University of Iowa, Iowa City
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Abstract
BACKGROUND In parallel with the rising incidence of cancer and improved treatment, there is a continuous increase in the number of patients living with cancer as a chronic condition. Many cancer patients experience long-term disability and require continuous oncological treatment, care and support. The aim of this review is to evaluate the most recent data on the effects of rehabilitation among patients with advanced cancer. MATERIAL AND METHODS A systematic review was conducted according to Fink's model. Only randomized controlled trials (RCTs) published in 2009-2014 were included. Medline/PubMed and Cochrane databases were searched; five groups of keywords were used. The articles were evaluated for outcome and methodological quality. RESULTS Thirteen RCTs (1169 participants) were evaluated. Most studies were on the effects of physical exercise in patients with advanced cancer (N = 7). Physical exercise was associated with a significant improvement in general wellbeing and quality of life. Rehabilitation had positive effects on fatigue, general condition, mood, and coping with cancer. CONCLUSIONS Rehabilitation is needed also among patients with advanced disease and in palliative care. Exercise improves physical performance and has positive effects on several other quality of life domains. More data and RCTs are needed, but current evidence gives an indication that rehabilitation is suitable and can be recommended for patients living with advanced cancer.
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Minton O, Jo F, Jane M. The role of behavioural modification and exercise in the management of cancer-related fatigue to reduce its impact during and after cancer treatment. Acta Oncol 2015; 54:581-6. [PMID: 25751756 DOI: 10.3109/0284186x.2014.996660] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Fatigue is a symptom that can occur during treatment as an acute side effect but can also result in persistent fatigue as a long-term side effect or late effect. MATERIALS AND METHODS We undertook a narrative review of the current literature and discuss the current evidence of assessment of fatigue and we specifically focus on the role of promoting behavioural change and focused rehabilitation to minimise these long-term effects and update the literature relating to this area from 2012 to date. RESULTS We suggest there are behavioural change models that can be scaled up to enable patients to manage long-term fatigue using exercise. However, from this updated review there are limitations to the current infrastructure and evidence base that will impact on the ability to do this. CONCLUSION We continually need to raise awareness amongst health professionals to continue to suggest modifications to impact on fatigue at all stages of cancer treatment and into survivorship and late effects. These can range from simple brief interventions suggested in the clinic to full scale rehabilitation programmes if the correct infrastructure is available. Whichever approach is adopted we suggest exercise will be the mainstay of the treatment of fatigue in this group.
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Affiliation(s)
- Ollie Minton
- Department of Palliative Medicine, St Georges Healthcare NHS Trust , London , UK
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Asano M, Preissner K, Duffy R, Meixell M, Finlayson M. Goals set after completing a teleconference-delivered program for managing multiple sclerosis fatigue. Am J Occup Ther 2015; 69:6903290010p1-8. [PMID: 25871602 PMCID: PMC4453039 DOI: 10.5014/ajot.2015.015370] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Setting goals can be a valuable skill to self-manage multiple sclerosis (MS) fatigue. A better understanding of the goals set by people with MS after completing a fatigue management program can assist health care professionals with tailoring interventions for clients. This study aimed to describe the focus of goals set by people with MS after a teleconference-delivered fatigue management program and to evaluate the extent to which participants were able to achieve their goals over time. In total, 485 goals were set by 81 participants. Over a follow-up period, 64 participants rated 284 goals regarding progress made toward goal achievement. Approximately 50% of the rated goals were considered achieved. The most common type of goal achieved was that of instrumental activities of daily living. Short-term goals were more likely to be achieved. This study highlights the need for and importance of promoting and teaching goal-setting skills to people with MS.
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Affiliation(s)
- Miho Asano
- Miho Asano, PhD, is Postdoctoral Research Fellow, School of Rehabilitation Therapy, Queen's University, Kingston, ON
| | - Katharine Preissner
- Katharine Preissner, EdD, OTR/L, is Clinical Associate Professor, Department of Occupational Therapy, University of Illinois at Chicago
| | - Rose Duffy
- Rose Duffy, MS, OTR/L, is Occupational Therapist, Swedish Covenant Hospital, Chicago, IL
| | - Maggie Meixell
- Maggie Meixell, MS, OTR/L, is Occupational Therapist, Evanston Hospital, Evanston, IL
| | - Marcia Finlayson
- Marcia Finlayson, PhD, OT Reg (Ont), OTR, is Professor and Director, School of Rehabilitation Therapy, Queen's University, Kingston, ON;
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Affiliation(s)
- Philip Sedgwick
- Institute for Medical and Biomedical Education, St George's, University of London, London, UK
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Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer 2015; 15:77. [PMID: 25885168 PMCID: PMC4364505 DOI: 10.1186/s12885-015-1069-4] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 02/03/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors. Approximately 40% to 80% of cancer patients undergoing active treatment suffer from CRF. Exercise improves overall quality of life and CRF; however, the specific effects of the training modalities are not well understood. METHODS This study aimed to determine the pooled effects of supervised exercise interventions on CRF in breast cancer survivors. We searched PubMed/MEDLINE, EMBASE, Scopus, CENTRAL and CINAHL databases between December 2013 and January 2014 without language restrictions. Risk of bias and methodological quality were evaluated using the PEDro score. Pooled effects were calculated with a random-effects model according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I (2) test. RESULTS Nine high-quality studies (n = 1156) were finally included. Supervised aerobic exercise was statistically more effective than conventional care in improving CRF among breast cancer survivors (SMD = -0.51, 95%CI -0.81 to -0.21), with high statistical heterogeneity (P = 0.001; I (2) = 75%). Similar effects were found for resistance training on CRF (SMD = -0.41, 95%CI -0.76 to -0.05; P = 0.02; I(2) = 64%). Meta-regression analysis revealed that exercise volume parameters are closely related with the effect estimates on CRF. Egger's test suggested moderate evidence of publication bias (P = 0.04). CONCLUSIONS Supervised exercise reduces CRF and must be implemented in breast cancer rehabilitation settings. High-volume exercises are safe and effective in improving CRF and overall quality of life in women with breast cancer. Further research is encouraged. TRIAL REGISTRATION CRD42014007223.
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Affiliation(s)
| | - Emilio González-Jiménez
- Departamento de Enfermería. Facultad de Ciencias de la Salud, Universidad de Granada, Granada, Spain.
| | - Robinson Ramírez-Vélez
- Grupo GICAEDS. Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, D.C, Colombia.
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Denlinger CS, Ligibel JA, Are M, Baker KS, Demark-Wahnefried W, Friedman DL, Goldman M, Jones L, King A, Ku GH, Kvale E, Langbaum TS, Leonardi-Warren K, McCabe MS, Melisko M, Montoya JG, Mooney K, Morgan MA, Moslehi JJ, O'Connor T, Overholser L, Paskett ED, Raza M, Syrjala KL, Urba SG, Wakabayashi MT, Zee P, McMillian N, Freedman-Cass D. Survivorship: fatigue, version 1.2014. J Natl Compr Canc Netw 2015; 12:876-87. [PMID: 24925198 DOI: 10.6004/jnccn.2014.0082] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many cancer survivors report that fatigue is a disruptive symptom even after treatment ends. Persistent cancer-related fatigue affects quality of life, because individuals become too tired to fully participate in the roles and activities that make life meaningful. Identification and management of fatigue remains an unmet need for many cancer survivors. This section of the NCCN Guidelines for Survivorship provides screening, evaluation, and management recommendations for fatigue in survivors. Management includes education and counseling, physical activity, psychosocial interventions, and pharmacologic treatments.
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Wedekind S. [Interval, strength, vibration. Which sports are especially suitable for patients with COPD?]. MMW Fortschr Med 2015; 157:20. [PMID: 25743286 DOI: 10.1007/s15006-015-2570-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
BACKGROUND Current cancer care increasingly incorporates psychosocial interventions. Cancer patients use dance/movement therapy to learn to accept and reconnect with their bodies, build new self-confidence, enhance self-expression, address feelings of isolation, depression, anger and fear and to strengthen personal resources. OBJECTIVES To update the previously published review that examined the effects of dance/movement therapy and standard care versus standard care alone or standard care and other interventions on psychological and physical outcomes in patients with cancer. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 6), MEDLINE (OvidSP, 1950 to June week 4, 2014), EMBASE (OvidSP, 1980 to 2014 week 26), CINAHL (EBSCOhost, 1982 to July 15 2014), PsycINFO (EBSCOhost, 1806 to July 15 2014), LILACS (Virual Health Library, 1982 to July 15 2014), Science Citation Index (ISI, 1974 to July 15 2014), CancerLit (1983 to 2003), International Bibliography of Theatre and Dance (1989 to July 15 2014), the National Research Register (2000 to September 2007), Proquest Digital Dissertations, ClinicalTrials.gov, and Current Controlled Trials (all to July 15 2014). We handsearched dance/movement therapy and related topics journals, reviewed reference lists and contacted experts. There was no language restriction. SELECTION CRITERIA We included all randomized and quasi-randomized controlled trials of dance/movement therapy interventions for improving psychological and physical outcomes in patients with cancer. We considered studies only if dance/movement therapy was provided by a formally trained dance/movement therapist or by trainees in a formal dance/movement therapy program. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data and assessed the methodological quality, seeking additional information from the trial researchers when necessary. Results were presented using standardized mean differences. MAIN RESULTS We identified one new trial for inclusion in this update. In total, the evidence for this review rests on three studies with a total of 207 participants.We found no evidence for an effect of dance/movement therapy on depression (standardized mean difference (SMD) = 0.02, 95% confidence interval (CI) -0.28 to 0.32, P = 0.89, I2 = 0%) (two studies, N = 170), stress (SMD = -0.18, 95% CI -0.48 to 0.12, P = 0.24, I2 = 0%) (two studies, N = 170), anxiety (SMD = 0.21, 95% CI -0.09 to 0.51 P = 0.18, I2 = 0%) (two studies, N = 170), fatigue (SMD = -0.36, 95% -1.26 to 0.55, P = 0.44, I² = 80%) (two studies, N = 170) and body image (SMD = -0.13, 95% CI -0.61 to 0.34, P = 0.58, I2 = 0%) (two studies, N = 68) in women with breast cancer. The data of one study with moderate risk of bias suggested that dance/movement therapy had a large beneficial effect on 37 participants' quality of life (QoL) (SMD = 0.89, 95% CI 0.21 to 1.57). One study with a high risk of bias reported greater improvements in vigor and greater reduction in somatization in the dance/movement therapy group compared to a standard care control group (N = 31). The individual studies did not find support for an effect of dance/movement therapy on mood, mental health, and pain. It is unclear whether this was due to ineffectiveness of the treatment, inappropriate outcome measures or limited power of the trials. Finally, the results of one study did not find evidence for an effect of dance/movement therapy on shoulder range of motion (ROM) or arm circumference in 37 women who underwent a lumpectomy or breast surgery. However, this was likely due to large within-group variability for shoulder ROM and a limited number of participants with lymphedema.Two studies presented moderate risk of bias and one study high risk of bias. Therefore, overall, the quality of the evidence is very low. AUTHORS' CONCLUSIONS We did not find support for an effect of dance/movement therapy on depression, stress, anxiety, fatigue and body image . The findings of individual studies suggest that dance/movement therapy may have a beneficial effect on QoL, somatization, and vigor. However, the limited number of studies prevents us from drawing conclusions concerning the effects of dance/movement therapy on psychological and physical outcomes in cancer patients.
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Affiliation(s)
- Joke Bradt
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
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Abstract
PURPOSE The purpose of this study was to describe household and community ambulatory activity profiles and their relationship to fatigue and cardiovascular fitness in a sample of men and women with chronic hemiparetic stroke. METHOD We quantified community-based ambulatory activity profiles in terms of step counts and intensity, along with cardiovascular fitness and fatigue severity, in a convenience sample of 79 men and women with chronic hemiparetic stroke. RESULTS As captured by daily step activity monitoring, participants demonstrated extremely low step counts (1389 +/- 797 steps/day), and almost no step activity at high intensity (78 +/- 168 steps/day at a rate of >or=30 steps/ minute). Mean high intensity activity constituted less than 3 minutes/day. The mean VO2 peak was 13.02 +/- 4.26 mL/kg/min, consistent with profound aerobic deconditioning. Total, low, and high intensity ambulatory activity were associated with VO2 peak. Mean fatigue severity was 3.28 +/- 1.36 on a scale of 7.00, with 42% of the sample reporting severe fatigue. There were no statistically significant correlations between fatigue severity and ambulatory activity or fitness measures. CONCLUSION Our results show that step activity intensity is strongly associated with cardiovascular fitness, lending credence to the hypothesis that rehabilitation interventions that build aerobic conditioning can influence daily activity. The challenge is to appreciate the features of ambulatory behavior after stroke and to use this information to integrate both exercise interventions and behavioral components into the successful translation of structured activities into home and community routines.
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Affiliation(s)
- Kathleen Michael
- University of Maryland, School of Nursing, Baltimore, Maryland, USA
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Sprod LK, Fernandez ID, Janelsins MC, Peppone LJ, Atkins JN, Giguere J, Block R, Mustian KM. Effects of yoga on cancer-related fatigue and global side-effect burden in older cancer survivors. J Geriatr Oncol 2014; 6:8-14. [PMID: 25449185 DOI: 10.1016/j.jgo.2014.09.184] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/26/2014] [Accepted: 09/22/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sixty percent of cancer survivors are 65years of age or older. Cancer and its treatments lead to cancer-related fatigue and many other side effects, in turn, creating substantial global side-effect burden (total burden from all side effects) which, ultimately, compromises functional independence and quality of life. Various modes of exercise, such as yoga, reduce cancer-related fatigue and global side-effect burden in younger cancer survivors, but no studies have specifically examined the effects of yoga on older cancer survivors. OBJECTIVES The purpose of this study was to assess the effects of a 4-week yoga intervention (Yoga for Cancer Survivors: YOCAS©®) on overall cancer-related fatigue, and due to its multidimensional nature, the subdomains of cancer-related fatigue (general, physical, emotional, and mental) and global side-effect burden in older cancer survivors. MATERIALS AND METHODS We conducted a secondary analysis on data from a multicenter phase III randomized controlled clinical trial with 2 arms (standard care and standard care plus a 4-week YOCAS©® intervention). The sample for this secondary analysis was 97 older cancer survivors (≥60years of age), between 2months and 2years post-treatment, who participated in the original trial. RESULTS Participants in the YOCAS©® intervention arm reported significantly lower cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden than participants in the standard care arm following the 4-week intervention period (p<0.05). CONCLUSIONS YOCAS©® is an effective standardized yoga intervention for reducing cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden among older cancer survivors.
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Affiliation(s)
- Lisa K Sprod
- School of Health and Applied Human Sciences, University of North Carolina at Wilmington, Wilmington, NC, USA.
| | - Isabel D Fernandez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle C Janelsins
- Department of Surgery, Cancer Control and Survivorship Program, University of Rochester Medical Center, Rochester, NY, USA
| | - Luke J Peppone
- Department of Surgery, Cancer Control and Survivorship Program, University of Rochester Medical Center, Rochester, NY, USA
| | - James N Atkins
- Southeast Cancer Control Consortium, Winston Salem, NC, USA
| | - Jeffrey Giguere
- Greenville Community Clinical Oncology Program, Greenville, SC, USA
| | - Robert Block
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Karen M Mustian
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Surgery, Cancer Control and Survivorship Program, University of Rochester Medical Center, Rochester, NY, USA
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Rietberg MB, van Wegen EEH, Eyssen ICJM, Kwakkel G. Effects of multidisciplinary rehabilitation on chronic fatigue in multiple sclerosis: a randomized controlled trial. PLoS One 2014; 9:e107710. [PMID: 25232955 PMCID: PMC4169408 DOI: 10.1371/journal.pone.0107710] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 08/11/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Several rehabilitation programmes aim at reducing the impact of fatigue in MS patients. Acute and chronic fatigue should require different management. OBJECTIVES To assess the effects of individually tailored, multidisciplinary outpatient rehabilitation (MDR) on chronic fatigue. METHODS Forty-eight ambulatory MS patients with chronic fatigue were randomized to MDR or to MS-nurse consultation. Fatigue was assessed by the Checklist Individual Strength (CIS-20R). Secondary outcomes included the Modified Fatigue Impact Scale, Fatigue Severity Scale, Functional Independence Measure, Disability and Impact Profile (DIP), Multiple Sclerosis Impact Scale and the Impact on Participation and Autonomy (IPA). RESULTS The primary outcome measure CIS-20R overall score showed no significant differences between groups at 12 weeks (P = 0.39) and 24 weeks follow-up (P = 0.14), nor for subscales (t = 12 and t = 24, 0.19≤P≤0.88). No significant within-group effects were found for both groups with respect to the primary (0.57≤p≤0.97) and secondary (0.11≤p≤0.92) outcome measures from baseline to 12 or 24 weeks. CONCLUSION Multidisciplinary rehabilitation was not more effective in terms of reducing self-reported fatigue in MS patients compared to MS-nurse consultation. Our results suggest that chronic fatigue in patients with MS may be highly invariant over time, irrespective of interventions. TRIAL REGISTRATION controlled-trials.com ISRCTN05017507.
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Affiliation(s)
- Marc B. Rietberg
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Erwin E. H. van Wegen
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Isaline C. J. M. Eyssen
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Gert Kwakkel
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Aleksandrov AA, Deĭnekina TS, Mattiasen SÉ, Lyskov EB. [The influence of movement's observation on recuperation after physical fatigue]. Zh Vyssh Nerv Deiat Im I P Pavlova 2014; 64:481-487. [PMID: 25710069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The study aim was to investigate effects of mental activity, accompanied by mu-rhythm depression, on recuperation after physical fatigue. In a study participants performed 11 one minute bouts of static hand grip intermitted by 2 minutes restpauses. During pauses participants watched video with either dynamic hand grips (biological movements) or deformation of geometric figure (control). Obtained data showed there was a significant depression of mu-rhythm during biological movement's observation. There was significant fatigue of subjects in an exercise with physical activity, but there was no reliable influence of performed mental activity on recovery after fatigue.
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