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López-Fernández MD, Fernández-Lao C, Ruíz-Martínez AM, Fernández-Gualda MÁ, Lozano-Lozano M, Ortiz-Comino L, Galiano-Castillo N. Exploring predictors of dysphagia in survivors of head and neck cancer: A cross-sectional study. Support Care Cancer 2024; 32:162. [PMID: 38366091 PMCID: PMC10873441 DOI: 10.1007/s00520-024-08358-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE To evaluate the prevalence of dysphagia in survivors of head and neck cancer (sHNC) and to identify the predictors contributing to the development of dysphagia. METHODS We enrolled 62 sHNC in a cross-sectional study to check the prevalence of dysphagia in sHNC and to evaluate which factors were influencing the presence of this side effect. Besides dysphagia, sociodemographic and clinical characteristics, oral symptoms, maximal mouth opening (MMO), sleep quality and physical condition were evaluated, and a linear regression analysis was performed to verify which of these outcomes impact dysphagia. RESULTS Among all the sHNC, 85.5% presented dysphagia. The linear regression analysis confirmed that 44.9% of the variance in dysphagia was determined by coughing, MMO and sleep quality, being MMO the most powerful predictor, followed by coughing and sleep quality. CONCLUSION Dysphagia affected the great majority of sHNC. Moreover, symptoms as coughing, reduced MMO and sleep disorders may act as predictors contributing to the development of dysphagia. Our results emphasize the importance of an early and proper identification of the symptoms as well as an adequate treatment strategy to address the cluster of symptoms that sHNC undergo.
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Affiliation(s)
- María Dolores López-Fernández
- UGC Medicina Física y Rehabilitación, Hospital de Neurotraumatología y Rehabilitación, Hospital Universitario Virgen de Las Nieves, Instituto de Investigación Biosanitaria Ibs, Granada, Spain
| | - Carolina Fernández-Lao
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Sport and Health Research Center (IMUDs), Instituto de Investigación Biosanitaria Ibs, Granada, Spain.
| | - Alba María Ruíz-Martínez
- Department of Radiation Oncology, Hospital Universitario Vírgen de Las Nieves, Instituto de Investigación Biosanitaria Ibs, Granada, Spain
| | - Miguel Ángel Fernández-Gualda
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Instituto de Investigación Biosanitaria Ibs, Granada, Spain
| | - Mario Lozano-Lozano
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Sport and Health Research Center (IMUDs), Instituto de Investigación Biosanitaria Ibs, Granada, Spain
| | - Lucía Ortiz-Comino
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty (Melilla), University of Granada, Sport and Health Research Center (IMUDs), Instituto de Investigación Biosanitaria Ibs, Granada, Spain
| | - Noelia Galiano-Castillo
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Sport and Health Research Center (IMUDs), Instituto de Investigación Biosanitaria Ibs, Granada, Spain
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Lopez-Garzon M, López-Fernández MD, Ruíz-Martínez AM, Galván-Banqueri P, Lozano-Lozano M, Tovar-Martín I, Postigo-Martin P, Ariza-Vega P, Artacho-Cordón F, Fernández-Lao C, Cantarero-Villanueva I, Fernández-Gualda MÁ, Arroyo-Morales M, Ruíz-Villaverde R, Galiano-Castillo N. Efficacy of photobiomodulation therapy combined with mobile health education in patients with head and neck cancer suffering from chronic xerostomia after radiotherapy: protocol for a three-arm, randomised, placebo-controlled, double-blinded study. BMJ Open 2024; 14:e078068. [PMID: 38267245 PMCID: PMC10824058 DOI: 10.1136/bmjopen-2023-078068] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION The role of photobiomodulation (PBM) therapy for oral tissue damage induced by cancer treatment is currently unclear, and there is low-quality to moderate-quality evidence supporting the use of this approach for treating xerostomia and/or hyposalivation. Consequently, patients with head and neck cancer increasingly turn to basic oral hygiene to alleviate salivary gland dysfunction, and their adherence can be improved by mobile health (mHealth) education. The primary objective of this study will be to analyse the effects of different doses of PBM therapy (7.5 J/cm2 vs 3 J/cm2) plus mHealth education on quality of life (QoL), oral health, salivary secretion and salivary gland ultrasound assessment at postintervention and at the 6-month follow-up in patients with head and neck cancer after radiotherapy compared with those in control group. METHODS AND ANALYSIS A prospective, three-arm, randomised, placebo-controlled, double-blinded study will be conducted among patients with head and neck cancer suffering from chronic xerostomia. A total of 20 patients per arm will be included and randomly assigned to receive 7.5 J/cm2 of PBM, 3 J/cm2 of PBM or placebo therapy. PBM therapy will be applied during 24 sessions at 22 points extra and intraorally two times per week for 3 months, combined with a mobile application (https://www.laxer.es). The assessments will be recorded at the beginning of the study, at postintervention and at the 6-month follow-up. The primary outcomes will be QoL, oral health, salivary secretion and salivary gland ultrasound. The pain pressure threshold, functional performance, mood and sleep quality will be secondary indicators. ETHICS AND DISSEMINATION This study received ethics approval from the Andalusian Biomedical Research Ethics Portal (2402-N-21 CEIM/CEI Provincial de Granada) according to the Declaration of Helsinki for Biomedical Research. The results of this study will be presented at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT05106608.
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Affiliation(s)
- Maria Lopez-Garzon
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - María Dolores López-Fernández
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
| | - Alba Maria Ruíz-Martínez
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pilar Galván-Banqueri
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Mario Lozano-Lozano
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Isabel Tovar-Martín
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Paula Postigo-Martin
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Physical Activity for HEaLth Promotion (PA-HELP), Department of Physical and Sport Education, Sports Sciences Faculty, University of Granada, Granada, Spain
| | - Francisco Artacho-Cordón
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiology and Physical Medicine, Medicine Faculty, University of Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Carolina Fernández-Lao
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Irene Cantarero-Villanueva
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Miguel Ángel Fernández-Gualda
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
| | - Manuel Arroyo-Morales
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Ricardo Ruíz-Villaverde
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Medical Surgical Dermatology and Venereology, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Noelia Galiano-Castillo
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
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Artacho-Cordón F, Salinas-Asensio MDM, Galiano-Castillo N, Ocón-Hernández O, Peinado FM, Mundo-López A, Lozano-Lozano M, Álvarez-Salvago F, Arroyo-Morales M, Fernández-Lao C, Cantarero-Villanueva I. Effect of a Multimodal Supervised Therapeutic Exercise Program on Quality of Life, Pain, and Lumbopelvic Impairments in Women With Endometriosis Unresponsive to Conventional Therapy: A Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:1785-1795. [PMID: 37467936 DOI: 10.1016/j.apmr.2023.06.020] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of "Physio-EndEA", a multimodal nine-week supervised exercise intervention, on quality of life, pain, and lumbopelvic impairments in women with endometriosis unresponsive to conventional therapy. DESIGN Parallel-group randomized controlled trial. Outcomes were measured at baseline, post-intervention, and at 1 year. SETTING Two Public University Hospitals. PARTICIPANTS This trial included 31 women with endometriosis (N=31) randomly allocated to "Physio-EndEA" group (n=16) or control group (n=15). Four participants dropped out of the study for causes unrelated to the intervention. INTERVENTIONS The "Physio-EndEA" program consisted of a 1-week lumbopelvic stabilization learning phase followed by an 8-week phase of stretching, aerobic, and resistance exercises focused on the lumbopelvic area. It was sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. Control group received the usual treatment stipulated by their gynecologist. MAIN OUTCOME MEASURES The primary outcome was quality of life. Secondary outcomes were pain intensity, pressure pain thresholds, pain-related catastrophic thoughts, abdominal and back strength, lumbopelvic stability, and muscle architecture. RESULTS Adherence rate was 90.6% and mean (±standard deviation) satisfaction was 9.44±0.73 out of 10. No remarkable health problems were reported during the trial. In comparison with controls, the quality of life was improved post-intervention and at 1 year in the Physio-EndEA group with large effect sizes (d>0.80). This group also evidenced: a reduced intensity of dyspareunia, catastrophic thoughts; an increase in pelvic, lumbar, and distal pressure pain thresholds; increases in abdominal and back strength and lumbopelvic stability; and increased thickness of transversus abdominis (right side) and width of lumbar multifidus (left side). CONCLUSION A 9-week program of multimodal supervised therapeutic exercise is a feasible and effective intervention to improve QoL in women with endometriosis. This program also offers benefits in terms of pain/sensitization and lumbopelvic impairments.
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Affiliation(s)
- Francisco Artacho-Cordón
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | | | - Noelia Galiano-Castillo
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Olga Ocón-Hernández
- Gynaecology and Obstetrics Unit, "San Cecilio" University Hospital, Granada, Spain
| | | | | | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Carolina Fernández-Lao
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Irene Cantarero-Villanueva
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
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Fernández-Gualda MÁ, Ariza-Vega P, Lozano-Lozano M, Cantarero-Villanueva I, Martín-Martín L, Castro-Martín E, Arroyo-Morales M, Tovar-Martín I, Lopez-Garzon M, Postigo-Martin P, González-Santos Á, Artacho-Cordón F, Ortiz-Comino L, Galiano-Castillo N, Fernández-Lao C. Persistent pain management in an oncology population through pain neuroscience education, a multimodal program: PaiNEd randomized clinical trial protocol. PLoS One 2023; 18:e0290096. [PMID: 37582097 PMCID: PMC10426993 DOI: 10.1371/journal.pone.0290096] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 06/27/2023] [Indexed: 08/17/2023] Open
Abstract
INTRODUCTION Pain is one of the most persistent symptoms after cancer treatment. The central nervous system can erroneously stay in its alarm phase, altering the pain experience of patients who have cancer. Pain neuroscience education (PNE) with multimodal approaches may benefit these patients. OBJECTIVE This protocol aims to determine the effectiveness of a PNE tool on pain, physical function and quality of life, as a supplement to a multimodal rehabilitation (MR) program in patients who had breast cancer (BC). METHODS An 8-week double-blinded randomized controlled trial will be conducted, including 72 participants who had BC and who have persistent pain, randomized into three groups: PNE program + MR program, traditional biomedical information + MR program and control group. The PNE program will include educational content that participants will learn through a mobile app and the MR program will include a concurrent exercise program and manual therapy. The primary outcome will be the perceived pain assessed using the Visual Analogue Scale and secondary outcomes are others related to pain, physical function and quality of life. All outcomes will be evaluated at baseline, at the end of the intervention and 6 months after the end of intervention. DISCUSSION The proposed study may help BC patients with persistent pain improve their pain experience, quality of life and provide for more adaptive pain-coping strategies. This protocol could propose an action guide to implement different integral approaches for the treatment of sequelae. This treatment option could be offered to this patient profile and it could be easily implemented in the healthcare systems due to its low costs. TRIAL REGISTRATION ClinicalTrials.gov, NCT04877860. (February18, 2022).
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Affiliation(s)
- Miguel Ángel Fernández-Gualda
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Patrocinio Ariza-Vega
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Department of Physical and Sport Education, PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Irene Cantarero-Villanueva
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Lydia Martín-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Eduardo Castro-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Manuel Arroyo-Morales
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Isabel Tovar-Martín
- Radiation Oncology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Maria Lopez-Garzon
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Paula Postigo-Martin
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Ángela González-Santos
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Francisco Artacho-Cordón
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain
| | - Lucía Ortiz-Comino
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Health Sciences Faculty (Melilla), University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
| | - Carolina Fernández-Lao
- Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
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Burgos-Mansilla B, Galiano-Castillo N, Lozano-Lozano M, Fernández-Lao C, Lopez-Garzon M, Arroyo-Morales M. Correction: Burgos-Mansilla et al. Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis. J. Clin. Med. 2021, 10, 4696. J Clin Med 2023; 12:jcm12030827. [PMID: 36769894 PMCID: PMC9917448 DOI: 10.3390/jcm12030827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
In the original publication [...].
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Affiliation(s)
- Barbara Burgos-Mansilla
- Kinesiology Program, Faculty of Health Sciences, Universidad Autónoma de Chile, Avenida Alemania, Temuco 4810101, Chile
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients (Bio277 Group), 18016 Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients (Bio277 Group), 18016 Granada, Spain
- Correspondence:
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients (Bio277 Group), 18016 Granada, Spain
| | - Maria Lopez-Garzon
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients (Bio277 Group), 18016 Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients (Bio277 Group), 18016 Granada, Spain
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Ortiz-Comino L, Martín-Martín L, Galiano-Castillo N, Castro-Martín E, Fernández-Gualda MÁ, Lozano-Lozano M, Fernández-Lao C. The effects of myofascial induction therapy in survivors of head and neck cancer: a randomized, controlled clinical trial. Support Care Cancer 2023; 31:49. [PMID: 36526871 PMCID: PMC9758021 DOI: 10.1007/s00520-022-07482-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE We aim to evaluate the effects of myofascial induction therapy (MIT) on the sequelae suffered by the survivors of HNC (sHNC). METHODS We enrolled 46 sHNC in a randomized controlled trial (RCT), of whom 20 received a MIT protocol and 23 were placed on a waitlist while receiving the recommended treatment for 6 weeks. The MIT protocol included a total of 18 sessions, 3 days a week on alternate days for 6 weeks. Maximal mouth opening, the presence of temporomandibular dysfunction, cervical endurance, active range of motion (AROM), shoulder AROM, handgrip strength, and perceived physical fitness were assessed. RESULTS Maximal mouth opening, temporomandibular dysfunction, cervical endurance, and AROM, affected shoulder abduction and unaffected shoulder flexion and external rotation significantly improved (p < .05) after an MIT protocol, but only cervical AROM and affected shoulder abduction changes were clinically meaningful. No statistically significant changes were observed in the other shoulder AROM, handgrip strength, or physical fitness perception (p > .05). CONCLUSION A 6-week MIT protocol improves mouth opening, TMD, cervical function (endurance and AROM), affected shoulder abduction and unaffected shoulder flexion, and external rotation AROM in the sHNC. However, no changes were observed in most of the shoulder AROM, muscular strength, or perceived physical fitness. Future studies should perform longer follow-up designs, increase the sample size, and include multimodal treatments to address these sequelae in the sHNC.
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Affiliation(s)
- Lucía Ortiz-Comino
- Department of Physical Therapy. Health Sciences Faculty, University of Granada, Melilla, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain ,Sport and Health Research Center (IMUDs), Granada, Spain ,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain ,Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain ,Sport and Health Research Center (IMUDs), Granada, Spain ,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain ,Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Eduardo Castro-Martín
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain ,Sport and Health Research Center (IMUDs), Granada, Spain ,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain ,Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Miguel Ángel Fernández-Gualda
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain ,Sport and Health Research Center (IMUDs), Granada, Spain ,Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain ,Sport and Health Research Center (IMUDs), Granada, Spain ,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain ,Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain ,Sport and Health Research Center (IMUDs), Granada, Spain ,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain ,Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
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Fernández-González M, Lozano-Lozano M, Martín-Martín L, Ortiz-Piña M, Martín-Matillas M, Ariza-Vega P. Is a telerehabilitation programme for older adults with hip fracture associated with burden of family caregivers who provide support? Digit Health 2023; 9:20552076231213574. [PMID: 38025098 PMCID: PMC10656811 DOI: 10.1177/20552076231213574] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Objective @ctivehip is a home-based multidisciplinary telerehabilitation programme for older adults with hip fracture, conducted with the assistance of their family caregivers. This programme was useful in improving their functional recovery. Nevertheless, we were concerned about how the programme might have affected caregivers, whose assistance was essential for supporting older adults in using new technologies and ensuring their safety during the exercises and activities at home. The aim of the present study was to compare the burden, psychological factors and physical fitness of the family caregivers of older adults who opted the @ctivehip telerehabilitation programme versus those family caregivers of older adults who received the face-to-face rehabilitation provided by the Andalusian Public Healthcare System (in Spain). Methods In this single-blinded, non-randomized clinical trial, participants were older adults with hip fracture and their family caregivers. The telerehabilitation group (n = 30) underwent a 12-week multidisciplinary telerehabilitation programme, and the comparative group (n = 32) received face-to-face rehabilitation. Caregivers outcomes measured were (i) the burden using the Zarit Burden Interview, (ii) the anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and (iii) the Physical Fitness with the International Fitness Scale (IFIS). Results There were not statistically significant differences on caregiver burden between family caregivers in the @ctivehip and the comparative group, although there was a trend towards lower values [[Mean (95%CI); 14.73 (9.09 to 20.37) vs 16.03 (10.63 to 21.43); p = 0.771] as well as for anxiety and depression [5.66 (3.21 to 8.78) vs 11.19 (8.52 to 13.86); p = 0.022]. Likewise achieved better, though not statistically significant, scores in physical fitness [19.37 (17.94 to 20.81) vs 17.15 (15.77 to 18.53); p = 0.055]. Conclusion Caregiver burden is not associated with telerehabilitation. In addition, telerehabilitation is associated with lower anxiety and depression levels among family caregivers who opt for this programme. Physical fitness is not related with telerehabilitation.
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Affiliation(s)
- María Fernández-González
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Mariana Ortiz-Piña
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Miguel Martín-Matillas
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sport Science, University of Granada, Granada, Spain
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8
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Lozano-Lozano M, Galiano-Castillo N, Gonzalez-Santos A, Ortiz-Comino L, Sampedro-Pilegaard M, Martín-Martín L, Arroyo-Morales M. Effect of mHealth plus occupational therapy on cognitive function, mood and physical function in people after cancer: Secondary analysis of a randomized controlled trial. Ann Phys Rehabil Med 2022; 66:101681. [PMID: 35671976 DOI: 10.1016/j.rehab.2022.101681] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 04/29/2022] [Accepted: 05/07/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Medical and surgical treatments for breast cancer have various adverse effects. Both mobile health and supervised intervention strategies have been implemented to overcome these effects, but some gaps remain to be addressed. Scientific evidence for the effectiveness of occupational therapy in cancer is limited. OBJECTIVE To compare the clinical effectiveness of the BENECA mHealth app used alone or combined with an integral supervised rehabilitation strategy that focused on cognitive performance, mood state, functional capacity, and cancer-related pain and fatigue in overweight women after breast cancer. METHODS In this secondary analysis of an assessor-blinded randomized controlled clinical trial, 80 overweight women after breast cancer (stage I-IIIA) were randomly allocated to an integral approach group (IA; n=40) or a control group (CG; n=40). All participants participated in an 8-week intervention. Assessments were performed at baseline, 8 weeks, and 6 months and included cognitive performance (Trial Making Test and Wechsler Adult Intelligence Scale), psychological state (Hospital Anxiety and Depression Scale), pain (Brief Pain Inventory), fatigue (Piper Fatigue Scale), and physical function (6 min walk test). An intention-to-treat analysis was conducted with analysis of covariance. RESULTS Selective attention (TMT) was significantly higher in the IA group, with a moderate to large effect size for TMT A (T2: d=1.1; T 3: d=1.2), working memory and processing speed (WAIS), anxiety and general HADS score (d=1.6), and functional capacity at 8 weeks and 6 months (d=1.5). Fatigue perception (mean difference, -0.6; 95% CI -1.4 to 0.04; p=0.009) and pain (intensity level p<0.001; interference level p=0.002) were also significantly more improved in the IA group. CONCLUSIONS An integral strategy involving the BENECA mHealth app with a supervised, multimodal intervention improved cognitive, psychological, and functional performance in women after breast cancer more than mHealth alone. Occupational therapy has a role to play in breast cancer rehabilitation.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; "Cuídate" Support Unit for Oncology Patients, Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; "Cuídate" Support Unit for Oncology Patients, Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Angela Gonzalez-Santos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; "Cuídate" Support Unit for Oncology Patients, Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Lucía Ortiz-Comino
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; "Cuídate" Support Unit for Oncology Patients, Granada, Spain
| | - Marc Sampedro-Pilegaard
- The Research Initiative of Activity Studies and Occupational Therapy, Department of Public Health, University of Southern Denmark, Denmark; REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative care, Odense University Hospital, Denmark
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; "Cuídate" Support Unit for Oncology Patients, Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; "Cuídate" Support Unit for Oncology Patients, Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
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9
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Lopez-Garzon M, Cantarero-Villanueva I, Postigo-Martin P, González-Santos Á, Lozano-Lozano M, Galiano-Castillo N. Can physical exercise prevent chemotherapy-induced peripheral neuropathy in patients with cancer? A systematic review and meta-analysis. Arch Phys Med Rehabil 2022; 103:2197-2208. [PMID: 35271844 DOI: 10.1016/j.apmr.2022.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/04/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This systematic review analyzed the effects of physical exercise programs in patients with cancer undergoing chemotherapy on Chemotherapy-induced Peripheral Neuropathy (CIPN) prevention. DATA SOURCES PubMed, Web of Science, Scopus, and Cochrane Library were searched for relevant studies published before December 2020. Additional references were identified by manual screening of the reference lists. STUDY SELECTION Based on the PICOS strategy, randomized controlled trials in which physical exercise was applied before or during chemotherapy to prevent or ameliorate CIPN were included. DATA EXTRACTION Two reviewers blinded and independent screened the articles, scored methodologic quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Sensitivity and precision analysis databases was included. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. DATA SYNTHESIS Of 229 potentially relevant studies, eight randomized controlled trials were included and scored. They comprise a total of 618 patients with cancer. Medline and Scopus databases recorded the highest sensitivity. None of the studies achieved a "low" overall risk of bias. Four studies were included in meta-analysis for quality of life, and a significance standardized mean difference was found between groups from baseline of 14.62, 95% CI 6.03, 23.20, with a large effect size g= .83, 95% CI .48, 1.18) in favor to physical exercise program compared with usual care. CONCLUSIONS Physical exercise at the onset of chemotherapy has shown promising effects on the prevention of CIPN, specially improving quality of life.
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Affiliation(s)
- Maria Lopez-Garzon
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain
| | - Irene Cantarero-Villanueva
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Paula Postigo-Martin
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain
| | - Ángela González-Santos
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain.
| | - Mario Lozano-Lozano
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
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10
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Lopez-Garzon M, Cantarero-Villanueva I, Legerén-Alvarez M, Gallart-Aragón T, Postigo-Martin P, González-Santos Á, Lozano-Lozano M, Martín-Martín L, Ortiz-Comino L, Castro-Martín E, Ariza-García A, Fernández-Lao C, Arroyo-Morales M, Galiano-Castillo N. Prevention of Chemotherapy-Induced Peripheral Neuropathy With PRESIONA, a Therapeutic Exercise and Blood Flow Restriction Program: A Randomized Controlled Study Protocol. Phys Ther 2022; 102:6497838. [PMID: 35079838 DOI: 10.1093/ptj/pzab282] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/27/2021] [Accepted: 10/25/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE This trial will analyze the acute and cumulative effects of a tailored program called PRESIONA that combines therapeutic exercise and blood flow restriction to prevent chemotherapy-induced peripheral neuropathy (CIPN) in individuals with early breast cancer undergoing neoadjuvant chemotherapy. METHODS PRESIONA will be a physical therapist-led multimodal exercise program that uses blood flow restriction during low-load aerobic and strength exercises. For the acute study, only 1 session will be performed 1 day before the first taxane cycle, in which 72 women will be assessed before intervention and 24 hours post intervention. For the cumulative study, PRESIONA will consist of 24 to 36 sessions for 12 weeks following an undulatory prescription. At least 80 women will be randomized to the experimental group or control group. Feasibility will be quantified based on the participant recruitment to acceptance ratio; dropout, retention, and adherence rates; participant satisfaction; tolerance; and program security. In the efficacy study, the main outcomes will be CIPN symptoms assessed with a participant-reported questionnaire (EORTC QLQ-CIPN20). In addition, to determine the impact on other participant-reported health and sensorimotor and physical outcomes, the proportion of completed scheduled chemotherapy sessions will be examined at baseline (t0), after anthracycline completion (t1), after intervention (t2), and at the 2-month (t3) and 1-year follow-ups (t4). CONCLUSION The proposed innovative approach of this study could have a far-reaching impact on therapeutic options, and the physical therapist role could be essential in the oncology unit to improve quality of life in individuals with cancer and reduce side effects of cancer and its treatments. IMPACT Physical therapists in the health care system could be essential to achieve the planned doses of chemotherapy to improve survival and decrease the side effects of individuals with breast cancer. The prevention of CIPN would have an impact on the quality of life in these individuals, and this protocol potentially could provide an action guide that could be implemented in any health care system.
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Affiliation(s)
- Maria Lopez-Garzon
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Marta Legerén-Alvarez
- FEA Oncología Médica, San Cecilio University Hospital, Andalusian Health Service, Granada, Spain
| | | | - Paula Postigo-Martin
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Ángela González-Santos
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Lydia Martín-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | | | - Eduardo Castro-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Angélica Ariza-García
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Carolina Fernández-Lao
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Manuel Arroyo-Morales
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Noelia Galiano-Castillo
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
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11
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del Mar Salinas-Asensio M, Ocón-Hernández O, Mundo-López A, Fernández-Lao C, Peinado FM, Padilla-Vinuesa C, Álvarez-Salvago F, Postigo-Martín P, Lozano-Lozano M, Lara-Ramos A, Arroyo-Morales M, Cantarero-Villanueva I, Artacho-Cordón F. 'Physio-EndEA' Study: A Randomized, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program to Improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis. Int J Environ Res Public Health 2022; 19:ijerph19031738. [PMID: 35162761 PMCID: PMC8834829 DOI: 10.3390/ijerph19031738] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/18/2022] [Accepted: 01/30/2022] [Indexed: 11/16/2022]
Abstract
Aim: The ‘Physio-EndEA’ study aims to explore the potential benefits of a therapeutic exercise program (focused on lumbopelvic stabilization and tolerance to exertion) on the health-related quality of life (HRQoL) of symptomatic endometriosis women. Design: The present study will use a parallel-group randomized controlled trial design. Methods: A total of 22 symptomatic endometriosis women will be randomized 1:1 to the Physio-EndEA or usual care groups. The ‘Physio-EndEA’ program will consist of a one-week lumbopelvic stabilization learning phase followed by an eight-week phase of stretching, aerobic and resistance exercises focused on the lumbopelvic area that will be sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. The primary outcome measure is HRQoL. The secondary outcome measures included clinician-reported outcomes (pressure pain thresholds, muscle thickness and strength, flexibility, body balance and cardiorespiratory fitness) and patient-reported outcomes (pain intensity, physical fitness, chronic fatigue, sexual function, gastrointestinal function and sleep quality). Discussion: Findings of this study will help to identify cost-effective non-pharmacological options (such as this exercise-based intervention) that may contribute to the improvement of HRQoL in symptomatic endometriosis women.
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Affiliation(s)
- María del Mar Salinas-Asensio
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
| | - Olga Ocón-Hernández
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Carolina Fernández-Lao
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco M. Peinado
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
| | - Carmen Padilla-Vinuesa
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Paula Postigo-Martín
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Ana Lara-Ramos
- Gynaecology and Obstetrics Unit, ‘Virgen de las Nieves’ University Hospital, E-18012 Granada, Spain;
| | - Manuel Arroyo-Morales
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco Artacho-Cordón
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), E-28029 Madrid, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
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Fernandez-Gonzalez M, Fernandez-Lao C, Martin-Martin L, Gonzalez-Santos A, Lopez-Garzon M, Ortiz-Comino L, Lozano-Lozano M. Therapeutic Benefits of Balneotherapy on Quality of Life of Patients with Rheumatoid Arthritis: A Systematic Review. Int J Environ Res Public Health 2021; 18:ijerph182413216. [PMID: 34948827 PMCID: PMC8701266 DOI: 10.3390/ijerph182413216] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 11/16/2022]
Abstract
Background: Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease. RA symptoms make the disease disabling and strongly impact the quality of life of patients. Among the available forms of treatment, balneotherapy seems to be one of the most common forms of nonpharmacological treatment for rheumatic disease. The aim was to explore the effectiveness of balneotherapy for improving the quality of life of patients with RA. Methods: Pubmed, Scopus, Web of Science and The Cochrane library were searched for randomized or clinical controlled trials published in English or Spanish until May 2021. Risk of bias of included articles were assessed using the Cochrane tool. A total 535 records were retrieved, and seven met the inclusion criteria. All the included studies showed statistically significant improvements in the quality of life of patients who received balneotherapy treatment despite differences in treatment administration. Sessions should be approximately 20 min long and use natural mineral waters enriched with elements, or mud, at a water temperature between 35–38 °C. Conclusions: Balneotherapy benefits the quality of life of people with RA. The obtained results show positive effects for both mineral bathing and immersion in sand or mud on the quality of life of people who suffer from RA.
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Affiliation(s)
- Maria Fernandez-Gonzalez
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain; (M.F.-G.); (A.G.-S.); (M.L.-G.); (L.O.-C.); (M.L.-L.)
| | - Carolina Fernandez-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain; (M.F.-G.); (A.G.-S.); (M.L.-G.); (L.O.-C.); (M.L.-L.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), 18010 Granada, Spain
- Correspondence: (C.F.-L.); (L.M.-M.)
| | - Lydia Martin-Martin
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain; (M.F.-G.); (A.G.-S.); (M.L.-G.); (L.O.-C.); (M.L.-L.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), 18010 Granada, Spain
- Correspondence: (C.F.-L.); (L.M.-M.)
| | - Angela Gonzalez-Santos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain; (M.F.-G.); (A.G.-S.); (M.L.-G.); (L.O.-C.); (M.L.-L.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), 18010 Granada, Spain
| | - Maria Lopez-Garzon
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain; (M.F.-G.); (A.G.-S.); (M.L.-G.); (L.O.-C.); (M.L.-L.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), 18010 Granada, Spain
| | - Lucia Ortiz-Comino
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain; (M.F.-G.); (A.G.-S.); (M.L.-G.); (L.O.-C.); (M.L.-L.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), 18010 Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain; (M.F.-G.); (A.G.-S.); (M.L.-G.); (L.O.-C.); (M.L.-L.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18016 Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), 18010 Granada, Spain
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Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Lozano-Lozano M, Rodenas-Herranz T, Ruiz-Villaverde R. Sexual Dysfunction and Atopic Dermatitis: A Systematic Review. Life (Basel) 2021; 11:life11121314. [PMID: 34947845 PMCID: PMC8708093 DOI: 10.3390/life11121314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease of the skin whose main symptom is pruritus and may affect all age ranges. Regarding the prevalence, it has been estimated at around 10% of the world population. Many concomitant diseases have been associated with AD, but the causal relationship between AD and psychological impairment has not been clearly established. Scientific literature studying the probable association between male or female sexual dysfunction and dermatological pathology is limited, even more so in AD. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the Cochrane Collaboration methodology for systematic reviews. All relevant articles in English were identified through a search from inception to 10 December 2020, including the following databases: Medline (via PubMed), Scopus, Web of Science Core Collection, and SciELO. The results of the search were compiled using the COVIDENCE software for systematic reviews. The methodological quality of the included studies was done using the “Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies” and the “Quality Assessment of Case-Control Studies” developed by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH). Our search yielded potentially relevant studies. Five studies that evaluated the prevalence of sexual dysfunction in atopic dermatitis were retrieved after applying the selection criteria. The present systematic review achieved data from 8088 patients with atopic dermatitis from four articles. Sample sizes for atopic dermatitis patients ranged from 266 to 3997. We identified one cohort study with four years of follow-up, three studies with a cross-sectional design, and one case-control study. Three studies reported data disaggregated by the severity of atopic dermatitis. Two studies included healthy controls with a total sample size of 1,747,755 subjects. Two studies compared data with other dermatological conditions such as psoriasis. In conclusion, we can establish that unlike other psychological comorbidities such as anxiety and depression, sexual dysfunction is a field scarcely explored in the literature. This sexual dysfunction focuses on the male sex in large population studies and in clinical diagnoses without exploring it through specific and validated questionnaires in this regard. Further studies focused on both genders are needed. It is important to correlate this sexual dysfunction with the severity of the disease, previous treatments, and cardiovascular comorbidities.
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Affiliation(s)
- Laura Linares-Gonzalez
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Correspondence:
| | - Ignacio Lozano-Lozano
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
| | - Luis Gutierrez-Rojas
- Department of Psychiatry, University of Granada, 18011 Granada, Spain;
- Psychiatry Service, Hospital Clínico San Cecilio, 18016 Granada, Spain
- CTS-549 Research Group, Institute of Neuroscience, University of Granada, 18016 Granada, Spain
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18011 Granada, Spain
- Sport and Health Joint University Institute (iMUDS), University of Granada, 18011 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18011 Granada, Spain
| | - Teresa Rodenas-Herranz
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
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14
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Lozano-Lozano M, Mundo-López A, San-Sebastian AP, Galiano-Castillo N, Fernandez-Lao C, Cantarero-Villanueva I, Arroyo-Morales M, Ocón-Hernández O, Artacho-Cordón F. Limitations in Activities of Daily Living Among Spanish Women Diagnosed With Endometriosis. Am J Occup Ther 2021; 75:23096. [PMID: 34842913 DOI: 10.5014/ajot.2021.044974] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Understanding the impact of endometriosis symptoms on patients' activities of daily living (ADLs) is a priority to establish effective and personalized intervention programs. OBJECTIVE To explore limitations in ADLs and instrumental ADLs (IADLs) and their association with pelvic pain (PP), chronic fatigue, and pain-catastrophizing thoughts among women with endometriosis. DESIGN Cross-sectional study. SETTING Spain. PARTICIPANTS Two hundred thirty women with endometriosis. Outcomes and Measures: Information regarding performance of ADLs (Barthel Index) and IADLs (Lawton-Brody questionnaire), PP intensity (Numeric Rating Scale), chronic fatigue (Piper Fatigue Scale), and pain-catastrophizing thoughts (Pain Catastrophizing Scale) was gathered. Multivariate regression analyses were created, and mediating effects of fatigue and pain-catastrophizing thoughts on the association between PP and ADL and IADL limitations were assessed. RESULTS The prevalence of limitations in at least one ADL and one IADL was 22.6% (95% confidence interval [CI] [17.2, 28.1]) and 39.1% (95% CI [32.8, 45.5]), respectively. Limitations in bowel continence, housework, shopping, and meal preparation were reported most frequently. Women reporting severe PP showed higher risk for ADL (odds ratio [OR] = 3.33, 95% CI [1.10, 10.10]) and IADL (OR = 7.99, 95% CI [2.86, 22.34]) limitations. Chronic fatigue and pain-catastrophizing thoughts were also positively related to ADL-IADL limitations, showing a mediating effect on the association between PP and ADL-IADL limitations. CONCLUSIONS AND RELEVANCE This study reveals the widespread presence of difficulties in ADL-IADL performance among women with endometriosis, with some symptoms underlying these difficulties in occupational performance. This study points to the need for cost-effective occupational therapy interventions for affected women. What This Article Adds: This research shows that the occupational performance of women with endometriosis is frequently impaired; therefore, the effectiveness of occupational therapy interventions should be addressed in the near future.
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Affiliation(s)
- Mario Lozano-Lozano
- Mario Lozano-Lozano, PhD, is Postdoctoral Researcher, Instituto de Investigación Biosanitaria ibs. Granada; Occupational Therapist Researcher, "Cuídate" Support Unit for Oncology Patients, Sport and Health University Research Institute; and Associate Professor, Department of Physiotherapy, University of Granada, Granada, Spain;
| | - Antonio Mundo-López
- Antonio Mundo-López, PhD, is Postdoctoral Researcher, Instituto de Investigación Biosanitaria ibs. Granada, University of Granada, Granada, Spain, and Psychologist, Clinic Psychology Center Alarcón, Granada, Spain
| | - Ainhoa P San-Sebastian
- Ainhoa P. San-Sebastian, BsC, is Occupational Therapist, Department of Radiology and Physical Medicine, University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Noelia Galiano-Castillo, PhD, is Professor, Instituto de Investigación Biosanitaria ibs. Granada; Physiotherapist Researcher, "Cuídate" Support Unit for Oncology Patients, Sport and Health University Research Institute; and Professor, Department of Physiotherapy, University of Granada, Granada, Spain
| | - Carolina Fernandez-Lao
- Carolina Fernández-Lao, PhD, is Researcher, Instituto de Investigación Biosanitaria ibs. Granada; Physiotherapist Researcher, "Cuídate" Support Unit for Oncology Patients, Sport and Health University Research Institute; and Professor, Department of Physiotherapy, University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Irene Cantarero-Villanueva, PhD, is Researcher, Instituto de Investigación Biosanitaria ibs. Granada; Physiotherapist Researcher, "Cuídate" Support Unit for Oncology Patients, Sport and Health University Research Institute; and Professor, Department of Physiotherapy, University of Granada, Granada, Spain
| | - Manuel Arroyo-Morales
- Manuel Arroyo-Morales, PhD, MD, is Researcher, Instituto de Investigación Biosanitaria ibs. Granada; Physiotherapist Researcher, "Cuídate" Support Unit for Oncology Patients, Sport and Health University Research Institute; and Professor, Department of Physiotherapy, University of Granada, Granada, Spain
| | - Olga Ocón-Hernández
- Olga Ocón-Hernández, PhD, MD, is Researcher, Instituto de Investigación Biosanitaria ibs. Granada, University of Granada, Granada, Spain, and Doctor, Gynaecology and Obstetrics Unit, San Cecilio University Hospital, Granada, Spain
| | - Francisco Artacho-Cordón
- Francisco Artacho-Cordón, PhD, is Researcher, Instituto de Investigación Biosanitaria ibs. Granada; Physiotherapist Researcher, "Cuídate" Support Unit for Oncology Patients, Sport and Health University Research Institute; and Professor, Department of Radiology and Physical Medicine, University of Granada, Granada, Spain, and Centro de Investigacion Biomédica en Red, Epidemiology and Public Health, Madrid, Spain
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15
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Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Ruiz-Villaverde R, Lozano-Lozano M. Sexual dysfunction in a cohort of patients with moderate-to-severe atopic dermatitis. Influence of dupilumab treatment. Int J Dermatol 2021; 61:607-610. [PMID: 34633064 DOI: 10.1111/ijd.15938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/05/2021] [Accepted: 09/20/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Atopic dermatitis is a systemic and immune-mediated dermatological disease that comprises a wide group of physiological and psychological comorbidities. Within the latter, the evaluation of anxiety and depression has been the subject of numerous studies, but sexual dysfunction (SD) is a fact that is rarely addressed in the literature. The objective of the present study is to assess the prevalence of SD in a cohort of patients with moderate-to-severe atopic dermatitis (AD) and to establish the possible impact of dupilumab therapy on it. MATERIAL AND METHODS A cross-sectional study was performed. Recruited patients had been diagnosed with moderate-to-severe AD at the Dermatology Unit of the Hospital Universitario San Cecilio, Granada, Spain, from July 1, 2019, through June 30, 2020. They were followed up for a 6-month period during which the impact of dupilumab treatment was measured. The main variable under study, sexual dysfunction, was evaluated differently according to gender. Regarding the male patients, the International Index Erectile Function (IIEF-5) was applied, whereas for female patients, the questionnaire "Female Sexual Function Index" was used. RESULTS Our study included 31 patients, 18 men and 13 women. Men's mean age was 35 +/- 14.55 years, while that of women was 33 +/- 10.46 years. Seventy-nine percent of patients in our series (n = 22) had SD compared to 29% (n = 9) who did not. A total of 66.9% of males and 76.9% (n = 10) of females sampled, suffered from SD. Six months after initiation of treatment, none of the patient had stopped it due to efficacy or safety issues. All severity indices (SCORAD, EASI, VAS pruritus, and DLQI) had significantly improved by more than 50% from baseline. The improvement in the sexual dysfunction index had improved by four points, both in the male and female patients. DISCUSSION Many large population studies on SD in patients with moderate-to-severe atopic AD only focus on male gender and clinical diagnoses, rather than specific and validated questionnaires. Dupilumab treatment in patients with moderate-to-severe AD has shown a positive impact on the levels of SD in both male and female populations. Further studies focused on populations with mild atopic AD and with larger sample sizes are required to corroborate these preliminary results.
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Affiliation(s)
- Laura Linares-Gonzalez
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Ignacio Lozano-Lozano
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Luis Gutierrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain.,CTS-549 Research Group, Institute of Neuroscience, Granada, Spain
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,Department of Physical Therapy, Faculty of Health Sciences, and University of Granada, Sport and Health Joint University Institute (iMUDS), Granada, Spain.,''Cuídate'' Support Unit for Oncological Patients (UAPO-Cuídate), Granada, Spain
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16
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Navarro-Triviño FJ, Lozano-Lozano M, Ruiz-Villaverde R. Calcipotriol/Betamethasone Dipropionate Aerosol Foam for Plaque Psoriasis: A Prospective, Observational, Non-Interventional, Single-Center Study of Patient Adherence and Satisfaction in Daily Use. Dermatol Pract Concept 2021; 11:e2021056. [PMID: 34123560 DOI: 10.5826/dpc.1103a56] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 10/31/2022] Open
Abstract
Background Psoriasis is a chronic inflammatory disease that has a negative impact on patients' quality of life. Patients with mild-moderate psoriasis can be treated with topical medications, such as the combination drug calcipotriol/betamethasone dipropionate (Cal/BD). Objectives This study investigated the adherence of psoriasis patients to therapy with Cal/BD aerosol foam, as well as their satisfaction with the treatment's efficacy, safety, and effect on their quality of life. Methods Patients with mild-moderate plaque psoriasis were eligible to participate in this open-label, non-placebo controlled, prospective single-center study. Adherence to treatment was assessed using the Morisky-Green scale 4 and 12 weeks after the start of treatment. Satisfaction with the treatment was assessed using the abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9). The severity of psoriasis was assessed on the mIGA and PGA scales, and the impact on quality of life was assessed using the PDI and DLQI scales. Results A total of 65 patients entered the study. Adherence to treatment was good, with 73.8% of patients showing high adherence at 12 weeks. Satisfaction was also good, with 46 patients (70.8%) being completely satisfied. Conclusions Over a 4-week period, patients treated with Cal/BD aerosol foam had significant improvement in disease severity that was directly related to treatment adherence.
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Affiliation(s)
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, and University of Granada & Sport and Health Joint University Institute (iMUDS), Granada, Spain
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17
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González-Santos Á, Postigo-Martin P, Gallart-Aragón T, Esteban-Cornejo I, Lopez-Garzon M, Galiano-Castillo N, Arroyo-Morales M, Illescas-Montes R, Artacho-Cordón F, Martín-Martín L, Forneiro-Pérez R, Lozano-Lozano M, Fernández-Lao C, Ruiz-Vozmediano J, Sánchez-Salgado C, Cantarero-Villanueva I. Neurotoxicity prevention with a multimodal program (ATENTO) prior to cancer treatment versus throughout cancer treatment in women newly diagnosed for breast cancer: Protocol for a randomized clinical trial. Res Nurs Health 2021; 44:598-607. [PMID: 33963594 DOI: 10.1002/nur.22136] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 01/22/2023]
Abstract
A current challenge in breast cancer (BC) patients is how to reduce the side effects of cancer and cancer treatments and prevent a decrease in quality of life (QoL). Neurotoxic side effects, especially from chemotherapy, are present in up to 75% of women with BC, which implies a large impact on QoL. There is a special interest in the preventive possibilities of therapeutic exercise (TE) for these neurological sequelae, and the benefits of TE could be improved when it is combined with vagal activation techniques (VATs). This superiority randomized controlled trial aims to examine the feasibility and efficacy of an 8-week multimodal intervention (ATENTO) based on moderate-vigorous intensity and individualized TE (aerobic and strength exercises) and VAT (myofascial and breathing exercises), on neurotoxicity prevention in women with BC before starting adjuvant chemotherapy (ATENTO-B) versus throughout adjuvant chemotherapy (ATENTO-T). A sample of 56 women newly diagnosed with BC, as calculated with a power of 85%, will be randomly allocated into these two groups. This study could provide an impetus for the introduction of early multimodal intervention methods to prevent neurotoxicity and consequently avoid the QoL deterioration that BC patients presently suffer throughout their treatments.
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Affiliation(s)
- Ángela González-Santos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Paula Postigo-Martin
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - Irene Esteban-Cornejo
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Granada, Spain
| | - Maria Lopez-Garzon
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Rebeca Illescas-Montes
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Nursing, Biomedical Group (BIO277), Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Francisco Artacho-Cordón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Radiology and Physical Medicine, University of Granada, Granada, Spain
| | - Lydia Martín-Martín
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | | | - Mario Lozano-Lozano
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | | | | | - Irene Cantarero-Villanueva
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,"CUIDATE" Support Unit for Oncology Patients (UAPO), University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
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Mundo-López A, Ocón-Hernández O, Lozano-Lozano M, San-Sebastián A, Fernández-Lao C, Galiano-Castillo N, Cantarero-Villanueva I, Arroyo-Morales M, Artacho-Cordón F. Impact of symptom burden on work performance status in Spanish women diagnosed with endometriosis. Eur J Obstet Gynecol Reprod Biol 2021; 261:92-97. [PMID: 33906026 DOI: 10.1016/j.ejogrb.2021.04.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore work performance status in Spanish women with endometriosis and to identify those endometriosis-related symptoms that potentially contribute to the reduced work performance. DESIGN Cross-sectional study. SETTING Spain. POPULATION Women with endometriosis working at enrolment (n = 148). METHODS Work performance status was assessed through the Work Role Functioning Questionnaire (WRFQ). Endometriosis-related symptoms (pelvic pain, catastrophizing thoughts related to pain, chronic fatigue, sleep quality, mood status, gastrointestinal discomfort and social support) were also evaluated through validated scales. Statistical analyses were performed through multivariate linear regression analyses. MAIN OUTCOME MEASURES Work performance status. RESULTS Median WRFQ score was 72.0, with the lowest scores found in demands related to worker's needs to manage the workday from beginning to end and those dynamic and static physical loads required in the conduct of work duties. Severe pelvic pain, depressive mood and poorer sleep quality was inversely related to work performance status (p-values <0.020). Finally, self-perceived social support was borderline associated with better work performance (p = 0.057). Considered together, these four psychosocial factors were responsible to explain the 37.9 % of the limitations on work performance observed in our study sample. CONCLUSIONS Spanish women with endometriosis reported lower WRQF scores (predominantly in work scheduling and physical demands) in comparison with previous studies on Spanish healthy adults. Psychosocial factors, including pelvic pain, sleep quality and depressive mood are related with work performance status. Thus, the effectiveness of physical and psychological rehabilitation programs in work productivity in women with endometriosis should be evaluated in the close future.
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Affiliation(s)
- Antonio Mundo-López
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain; Centro de Psicología Clínica Alarcón (CPCA), Granada, Spain.
| | - Olga Ocón-Hernández
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Gynaecology and Obstetrics Unit, 'San Cecilio' University Hospital, Granada, Spain.
| | - Mario Lozano-Lozano
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, University of Granada, Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS, University of Granada, Granada, Spain.
| | - Ainhoa San-Sebastián
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain.
| | - Carolina Fernández-Lao
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, University of Granada, Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS, University of Granada, Granada, Spain.
| | - Noelia Galiano-Castillo
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, University of Granada, Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS, University of Granada, Granada, Spain.
| | - Irene Cantarero-Villanueva
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, University of Granada, Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS, University of Granada, Granada, Spain.
| | - Manuel Arroyo-Morales
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, University of Granada, Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS, University of Granada, Granada, Spain.
| | - Francisco Artacho-Cordón
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS, University of Granada, Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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19
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Martin-Perez AJ, Fernández-González M, Postigo-Martin P, Sampedro Pilegaard M, Fernández-Lao C, Castro-Martín E, Martín-Martín L, Lozano-Lozano M. Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph18083991. [PMID: 33920146 PMCID: PMC8069127 DOI: 10.3390/ijerph18083991] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 12/02/2022]
Abstract
There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.
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Affiliation(s)
- Antonio Jose Martin-Perez
- Department of Internal Medicine, San Cecilio University Hospital, Hospital Universitario San Cecilio, 18016 Granada, Spain;
- Clinical Medicine and Public Health Doctoral Studies, University of Granada, 18010 Granada, Spain
| | - María Fernández-González
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18010 Granada, Spain;
| | - Paula Postigo-Martin
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
| | - Marc Sampedro Pilegaard
- Occupational Science and Occupational Therapy, The Research Unit for User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, 5230 Odense, Denmark;
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, 5000 Odense, Denmark
| | - Carolina Fernández-Lao
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
| | - Eduardo Castro-Martín
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
| | - Lydia Martín-Martín
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
- Correspondence: ; Tel.: +34-958249004
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), 18016 Granada, Spain; (P.P.-M.); (C.F.-L.); (E.C.-M.); (M.L.-L.)
- Sport and Health University Research Institute (iMUDS), “Cuídate” Support Unit for Oncology Patients (UAPO-Cuíate), 18010 Granada, Spain
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20
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Postigo-Martin P, Peñafiel-Burkhardt R, Gallart-Aragón T, Alcaide-Lucena M, Artacho-Cordón F, Galiano-Castillo N, Fernández-Lao C, Martín-Martín L, Lozano-Lozano M, Ruíz-Vozmediano J, Moreno-Gutiérrez S, Illescas-Montes R, Arroyo-Morales M, Cantarero-Villanueva I. Attenuating Treatment-Related Cardiotoxicity in Women Recently Diagnosed With Breast Cancer via a Tailored Therapeutic Exercise Program: Protocol of the ATOPE Trial. Phys Ther 2021; 101:6124131. [PMID: 33528004 DOI: 10.1093/ptj/pzab014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/09/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Therapeutic exercise is already used to ameliorate some of the side effects of cancer treatment. Recent studies examined its preventive potential regarding treatment-related toxicity, which can increase the risk of functional decline and lead to disease recurrence and death. This trial will examine whether the Tailored Therapeutic Exercise and Recovery Strategies (ATOPE) program, performed before treatment, can mitigate the onset and extent of cardiotoxicity beyond that achieved when the program is followed during treatment in recently diagnosed breast cancer patients. METHODS The intervention has a preparatory phase plus 12 to 18 sessions of tailored, high-intensity exercise, and post-exercise recovery strategies. A total of 120 women recently diagnosed with breast cancer, at risk of cardiotoxicity due to anticancer treatment awaiting surgery followed by chemotherapy and/or radiotherapy, will be randomized to either group. In a feasibility study, measurements related to recruitment rate, satisfaction with the program, adherence to them, the retention of participants, safety, and adverse effects will be explored. In the main trial, the efficacy of these interventions will be examined. The major outcome will be cardiotoxicity, assessed echocardiographically via the left ventricular ejection fraction. Other clinical, physical, and anthropometric outcomes and biological and hormonal variables will also be assessed after diagnosis, after treatment, 1 year after treatment ends, and 3 years after treatment ends. CONCLUSION Given its potential effect on patient survival, the mitigation of cardiotoxicity is a priority, and physical therapists have an important role in this mitigation. If the ATOPE intervention performed before treatment returns better cardioprotection results, it may be recommendable that patients recently diagnosed follow this program. IMPACT The ATOPE program will highlight the need for a physical therapist intervention from the moment of diagnosis, in the prevention or mitigation of cardiotoxicity, in women with breast cancer. It could help physical therapists to establish an adequate therapeutic exercise dose adapted to breast cancer patients and to propose correct therapeutic exercise prescription according to the assimilation of the sessions.
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Affiliation(s)
- Paula Postigo-Martin
- Health Sciences Faculty, University of Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain.,Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain
| | | | | | | | - Francisco Artacho-Cordón
- Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Department of Radiology and Physical Medicine, University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Health Sciences Faculty, University of Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain.,Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Health Sciences Faculty, University of Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain.,Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Lydia Martín-Martín
- Health Sciences Faculty, University of Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain.,Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Health Sciences Faculty, University of Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain.,Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | | | - Salvador Moreno-Gutiérrez
- Department of Computer Architecture and Technology, Information and Communication Technologies Research Center (CITIC), University of Granada, Spain
| | | | - Manuel Arroyo-Morales
- Health Sciences Faculty, University of Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain.,Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Health Sciences Faculty, University of Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain.,Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
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21
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Ramirez-Moreno E, Lozano-Lozano M, O'Valle Ravassa F, Ramirez-Tortosa C, Ruiz-Villaverde R. Expression of IMP3 in a retrospective cohort of melanomas with selective lymph node biopsy. Dermatol Ther 2020; 33:e14413. [PMID: 33073451 DOI: 10.1111/dth.14413] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/24/2020] [Accepted: 10/07/2020] [Indexed: 12/23/2022]
Abstract
Insulin-like growth factor-II mRNA-binding protein 3 (IMP-3), which is a member of the insulin-like growth factor mRNA-binding protein family, is expressed at high levels in many types of cancer, where it plays an important role in cell proliferation, as well as in the processes of invasion, migration, and metastasis. Its expression has also been demonstrated in malignant melanoma, but not in other benign skin lesions, which has raised the possibility of using it as a predictive and prognosis marker. Its relationship with sentinel lymph node biopsy, however, has not been explored yet. A retrospective study including 120 histological samples of patients diagnosed with malignant cutaneous melanoma in Granada, between 2012 and 2018, was developed. All patients had had a sentinel lymph node biopsy (SLNB) performed at Hospital Universitario San Cecilio. IMP3 immunostaining was simultaneously carried out in the cutaneous lesion. We observed a significant difference regarding the percentage of cells expressing IMP3 (29.73 ± 3.81 for negative SLNB vs 44.86 ± 5.91 for positive SLNB, P = .020). Our endpoint calculated according to the ROC curve of 35% was significant with P = .007. H (P = .013) and AR (P = .016) indexes, created by the percentage of positive tumor cells and the intensity of the IMP3 expression, were also statistically significant. The most optimal cut-off points to predict the positivity of the SLNB were 35 for the percentage of positive tumor cells and 70 for the H score. We found a significant association between the expression of IMP3 and the regional nodal status defined by the SLNB on malignant melanomas in our series.
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Affiliation(s)
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, Sport and Health Joint University Institute (iMUDS), University of Granada, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,"Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain.,Instituto Biosanitario de Granada, ibs.GRANADA, Granada, Spain
| | - Francisco O'Valle Ravassa
- Instituto Biosanitario de Granada, ibs.GRANADA, Granada, Spain.,Department of Histology, Faculty of Medicine, University of Granada, Granada, Spain
| | - César Ramirez-Tortosa
- Department of Pathology, Hospital Universitario San Cecilio, Granada, Spain.,Instituto Biosanitario de Granada, ibs.GRANADA, Granada, Spain
| | - Ricardo Ruiz-Villaverde
- Department of Physical Therapy, Faculty of Health Sciences, Sport and Health Joint University Institute (iMUDS), University of Granada, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,"Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain.,Instituto Biosanitario de Granada, ibs.GRANADA, Granada, Spain
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22
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Galiano-Castillo N, Liu L, Lozano-Lozano M, Tumilty S, Cantarero-Villanueva I, Baxter GD. Acute and cumulative benefits of Photobiomodulation for xerostomia: A systematic review and meta-analysis. Oral Dis 2020; 27:1115-1126. [PMID: 32964596 DOI: 10.1111/odi.13648] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 12/20/2022]
Abstract
The objective was to explore the effectiveness of photobiomodulation therapy for treating patients who suffer xerostomia and/or hyposalivation due to the most prevalent clinical diagnoses. We searched PubMed, Scopus, Web of Science, CINAHL and Cochrane Library for randomized or clinical controlled trials published until 31 October 2019. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 274 records were retrieved, and 11 met the inclusion criteria. Interventions whose parameters ranged between wavelengths of 790-830 nm (infrared), 30-120 mW of power and an energy density below 30 J/cm-2 were associated with improvements in xerostomia/hyposalivation. As for the assessment of methodological quality, 10 of the 11 articles included had a high risk of overall bias. Only 3 articles provided sufficient information to conduct a meta-analysis for quality of life, compared with placebo in patients with burning mouth syndrome, showing a standardized mean difference between groups from baseline of -0.90 (-1.48; -0.32). The present review and meta-analysis suggest that photobiomodulation therapy is an effective, non-invasive and safe approach in patients with xerostomia. However, despite the potential, it is not possible to reach a reliable consensus on the parameters to be used, and future studies should be conducted by standardizing intervention protocols.
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Affiliation(s)
- Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute (iMUDS), Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Lizhou Liu
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute (iMUDS), Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute (iMUDS), Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - George David Baxter
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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23
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Castro-Martín E, Galiano-Castillo N, Ortiz-Comino L, Cantarero-Villanueva I, Lozano-Lozano M, Arroyo-Morales M, Fernández-Lao C. Effects of a Single Myofascial Induction Session on Neural Mechanosensitivity in Breast Cancer Survivors: A Secondary Analysis of a Crossover Study. J Manipulative Physiol Ther 2020; 43:394-404. [PMID: 32703613 DOI: 10.1016/j.jmpt.2019.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/07/2019] [Accepted: 03/29/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the short-term effects of myofascial induction on mechanosensitivity of upper limb nerves. METHODS In this secondary analysis of a randomized, single-blind, placebo-controlled crossover study, 21 breast cancer survivors with stage I-IIIA cancer were randomly allocated to an experimental group (30 minutes of myofascial induction session) or placebo control group (unplugged pulsed 30 minutes of shortwave therapy), with a 4-week washout period between sessions that occurred in a physical therapy laboratory in the Health Science Faculty (University of Granada, Spain). Range of motion (universal goniometry), structural differentiation, symptoms (yes/no), and pressure pain thresholds (electronic algometry) were assessed during neurodynamic tests and attitude toward massage scale as covariate. RESULTS An analysis of covariance revealed significant time × group interactions for range of motion in affected upper limb nerves (median, P < .001; radial, P = .036; ulnar, P = .002), but not for nonaffected upper limb nerves (median, P = .083; radial, P = .072; ulnar, P = .796). A χ2 or Fisher exact test, as appropriate, also revealed a significant difference (P = .044) in sensitivity for the affected upper limb ulnar nerve in the experimental group, whereas the rest of the assessed nerves (affected and nonaffected upper limb nerves) showed no significant changes in either the experimental or control groups (P > .05). An analysis of covariance revealed no significant interactions on pressure pain thresholds over the nerves for affected (all P > .05) and nonaffected (all P > .05) upper limb nerves. CONCLUSION A single myofascial induction session may partially improve mechanosensitivity of median, radial, and ulnar nerves and yield positive effects on symptom mechanosensitivity, especially regarding the ulnar nerve in breast cancer survivors.
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Affiliation(s)
- Eduardo Castro-Martín
- Department of Physical Therapy, University of Granada, Granada, Spain; Instituto Mixto Universitario Deporte y Salud, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, University of Granada, Granada, Spain; Instituto Mixto Universitario Deporte y Salud, Granada, Spain; Instituto Biosanitario Granada, Granada, Spain.
| | | | - Irene Cantarero-Villanueva
- Department of Physical Therapy, University of Granada, Granada, Spain; Instituto Mixto Universitario Deporte y Salud, Granada, Spain; Instituto Biosanitario Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, University of Granada, Granada, Spain; Instituto Mixto Universitario Deporte y Salud, Granada, Spain; Instituto Biosanitario Granada, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, University of Granada, Granada, Spain; Instituto Mixto Universitario Deporte y Salud, Granada, Spain; Instituto Biosanitario Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, University of Granada, Granada, Spain; Instituto Mixto Universitario Deporte y Salud, Granada, Spain; Instituto Biosanitario Granada, Granada, Spain
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24
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Lozano-Lozano M, Fernández-Lao C, Cantarero-Villanueva I, Noguerol I, Álvarez-Salvago F, Cruz-Fernández M, Arroyo-Morales M, Galiano-Castillo N. A Blended Learning System to Improve Motivation, Mood State, and Satisfaction in Undergraduate Students: Randomized Controlled Trial. J Med Internet Res 2020; 22:e17101. [PMID: 32441655 PMCID: PMC7275253 DOI: 10.2196/17101] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/20/2020] [Accepted: 01/26/2020] [Indexed: 01/10/2023] Open
Abstract
Background Smartphone-based learning, or mobile learning (m-learning), has become a popular learning-and-teaching strategy in educational environments. Blended learning combines strategies such as m-learning with conventional learning to offer continuous training, anytime and anywhere, via innovative learning activities. Objective The main aim of this work was to examine the short-term (ie, 2-week) effects of a blended learning method using traditional materials plus a mobile app—the iPOT mobile learning app—on knowledge, motivation, mood state, and satisfaction among undergraduate students enrolled in a health science first-degree program. Methods The study was designed as a two-armed, prospective, single-blind, randomized controlled trial. Subjects who met the inclusion criteria were randomly assigned to either the intervention group (ie, blended learning involving traditional lectures plus m-learning via the use of the iPOT app) or the control group (ie, traditional on-site learning). For both groups, the educational program involved 13 lessons on basic health science. The iPOT app is a hybrid, multiplatform (ie, iOS and Android) smartphone app with an interactive teacher-student interface. Outcomes were measured via multiple-choice questions (ie, knowledge), the Instructional Materials Motivation Survey (ie, motivation), the Profile of Mood States scale (ie, mood state), and Likert-type questionnaires (ie, satisfaction and linguistic competence). Results A total of 99 students were enrolled, with 49 (49%) in the intervention group and 50 (51%) in the control group. No difference was seen between the two groups in terms of theoretical knowledge gain (P=.92). However, the intervention group subjects returned significantly higher scores than the control group subjects for all postintervention assessed items via the motivation questionnaire (all P<.001). Analysis of covariance (ANCOVA) revealed a significant difference in the confusion and bewilderment component in favor of the intervention group (P=.01), but only a trend toward significance in anger and hostility as well as total score. The intervention group subjects were more satisfied than the members of the control group with respect to five out of the six items evaluated: general satisfaction (P<.001), clarity of the instructions (P<.01), clarity with the use of the learning method (P<.001), enough time to complete the proposed exercises (P<.01), and improvement in the capacity to learn content (P<.001). Finally, the intervention group subjects who were frequent users of the app showed stronger motivation, as well as increased perception of greater gains in their English-language competence, than did infrequent users. Conclusions The blended learning method led to significant improvements in motivation, mood state, and satisfaction compared to traditional teaching, and elicited statements of subjective improvement in terms of competence in English. Trial Registration ClinicalTrials.gov NCT03335397; https://clinicaltrials.gov/ct2/show/NCT03335397
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
| | - Ignacio Noguerol
- Departamento de Lenguajes y Sistemas Informáticos e Ingeniería de Software, Universidad Politécnica de Madrid, Madrid, Spain
| | | | | | - Manuel Arroyo-Morales
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Scientific Unit of Excellence on Exercise and Health, University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
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Lozano-Lozano M, Galiano-Castillo N, Fernández-Lao C, Postigo-Martin P, Álvarez-Salvago F, Arroyo-Morales M, Cantarero-Villanueva I. The Ecofisio Mobile App for Assessment and Diagnosis Using Ultrasound Imaging for Undergraduate Health Science Students: Multicenter Randomized Controlled Trial. J Med Internet Res 2020; 22:e16258. [PMID: 32154784 PMCID: PMC7093774 DOI: 10.2196/16258] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 10/24/2019] [Accepted: 11/13/2019] [Indexed: 11/23/2022] Open
Abstract
Background Generation Z is starting to reach college age. They have adopted technology from an early age and have a deep dependence on it; therefore, they have become more drawn to the virtual world. M-learning has experienced huge growth in recent years, both in the medical context and in medical and health sciences education. Ultrasound imaging is an important diagnosis technique in physiotherapy, especially in sports pathology. M-learning systems could be useful tools for improving the comprehension of ultrasound concepts and the acquisition of professional competencies. Objective The purpose of this study was to evaluate the efficacy and use of an interactive platform accessible through mobile devices—Ecofisio—using ultrasound imaging for the development of professional competencies in the evaluation and diagnosis of sports pathologies. Methods Participants included 110 undergraduate students who were placed into one of two groups of a randomized controlled multicenter study: control group (ie, traditional learning) and experimental group (ie, Ecofisio mobile app). Participants’ theoretical knowledge was assessed using a multiple-choice questionnaire (MCQ); students were also assessed by means of the Objective Structured Clinical Examination (OSCE). Moreover, a satisfaction survey was completed by the students. Results The statistical analyses revealed that Ecofisio was effective in most of the processes evaluated when compared with the traditional learning method: all OSCE stations, P<.001; MCQ, 43 versus 15 students passed in the Ecofisio and control groups, respectively, P<.001. Moreover, the results revealed that the students found the app to be attractive and useful. Conclusions The Ecofisio mobile app may be an effective way for physiotherapy students to obtain adequate professional competencies regarding evaluation and diagnosis of sports pathologies. Trial Registration ClinicalTrials.gov NCT04138511; https://clinicaltrials.gov/ct2/show/NCT04138511
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
| | - Paula Postigo-Martin
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain
| | | | - Manuel Arroyo-Morales
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain
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Sampedro Pilegaard M, la Cour K, Brandt Å, Lozano-Lozano M, Gregersen Oestergaard L. Impact of pain, fatigue and dyspnoea on occupational performance in people with advanced cancer: A longitudinal study. Scand J Occup Ther 2019; 27:507-516. [PMID: 31729272 DOI: 10.1080/11038128.2019.1690042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Pain, fatigue and dyspnoea are symptoms commonly experienced by people with advanced cancer, which may impact on their occupational performance. It is not known whether these symptoms impact their occupational performance over time.Objective: To examine correlation between pain, fatigue and dyspnoea and occupational performance and the impact of such symptoms on occupational performance over time in people with advanced cancer.Material and Methods: A longitudinal study was conducted including 242 participants assessed at baseline and after six and 12 weeks. Spearman's rank-order test and mixed linear models were performed.Results: The correlation between pain, fatigue and dyspnoea and occupational performance at baseline spanned from trivial to moderate (Spearman's rho: -0.004 to 0.34). Only pain had a statistically significant impact on activities of daily living (ADL) motor ability over time (p = 0.01). Participants with no pain problems had the largest decrease in ADL motor ability (-0.24 logits (95%-CI: -0.37 to -0.12)), but the observed decrease was not clinically relevant (≥-0.30).Conclusion: Pain, fatigue and dyspnoea did not seem to highly correlate with occupational performance or impact occupational performance over time of people with advanced cancer.
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Affiliation(s)
- Marc Sampedro Pilegaard
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark.,Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Denmark
| | - Karen la Cour
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Åse Brandt
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Mario Lozano-Lozano
- The Department of Physical Therapy, University of Granada, Granada, Spain.,The "Cuídate", Support Unit for Oncology Patients (UAPO), Granada, Spain.,Department of Physical and Occupational Therapy, The Sport and Health Joint University Institute (IMUDS), Granada, Spain
| | - Lisa Gregersen Oestergaard
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark.,Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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27
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Lozano-Lozano M, Martín-Martín L, Galiano-Castillo N, Fernández-Lao C, Cantarero-Villanueva I, López-Barajas IB, Arroyo-Morales M. Mobile health and supervised rehabilitation versus mobile health alone in breast cancer survivors: Randomized controlled trial. Ann Phys Rehabil Med 2019; 63:316-324. [PMID: 31454561 DOI: 10.1016/j.rehab.2019.07.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Survival rates in cancer are increasing exponentially, with a corresponding increase/influence in disability-adjusted life-years. Efforts should be made to explore the optimal balance between unsupervised/distance-based and supervised/onsite approaches to cancer care. OBJECTIVE This study aimed to compare the clinical efficacy of the BENECA mobile Health (mHealth) lifestyle application combined with a supervised rehabilitation program (BENECA and supervised rehabilitation) versus the BENECA mHealth lifestyle application alone on quality of life (QoL) and functional outcomes of breast cancer survivors. METHODS This randomized controlled trial included 80 survivors of breast cancer diagnosed at stage I-IIIA, who completed adjuvant therapy and were overweight or obese at diagnosis. Participants were randomly allocated (ratio 1:1, 3 waves) to BENECA mHealth and rehabilitation for 2months (n=40) or BENECA mHealth and usual care (BENECA mHealth alone; n=40). Participants completed a questionnaire at baseline (T1), 8-weeks post-intervention (T2) and 6-month follow-up (T3). The primary outcome was QoL assessed with the EORT QLQ-C30. Secondary outcomes included upper-limb functionality and body composition. Statistical (between-group analyses of covariance) and clinical effects were analyzed by intention to treat. RESULTS Both groups showed improved outcomes, but global QoL was significantly better with BENECA mHealth and rehabilitation than BENECA mHealth alone (mean difference, 12.76; 95% confidence interval 4.85; 20.67; P=0.004), with a moderate-to-large effect size (d=72). The proportion of participants reporting reliable clinical improvement on global QoL at T2 was higher with BENECA mHealth and rehabilitation than BENECA mHealth alone (57.5% vs 26.3%, P=0.008). Improvement in subjective and objective upper-limb functionality was also higher with BENECA mHealth and rehabilitation. CONCLUSIONS The BENECA mHealth lifestyle application with a supervised rehabilitation program had a statistically and clinically significant effect on QoL and upper-limb functionality in breast cancer survivors and is a unique and important promising new approach.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain.
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
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Lozano-Lozano M, Melguizo-Rodríguez L, Fernández-Lao C, Galiano-Castillo N, Cantarero-Villanueva I, Martín-Martín L, Arroyo-Morales M. Association Between the Use of a Mobile Health Strategy App and Biological Changes in Breast Cancer Survivors: Prospective Pre-Post Study. J Med Internet Res 2019; 21:e15062. [PMID: 31414667 PMCID: PMC6712956 DOI: 10.2196/15062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022] Open
Abstract
Background There is a bidirectional relationship between chronic low-grade inflammation and cancer. Inflammatory markers, such as interleukin-6 (IL-6), have been associated with both the malignant transformation of epithelial cells and tumor progression, thus linking low-grade inflammation with a higher risk of cancer and recurrence in the survival phase. Therefore, they are considered valuable prognostic biomarkers. Knowing and finding appropriate primary prevention strategies to modify these parameters is a major challenge in reducing the risk of cancer recurrence and increasing survival. Different therapeutic strategies have shown efficacy in the modification of these and other biological parameters, but with contradictory results. There are apparently no strategies in which telemedicine, and specifically mobile health (mHealth), are used as a means to potentially cause biological changes. Objective The objectives of this study were to: (1) check whether it is feasible to find changes in inflammation biomarkers through an mHealth strategy app as a delivery mechanism of an intervention to monitor energy balance; and (2) discover potential predictors of change of these markers in breast cancer survivors (BCSs). Methods A prospective quasi-experimental pre-post study was conducted through an mHealth energy balance monitoring app with 73 BCSs, defined as stage I-IIIA of breast cancer and at least six months from the completion of the adjuvant therapy. Measurements included were biological salivary markers (IL-6 and C-reactive protein [CRP]), self-completed questionnaires (the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, the user version of the Mobile Application Rating Scale [uMARS] and an ad hoc clinical and sociodemographic questionnaire) and physical objective measures (accelerometry, weight and height). In addition, using the logging data of the mHealth app, the rate of use (in days) was recorded during the entire experimental phase of the study. Using Stata software, a paired two-tailed t test, Pearson and Spearman correlations, and a stepwise multiple regression analysis were used to interpret the data. Results Analyzing changes in inflammatory biomarker concentrations after using the mHealth app, differences between preassessment CRP (4899.04 pg/ml; SD 1085.25) and IL-6 (87.15 pg/ml; SD 33.59) and postassessment CRP (4221.24 pg/ml; SD 911.55) and IL-6 (60.53 pg/ml; SD 36.31) showed a significant decrease in both markers, with a mean difference of –635.25 pg/ml (95% CI –935.65 to –334.85; P<.001) in CRP and –26.61 pg/ml (95% CI –42.51 to –10.71; P=.002) in IL-6. Stepwise regression analyses revealed that changes in global quality of life, as well as uMARS score and hormonal therapy, were possible predictors of change in CRP concentration after using the mHealth app. In the same way, the type of tumor removal surgery conducted, as well as changes in weight and pain score, were possible predictors of change in IL-6 concentration after using the app. Conclusions In conclusion, through the results of this study, we hypothesize that there is a possible association between an mHealth energy balance monitoring strategy and biological changes in BCSs. These changes could be explained by different biopsychosocial parameters, such as the use of the application itself, quality of life, pain, type of tumor removal surgery, hormonal treatment or obesity.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute, Granada, Spain.,"Cuidate" Support Unit for Oncology Patients, Granada, Spain
| | - Lucia Melguizo-Rodríguez
- Biohealth Research Institute, Granada, Spain.,Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute, Granada, Spain.,"Cuidate" Support Unit for Oncology Patients, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute, Granada, Spain.,"Cuidate" Support Unit for Oncology Patients, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute, Granada, Spain.,"Cuidate" Support Unit for Oncology Patients, Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute, Granada, Spain.,"Cuidate" Support Unit for Oncology Patients, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute, Granada, Spain.,Biohealth Research Institute, Granada, Spain.,"Cuidate" Support Unit for Oncology Patients, Granada, Spain
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Martín-Martín L, Membrilla-Mesa MD, Lozano-Lozano M, Galiano-Castillo N, Fernández-Lao C, Arroyo-Morales M. Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study. J Clin Med 2019; 8:jcm8081093. [PMID: 31344928 PMCID: PMC6722959 DOI: 10.3390/jcm8081093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/13/2019] [Accepted: 07/23/2019] [Indexed: 12/29/2022] Open
Abstract
Background: Patients often experience pain as a result of a stroke. However, the mechanism of this pain remains uncertain. Our aim was to investigate the relationship between pressure pain thresholds (PPTs) and disability pain in patients with hemiplegic shoulder pain (HSP). Methods: Twenty-six post-stroke patients (age 53.35 ± 13.09 years) and healthy controls (54.35 ± 12.37 years) participated. We investigated spontaneous shoulder pain, disability pain perception through the shoulder pain and disability index (SPADI), and the PPTs over joint C5–C6, upper trapezius, deltoid, epicondyle, second metacarpal, and tibialis anterior, bilaterally. Results: The analysis of variance (ANOVA) showed significant differences in pain between groups (p < 0.001) and differences in the SPADI (p < 0.001) between groups but not between sides for PPTs over deltoid (group: p = 0.007; side: p = 0.750), epicondyle (group: p = 0.001; side: p = 0.848), and tibialis anterior (group: p < 0.001; side: p = 0.932). Pain in the affected arm was negatively associated with PPTs over the affected epicondyle (p = 0.003) and affected tibialis anterior (p = 0.009). Pain (SPADI) appeared negatively correlated with PPTs over the affected epicondyle (p = 0.047), and disability (SPADI) was negatively associated with PPTs over the affected tibialis anterior (p = 0.041). Conclusions: Post-stroke patients showed a relationship between widespread pressure pain hypersensitivity with lower PPT levels and pain disability perception, suggesting a central sensitization mediated by bilateral and symmetric pain patterns.
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Affiliation(s)
- Lydia Martín-Martín
- Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada). University of Granada, Granada 18071, Spain
| | - Miguel David Membrilla-Mesa
- Physical Medicine and Rehabilitation Department, Section Rehabilitation and Traumatology, Hospital Virgen de las Nieves, Granada 18014, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada). University of Granada, Granada 18071, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada 18071, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada 18071, Spain.
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada 18071, Spain
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Ariza-Garcia A, Lozano-Lozano M, Galiano-Castillo N, Postigo-Martin P, Arroyo-Morales M, Cantarero-Villanueva I. A Web-Based Exercise System (e-CuidateChemo) to Counter the Side Effects of Chemotherapy in Patients With Breast Cancer: Randomized Controlled Trial. J Med Internet Res 2019; 21:e14418. [PMID: 31342907 PMCID: PMC6685131 DOI: 10.2196/14418] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 01/10/2023] Open
Abstract
Background Breast cancer patients have to face a high-risk state during chemotherapy, which involves deterioration of their health including extensive physical deterioration. Face-to-face physical exercise programs have presented low adherence rates during medical treatment, and telehealth systems could improve these adherence rates. Objective This study aimed to evaluate the effectiveness of a Web-based exercise program (e-CuidateChemo) to mitigate the side effects of chemotherapy on the physical being, anthropometric aspects, and body composition. Methods A total of 68 patients diagnosed with breast cancer, who were undergoing chemotherapy, were enrolled. The patients were categorized into two groups: e-CuidateChemo (n=34) and controls (n=34). The e-CuidateChemo group participated in an adapted 8-week tailored exercise program through a Web-based system. A blinded, trained researcher assessed functional capacity, strength, anthropometric parameters, and body composition. The intervention effects were tested using analysis of covariance and Cohen d tests. Results Functional capacity improved significantly in the e-CuidateChemo group compared to the control group (6-minute walk test: 62.07 [SD 130.09] m versus –26.34 [SD 82.21] m; 6-minute walk test % distance predicted: 10.81% [SD 22.69%] m versus –4.60% [SD 14.58%]; between-group effect: P=.015 for both). The intervention group also showed significantly improved secondary outcomes such as between-group effects for abdominal (24.93 [SD 26.83] s vs –18.59 [SD 38.69] s), back (12.45 [SD 10.20] kg vs 1.39 [10.72] kg), and lower body (–2.82 [SD 3.75] s vs 1.26 [SD 2.84] s) strength; all P<.001 compared to the control group. Conclusions This paper showed that a Web-based exercise program was effective in reversing the detriment in functional capacity and strength due to chemotherapy. Trial Registration ClinicalTrials.gov NCT02350582; https://clinicaltrials.gov/ct2/show/NCT02350582
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Affiliation(s)
- Angelica Ariza-Garcia
- Department of Physical Therapy, University of Granada, Granada, Spain.,"San Cecilio" University Hospital, Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuídate-Support Unit for Oncology Patients, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuídate-Support Unit for Oncology Patients, Granada, Spain
| | - Paula Postigo-Martin
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Cuídate-Support Unit for Oncology Patients, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuídate-Support Unit for Oncology Patients, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, University of Granada, Granada, Spain.,Sport and Health University Research Institute, University of Granada, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuídate-Support Unit for Oncology Patients, Granada, Spain
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Martin-Alguacil JL, Arroyo-Morales M, Martin-Gómez JL, Lozano-Lozano M, Galiano-Castillo N, Cantarero-Villanueva I. Comparison of knee sonography and pressure pain threshold after anterior cruciate ligament reconstruction with quadriceps tendon versus hamstring tendon autografts in soccer players. Acta Orthop Traumatol Turc 2019; 53:260-265. [PMID: 31201076 PMCID: PMC6738273 DOI: 10.1016/j.aott.2019.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 03/05/2019] [Accepted: 04/28/2019] [Indexed: 12/16/2022]
Abstract
Objective The aim of this study was to compare the pressure pain threshold and muscle architecture after an anatomic single bundle reconstruction with quadriceps tendon and hamstring tendon autografts of the anterior cruciate ligament in competitive soccer players. We hypothesized that both procedures will obtain similar outcomes. Methods Fifty-one participants were enrolled in this secondary analysis of a randomized controlled trial and were categorised into two groups: quadriceps tendon (QT) group (23 men and 3 women; mean age 18.7 ± 3.6; BMI 23.0 ± 2.2) or hamstring tendon (HT) group (16 men and 9 women; mean age 19.2 ± 3.6 BMI 23.5 ± 3.5). Both groups followed the same rehabilitation staged protocol. Pressure pain threshold (PPT), as a measure of perceived pain, was obtained in several points of quadriceps and hamstring muscles. Ultrasound imaging measurements were obtained in quadriceps tendon and knee cartilage thickness. Four measurements were taken in this study: baseline, 1, 3, 6, and 12 months after the anterior cruciate ligament (ACL) reconstruction. Results The analysis of PPT did not find significant differences in both groups × interaction time in the points evaluated: epicondyle (QT = 421.1 ± 184.1 vs HT = 384.7 ± 154.1 kPa), vastus lateralis (QT = 576.2 ± 221.3 vs HT = 560.1 ± 167.7 kPa), vastus medialis (QT = 544.7 ± 198.8 vs HT = 541.1.1 ± 181.77 kPa), patellar tendon (QT = 626.3 ± 221.1 vs HT = 665.0 ± 205.5 kPa), QT (QT = 651.1 ± 276.9 vs HT = 660.0 ± 195.2 kPa). (QT = 667.8 ± 284.7 vs HT = 648.2 ± 193.4 kPa) injured knee (all P > 0.05). The results of ultrasound imaging did not show significant differences in both groups × interaction time in the thickness of the QT (QT = 9.9 ± 2.4 vs HT = 9.4 ± 1.7 kPa) and patellar cartilage (QT = 3.2 ± 0.6 vs HT = 3.2 ± 0.4 kPa) (P > 0.05). Conclusion A QT autograft produces similar results to a HT autograft in ACL reconstructions in terms of pressure pain threshold and ultrasound muscle architecture during the 1-year follow-up. Level of Evidence Level I, Therapeutic Study.
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Lozano-Lozano M, Cantarero-Villanueva I, Martin-Martin L, Galiano-Castillo N, Sanchez MJ, Fernández-Lao C, Postigo-Martin P, Arroyo-Morales M. A Mobile System to Improve Quality of Life Via Energy Balance in Breast Cancer Survivors (BENECA mHealth): Prospective Test-Retest Quasiexperimental Feasibility Study. JMIR Mhealth Uhealth 2019; 7:e14136. [PMID: 31237570 PMCID: PMC6614997 DOI: 10.2196/14136] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/13/2019] [Accepted: 05/16/2019] [Indexed: 02/06/2023] Open
Abstract
Background Energy balance is defined as the difference between energy expenditure and energy intake. The current state of knowledge supports the need to better integrate mechanistic approaches through effective studies of energy balance in the cancer population because of an observed significant lack of adherence to healthy lifestyle recommendations. To stimulate changes in breast cancer survivors’ lifestyles based on energy balance, our group developed the BENECA (Energy Balance on Cancer) mHealth app. BENECA has been previously validated as a reliable energy balance monitoring system. Objective Based on our previous results, the goal of this study was to investigate the feasibility of BENECA mHealth in an ecological clinical setting with breast cancer survivors, by studying (1) its feasibility and (2) pretest-posttest differences with regard to breast cancer survivor lifestyles, quality of life (QoL), and physical activity (PA) motivation. Methods Eighty breast cancer survivors diagnosed with stage I to IIIA and with a body mass index over 25 kg/m2 were enrolled in this prospective test-retest quasi-experimental study. Patients used BENECA mHealth for 8 weeks and were assessed at baseline and the postintervention period. Feasibility main outcomes included percentage of adoption, usage, and attrition; user app quality perception measured with the Mobile App Rating Scale (MARS); satisfaction with the Net Promoter Score (NPS); and barriers and facilitators of its use. Clinical main outcomes included measuring QoL with the European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORT QLQ-C30), PA assessment with accelerometry, PA motivation measure with a Spanish self-efficacy scale for physical activity (EAF), and body composition with dual-energy x-ray absorptiometry. Statistical tests (using paired-sample t tests) and Kaplan-Meier survival curves were analyzed. Results BENECA was considered feasible by the breast cancer survivors in terms of use (76%, 58/76), adoption (69%, 80/116), and satisfaction (positive NPS). The app quality score did not make it one of the best-rated apps (mean 3.71, SD 0.47 points out of 5). BENECA mHealth improved the QoL of participants (global health mean difference [MD] 12.83, 95% CI 8.95-16.71, P<.001), and EAF score (global MD 36.99, 95% CI 25.52-48.46, P<.001), daily moderate-to-vigorous PA (MD 7.38, 95% CI 0.39-14.37, P=.04), and reduced body weight (MD −1.42, 95% CI −1.97 to −0.87, P<.001). Conclusions BENECA mHealth can be considered feasible in a real clinical context to promote behavioral changes in the lifestyles of breast cancer survivors, but it needs to be enhanced to improve user satisfaction with use and functionality. This study highlights the importance of the use of mobile apps based on energy balance and how the QoL of breast cancer survivors can be improved via monitoring.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Lydia Martin-Martin
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Maria-José Sanchez
- Biohealth Research Institute in Granada, Granada, Spain.,Andalusian School of Public Health, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Paula Postigo-Martin
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
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Cantarero-Villanueva I, Cuesta-Vargas AI, Lozano-Lozano M, Fernández-Lao C, Fernández-Pérez A, Galiano-Castillo N. Changes in Pain and Muscle Architecture in Colon Cancer Survivors After a Lumbopelvic Exercise Program: A Secondary Analysis of a Randomized Controlled Trial. Pain Med 2018; 18:1366-1376. [PMID: 28340204 DOI: 10.1093/pm/pnx026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To investigate the efficacy of an eight-week lumbopelvic stabilization program (CO-CUIDATE) for colon cancer survivors. Design A secondary analysis of a randomized controlled clinical trial. Settings A blinded, trained researcher performed the end point assessments for pain (Pressure Pain Threshold and Brief Pain Inventory) and muscle architecture (ultrasound imaging measurements). Subjects Forty-six colon cancer survivors who were assigned to the CO-CUIDATE group or usual care group. Methods The CO-CUIDATE program was conducted for eight weeks. A trained researcher who was blinded to patient group performed the assessments. The tests were carried out with multiple observations. Intention-to-treat analyses were performed. Results The program had an adherence rate of 88.36% and two dropouts (10.5%). The participants reported some minor side effects during the first exercise sessions. The analysis revealed significant differences in the group x time interactions for the lumbar side (dominant: F = 3.1, P < 0.001; nondominant: F = 3.0, P = 0.01) and the infra-umbilical dominant side (F = 1.2, P = 0.04) after the program and at the six-month follow-up and for the internal oblique thickness (F = 5.1, P = 0.030) after the program. The experimental group experienced a greater improvement in all values after the program compared with the control group. There were no significant changes in the other pressure pain threshold points, pain severity, interference of pain, or the remaining ultrasound imaging measurements. Conclusion The CO-CUIDATE program is effective for improving the musculoskeletal conditions related to the lumbopelvic area in colon cancer survivors, specifically in relation to pain and the internal oblique thickness.
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Affiliation(s)
- Irene Cantarero-Villanueva
- Department of Physiotherapy, Faculty of Health Sciences, Granada University, Granada, Spain.,Institute for Biomedical Research (IBS), Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain
| | - Antonio I Cuesta-Vargas
- Department of Psychiatry and Physiotherapy, Faculty of Medicine, Arquitecto, Francisco, Peñalosa, Ampliación Campus Teatinos, Malaga University, Malaga, Spain.,Andalucia Tech, Institute for Biomedical Research Málaga (IBIMA), Málaga, Spain.,AEClinimetry Group (-14), Málaga, Spain.,School of Clinical Science, Faculty of Health Science, Queensland University
| | - Mario Lozano-Lozano
- Department of Physiotherapy, Faculty of Health Sciences, Granada University, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physiotherapy, Faculty of Health Sciences, Granada University, Granada, Spain.,Institute for Biomedical Research (IBS), Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain
| | | | - Noelia Galiano-Castillo
- Department of Physiotherapy, Faculty of Health Sciences, Granada University, Granada, Spain.,Institute for Biomedical Research (IBS), Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain
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Álvarez-Salvago F, Galiano-Castillo N, Arroyo-Morales M, Cruz-Fernández M, Lozano-Lozano M, Cantarero-Villanueva I. Health status among long-term breast cancer survivors suffering from higher levels of fatigue: a cross-sectional study. Support Care Cancer 2018; 26:3649-3658. [PMID: 29730714 DOI: 10.1007/s00520-018-4240-z] [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: 12/12/2017] [Accepted: 04/26/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE The aims of this study were to evaluate the health status of long-term breast cancer survivors (LTBCS) suffering from higher levels of fatigue, to highlight their needs, and to establish the key points of intervention support programs. METHODS A cross-sectional observational study was conducted at the Sport and Health Joint University Institute (iMUDS) between September 2016 and July 2017 with 80 LTBCS that were classified into non-fatigued (≤ 3.9) or fatigued (≥ 4) according to the Piper Fatigue Scale (PFS) total score. The instruments used were the European Organization for Research and Treatment of Cancer Core 30 and its breast cancer (BC) module, the Visual Analog Scale (VAS), the Brief Pain Inventory (BPI), the Scale for Mood Assessment (EVEA), the International Fitness Scale (IFIS), and the Charlson Comorbidity Index. RESULTS The analysis revealed that 41.2% of LTBCS were considered moderately fatigued and showed significantly higher levels for the categories of "nausea and vomiting" (P = .005), "pain," "dyspnea" and "insomnia" (P < .001), "appetite loss" (P = .002), "financial difficulties" (P = .010), "systemic therapy side effects" (P < .001), "breast symptoms" and "arm symptoms" (P = .002), and "upset by hair loss" (P = .016). In addition, LTBCS presented significantly higher levels of pain in the affected and non-affected arm, "sadness-depression." "anxiety," "anger/hostility" (All: P < .001), and lower general physical fitness (P < .001). The rest of the variables did not show significant differences. CONCLUSION LTBCS suffering from higher levels of fatigue had lower QoL, higher level of pain, worse mood state, and lower physical fitness.
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Affiliation(s)
| | - Noelia Galiano-Castillo
- Department of Physiotherapy, University of Granada, Granada, Spain.
- Biohealth Research Institute in Granada (ibs.GRANADA), University Hospital Complex of Granada/University of Granada, Granada, Spain.
- Sport and Health Joint University Institute (iMUDS), Granada, Spain.
| | - Manuel Arroyo-Morales
- Department of Physiotherapy, University of Granada, Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), University Hospital Complex of Granada/University of Granada, Granada, Spain
- Sport and Health Joint University Institute (iMUDS), Granada, Spain
| | | | - Mario Lozano-Lozano
- Department of Physiotherapy, University of Granada, Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), University Hospital Complex of Granada/University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physiotherapy, University of Granada, Granada, Spain
- Biohealth Research Institute in Granada (ibs.GRANADA), University Hospital Complex of Granada/University of Granada, Granada, Spain
- Sport and Health Joint University Institute (iMUDS), Granada, Spain
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Lozano-Lozano M, Galiano-Castillo N, Martín-Martín L, Pace-Bedetti N, Fernández-Lao C, Arroyo-Morales M, Cantarero-Villanueva I. Monitoring Energy Balance in Breast Cancer Survivors Using a Mobile App: Reliability Study. JMIR Mhealth Uhealth 2018; 6:e67. [PMID: 29588273 PMCID: PMC5893887 DOI: 10.2196/mhealth.9669] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/25/2018] [Accepted: 01/26/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The majority of breast cancer survivors do not meet recommendations in terms of diet and physical activity. To address this problem, we developed a mobile health (mHealth) app for assessing and monitoring healthy lifestyles in breast cancer survivors, called the Energy Balance on Cancer (BENECA) mHealth system. The BENECA mHealth system is a novel and interactive mHealth app, which allows breast cancer survivors to engage themselves in their energy balance monitoring. BENECA was designed to facilitate adherence to healthy lifestyles in an easy and intuitive way. OBJECTIVE The objective of the study was to assess the concurrent validity and test-retest reliability between the BENECA mHealth system and the gold standard assessment methods for diet and physical activity. METHODS A reliability study was conducted with 20 breast cancer survivors. In the study, tri-axial accelerometers (ActiGraphGT3X+) were used as gold standard for 8 consecutive days, in addition to 2, 24-hour dietary recalls, 4 dietary records, and sociodemographic questionnaires. Two-way random effect intraclass correlation coefficients, a linear regression-analysis, and a Passing-Bablok regression were calculated. RESULTS The reliability estimates were very high for all variables (alpha≥.90). The lowest reliability was found in fruit and vegetable intakes (alpha=.94). The reliability between the accelerometer and the dietary assessment instruments against the BENECA system was very high (intraclass correlation coefficient=.90). We found a mean match rate of 93.51% between instruments and a mean phantom rate of 3.35%. The Passing-Bablok regression analysis did not show considerable bias in fat percentage, portions of fruits and vegetables, or minutes of moderate to vigorous physical activity. CONCLUSIONS The BENECA mHealth app could be a new tool to measure energy balance in breast cancer survivors in a reliable and simple way. Our results support the use of this technology to not only to encourage changes in breast cancer survivors' lifestyles, but also to remotely monitor energy balance. TRIAL REGISTRATION ClinicalTrials.gov NCT02817724; https://clinicaltrials.gov/ct2/show/NCT02817724 (Archived by WebCite at http://www.webcitation.org/6xVY1buCc).
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | | | - Carolina Fernández-Lao
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
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Gallart-Aragón T, Fernández-Lao C, Galiano-Castillo N, Cantarero-Villanueva I, Lozano-Lozano M, Arroyo-Morales M. Improvements in Health-Related Quality of Life and Pain: A Cohort Study in Obese Patients After Laparoscopic Sleeve Gastrectomy. J Laparoendosc Adv Surg Tech A 2017; 28:53-57. [PMID: 28850292 DOI: 10.1089/lap.2017.0415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE The principal aim of the study was to investigate the effect of the sleeve gastrectomy (SG) in the quality of life (QoL) and pain in a population of morbidly obese patients. METHODS Seventy-two SG patients were assessed in this descriptive observational study, before the surgery and 6 months after that. We evaluated health-related QoL (Gastrointestinal Quality of Life Index [GIQLI]) and pain (spontaneous low back pain by Numerical Point Rate Scale [NPRS] and pressure pain thresholds [PPTs]). RESULTS The results of the analysis of variance (ANOVA) revealed significant improvements in nearly all of the subscales of GIQLI questionnaire after 6 months: gastrointestinal symptoms (P = .01), physical well-being (P < .001), social well-being (P = .03), and total GIQLI score (P < .001), but not for the emotional condition (P = .20). Patients also had improvements in spontaneous low back pain (P = .002), but not in the PPTs in all the body areas explored, including the cervical area, low back, and hands (P > .05). CONCLUSION Patients receiving SG improved their health-related QoL and low back pain 6 months after the intervention, but this improvement was not so important for pressure pain thresholds in different body areas.
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Affiliation(s)
| | - Carolina Fernández-Lao
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
| | - Noelia Galiano-Castillo
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
| | - Irene Cantarero-Villanueva
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
| | | | - Manuel Arroyo-Morales
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
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Galiano-Castillo N, Arroyo-Morales M, Lozano-Lozano M, Fernández-Lao C, Martín-Martín L, Del-Moral-Ávila R, Cantarero-Villanueva I. Effect of an Internet-based telehealth system on functional capacity and cognition in breast cancer survivors: a secondary analysis of a randomized controlled trial. Support Care Cancer 2017. [PMID: 28639097 DOI: 10.1007/s00520-017-3782-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE This trial determines the effect of an Internet-based tailored exercise program compared to usual care control for improving functional capacity and cognition among breast cancer survivors. METHODS A two-arm, assessor-blinded, parallel, randomized controlled efficacy trial was conducted. Participants were recruited from the Oncology and Breast unit at the Virgen de las Nieves Hospital (Granada, Spain) between March 2012 to November 2013 and randomized to either the experimental group (an 8-week Internet-based tailored exercise program) or control group (usual care). The outcome measures were the 6-min walk test, Auditory Consonant Trigrams, and Trail Making Test. All were assessed at baseline, post-intervention, and 6-month follow-up. RESULTS After intervention, the telerehabilitation group had significantly improved distances (d = 0.92, P < 0.001) as well as percentage of predicted of the 6-min walk test (d = 0.93, P < 0.001) compared with the control group. Significant improvement was also observed favoring the telerehabilitation group for the number of consonants recalled in total compared with the control group (d = 0.47, P = 0.04). These findings were maintained after 6-month follow-up (d = 0.80, P = 0.001; d = 0.76, P = 0.002; and d = 0.57, P = 0.02, respectively). Analysis was based on intention-to-treat principle. CONCLUSIONS These findings support the effectiveness of a telehealth system based on an 8-week physical exercise to achieve improvements and maintain them after 6-month follow-up in terms of functional and cognitive performance in breast cancer survivors. This broad-reach modality could help the growing number of cancer survivors to face their disabling side effects.
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Affiliation(s)
- Noelia Galiano-Castillo
- Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain.,Sport and Health Research Center (CIDS), Granada, Spain
| | - Manuel Arroyo-Morales
- Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain. .,Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain. .,Sport and Health Research Center (CIDS), Granada, Spain.
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain
| | - Carolina Fernández-Lao
- Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain.,Sport and Health Research Center (CIDS), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain
| | | | - Irene Cantarero-Villanueva
- Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.,Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain.,Sport and Health Research Center (CIDS), Granada, Spain
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Lozano-Lozano M, Martín-Martín L, Galiano-Castillo N, Álvarez-Salvago F, Cantarero-Villanueva I, Fernández-Lao C, Sánchez-Salado C, Arroyo-Morales M. Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial. BMC Med Inform Decis Mak 2016; 16:150. [PMID: 27887610 PMCID: PMC5124301 DOI: 10.1186/s12911-016-0394-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/22/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Technological support using e-health mobile applications (m-health) is a promising strategy to improve the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus an integral strategy to improve Quality of Life in breast cancer survivors. METHODS This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema. DISCUSSION This study has been designed to seek to address the new needs for support and treatment of breast cancer survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of health professionals in this type of patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016).
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Affiliation(s)
- Mario Lozano-Lozano
- Department Physical Therapy, University of Granada, Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain
| | | | - Noelia Galiano-Castillo
- Department Physical Therapy, University of Granada, Granada, Spain.,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain
| | | | - Irene Cantarero-Villanueva
- Department Physical Therapy, University of Granada, Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain.,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department Physical Therapy, University of Granada, Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain.,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain
| | | | - Manuel Arroyo-Morales
- Department Physical Therapy, University of Granada, Granada, Spain. .,Mixed University Sport and Health Institute (iMUDS), Granada, Spain. .,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain.
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