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Klemm P, Schulz N, Boettger P, Lange U. Heat therapy in rheumatic and musculoskeletal diseases - an overview of clinical and molecular effects. Int J Hyperthermia 2024; 41:2322667. [PMID: 38439192 DOI: 10.1080/02656736.2024.2322667] [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: 08/28/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
Rheumatic and musculoskeletal diseases (RMDs) usually lead to morphological and functional deficits of various extend, increased morbidity and a considerable loss of quality of life. Modern pharmacological treatment has become effective and can stop disease progression. Nonetheless, disease progression is often only slowed down. Moreover, pharmacological treatment does not improve functionality per se. Therefore, multimodal treatment of rheumatic disorders with physical therapy being a key element is of central importance for best outcomes. In recent years, research into physical medicine shifted from a sole investigation of its clinical effects to a combined investigation of clinical effects and potential changes in the molecular level (e.g., inflammatory cytokines and the cellular autoimmune system), thus offering new explanations of clinical effects of physical therapy. In this review we provide an overview of studies investigating different heat applications in RMDs, their effect on disease activity, pain and their influence on the molecular level.
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Affiliation(s)
- Philipp Klemm
- Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany
| | - Nils Schulz
- Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany
| | - Priyanka Boettger
- Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany
| | - Uwe Lange
- Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany
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Martínez-Ramos S, García S. An update of murine models and their methodologies in immune-mediated joint damage and pain research. Int Immunopharmacol 2024; 128:111440. [PMID: 38176343 DOI: 10.1016/j.intimp.2023.111440] [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: 11/15/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
Murine models have played an indispensable role in the understanding of rheumatic and musculoskeletal disorders (RMD), elucidating the genetic, endocrine and biomechanical pathways involved in joint pathology and associated pain. To date, the available models in RMD can be classified as induced or spontaneous, both incorporating transgenic alternatives that improve specific insights. It is worth noting that the selection of the most appropriate model together with the evaluation of their specific characteristics and technical capabilities are crucial when designing the experiments. Furthermore, it is also imperative to consistently adhere to the ethical standards concerning animal experimentation. Recognizing the inherent limitation that any model can entirely encapsulates the complexity of the pathophysiology of these conditions, the aim of this review is to provide an updated overview on the methodology of current murine models in major arthropathies and their immune-mediated pathways, addressing to basic, translational and pharmacological research in joint damage and pain.
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Affiliation(s)
- Sara Martínez-Ramos
- Rheumatology & Immuno-mediated Diseases Research Group (IRIDIS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain; Rheumatology Department, University Hospital Complex of Vigo, Vigo, Spain.
| | - Samuel García
- Rheumatology & Immuno-mediated Diseases Research Group (IRIDIS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain; Rheumatology Department, University Hospital Complex of Vigo, Vigo, Spain
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Bixio R, Bertelle D, Bertoldo E, Morciano A, Rossini M. The potential pathogenic role of gut microbiota in rheumatic diseases: a human-centred narrative review. Intern Emerg Med 2023:10.1007/s11739-023-03496-1. [PMID: 38141117 DOI: 10.1007/s11739-023-03496-1] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
A growing amount of evidence suggests that gut microbiota plays an important role in human health, including a possible role in the pathogenesis of rheumatic and musculoskeletal diseases (RMD). We analysed the current evidence about the role of microbiota in rheumatoid arthritis (RA), spondyloarthritis (SpA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). In RA, we found a general consensus regarding a reduction of diversity and a specific bacterial signature, with consistent changes according to the different ethnic and geographical areas. The major pathogenetic role in RA is recognised for P. copri, L. salivarius and Collinsella, even if findings become more heterogeneous when considering established disease. In SpA, we found a relative gut abundance of Akkermansia, Coprococcus, Ruminoccocus and a relative reduction in Bacterioides and Firmicutes spp. Human and preclinical data suggest loss of mucosal barrier, increased permeability and Th1- and Th17-mediated inflammation. Additionally, HLA-B27 seems to play a role in shaping the intestinal microbiota and the consequent inflammation. In SLE, the typical gut microbiota signature was characterised by a reduction in the Firmicutes/Bacteroidetes ratio and by enrichment of Rhodococcus, Eggerthella, Klebsiella, Prevotella, Eubacterium and Flavonifractor, even if their real pathogenic impact remains unclear. In SSc, gastrointestinal dysbiosis is well documented with an increase of pro-inflammatory species (Fusobacterium, Prevotella, Ruminococcus, Akkermansia, γ-Proteobacteria, Erwinia, Trabsulsiella, Bifidobacterium, Lactobacillus, Firmicutes and Actinobacteria) and a reduction of species as Faecalibacterium, Clostridium, Bacteroidetes and Rikenella. In conclusion, seems possible to recognise a distinct gut microbiota profile for each RMD, even if significant differences in bacterial species do exist between different studies and there is a high risk of bias due to the cross-sectional nature of such studies. Therefore longitudinal studies are needed, especially on patients with preclinical and early disease, to investigate the real role of gut microbiota in the pathogenesis of RMD.
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Affiliation(s)
- Riccardo Bixio
- Rheumatology Section, Department of Medicine, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy.
| | - Davide Bertelle
- Rheumatology Section, Department of Medicine, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
- Rheumatology Section, Department of Medicine, Azienda Ospedaliera Friuli Occidentale, Pordenone, Italy
| | - Eugenia Bertoldo
- Rheumatology Section, Department of Medicine, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
- Internal Medicine Unit, Department of Medicine, Mater Salutis Hospital, Legnago, Italy
| | - Andrea Morciano
- Rheumatology Section, Department of Medicine, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Section, Department of Medicine, University of Verona, P.Le L.A. Scuro 10, 37134, Verona, Italy
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Madrid-García A, Merino-Barbancho B, Rodríguez-González A, Fernández-Gutiérrez B, Rodríguez-Rodríguez L, Menasalvas-Ruiz E. Understanding the role and adoption of artificial intelligence techniques in rheumatology research: An in-depth review of the literature. Semin Arthritis Rheum 2023; 61:152213. [PMID: 37315379 DOI: 10.1016/j.semarthrit.2023.152213] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/21/2022] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/16/2023]
Abstract
The major and upward trend in the number of published research related to rheumatic and musculoskeletal diseases, in which artificial intelligence plays a key role, has exhibited the interest of rheumatology researchers in using these techniques to answer their research questions. In this review, we analyse the original research articles that combine both worlds in a five- year period (2017-2021). In contrast to other published papers on the same topic, we first studied the review and recommendation articles that were published during that period, including up to October 2022, as well as the publication trends. Secondly, we review the published research articles and classify them into one of the following categories: disease identification and prediction, disease classification, patient stratification and disease subtype identification, disease progression and activity, treatment response, and predictors of outcomes. Thirdly, we provide a table with illustrative studies in which artificial intelligence techniques have played a central role in more than twenty rheumatic and musculoskeletal diseases. Finally, the findings of the research articles, in terms of disease and/or data science techniques employed, are highlighted in a discussion. Therefore, the present review aims to characterise how researchers are applying data science techniques in the rheumatology medical field. The most immediate conclusions that can be drawn from this work are: multiple and novel data science techniques have been used in a wide range of rheumatic and musculoskeletal diseases including rare diseases; the sample size and the data type used are heterogeneous, and new technical approaches are expected to arrive in the short-middle term.
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Affiliation(s)
- Alfredo Madrid-García
- Grupo de Patología Musculoesquelética. Hospital Clínico San Carlos, Prof. Martin Lagos s/n, Madrid, 28040, Spain; Escuela Técnica Superior de Ingenieros de Telecomunicación. Universidad Politécnica de Madrid, Avenida Complutense, 30, Madrid, 28040, Spain.
| | - Beatriz Merino-Barbancho
- Escuela Técnica Superior de Ingenieros de Telecomunicación. Universidad Politécnica de Madrid, Avenida Complutense, 30, Madrid, 28040, Spain
| | | | - Benjamín Fernández-Gutiérrez
- Grupo de Patología Musculoesquelética. Hospital Clínico San Carlos, Prof. Martin Lagos s/n, Madrid, 28040, Spain
| | - Luis Rodríguez-Rodríguez
- Grupo de Patología Musculoesquelética. Hospital Clínico San Carlos, Prof. Martin Lagos s/n, Madrid, 28040, Spain
| | - Ernestina Menasalvas-Ruiz
- Centro de Tecnología Biomédica. Universidad Politécnica de Madrid, Pozuelo de Alarcón, Madrid, 28223, Spain
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Barnett R, Clarke C, Sengupta R, Rouse PC. Protocol for a systematic literature review of smartphone apps to support the self-management of rheumatic and musculoskeletal diseases: development strategies, theoretical underpinnings and barriers to engagement. Syst Rev 2023; 12:129. [PMID: 37516896 PMCID: PMC10385957 DOI: 10.1186/s13643-023-02276-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 06/18/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Rheumatic and musculoskeletal diseases (RMDs) cause significant burden to the individual and society, requiring lifelong management and specialist healthcare resource use. Costing over 200 billion euros per year in Europe, RMDs are the most expensive of all diseases for European healthcare systems. The incidence and burden of RMDs are projected to rise with the ageing global population and increase in sedentary, obesogenic lifestyles. In parallel, there is a global crisis in the rheumatology workforce, whereby capacity to deliver specialist care is being exceeded by demand. Pervasive, scalable mobile health technologies, such as apps, are being developed to support the self-management of RMDs and reduce pressure on healthcare services. However, it is unknown whether these apps are informed by theory or their use supported by an appropriate evidence base. The purpose of this review is therefore to provide a comprehensive overview of the development strategies, interventional components and theoretical underpinnings of existing smartphone apps, designed to support the self-management of RMDs. METHODS Searches will be conducted within PubMed, Scopus, Web of Science, Embase, MEDLINE and PsycINFO. Reference lists and citing articles of the included studies will be searched. Identified publications will be screened for eligibility by two independent reviewers. Any discrepancies between reviewers will be resolved by consensus, with input from a third reviewer if required. Data will be extracted on study designs, methods, populations, setting, utilised theoretical frameworks, intervention components, behaviour change techniques, methods to evaluate effectiveness and barriers/facilitators to intervention engagement. Exploratory outcomes include reported effectiveness, acceptability and usability. A systematic, narrative synthesis of evidence will be presented. If appropriate (depending on quality and pool of evidence identified), qualitative meta-summary techniques will be used to combine and summarise qualitative findings regarding barriers/facilitators to intervention engagement. DISCUSSION The results of this systematic literature review will provide insights for healthcare professionals, researchers, app designers and policy makers, to inform future development and implementation of smartphone apps to support self-management of RMDs. Evidence gaps for future research will be identified. Findings will be disseminated through a final manuscript/publication of results and via a conference abstract, patient organisations and social media. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022359704.
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Affiliation(s)
- Rosemarie Barnett
- Department for Health, University of Bath, Bath, UK.
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
| | | | - Raj Sengupta
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
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Berdal G, Sand-Svartrud AL, Linge AD, Aasvold AM, Tennebø K, Eppeland SG, Hagland AS, Ohldieck-Fredheim G, Valaas HL, Bø I, Klokkeide Å, Sexton J, Azimi M, Dager TN, Kjeken I. Bridging gaps across levels of care in rehabilitation of patients with rheumatic and musculoskeletal diseases: Results from a stepped-wedge cluster randomized controlled trial. Clin Rehabil 2023:2692155231153341. [PMID: 36862585 PMCID: PMC10387727 DOI: 10.1177/02692155231153341] [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] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To compare the effectiveness of a structured goal-setting and tailored follow-up rehabilitation intervention with existing rehabilitation in patients with rheumatic and musculoskeletal diseases. DESIGN A pragmatic stepped-wedge cluster randomized trial. SETTING Eight rehabilitation centers in secondary healthcare, Norway. PARTICIPANTS A total of 374 adults with rheumatic and musculoskeletal diseases were included in either the experimental (168) or the control group (206). INTERVENTIONS A new rehabilitation intervention which comprised structured goal setting, action planning, motivational interviewing, digital self-monitoring of goal progress, and individual follow-up support after discharge according to patients' needs and available resources in primary healthcare (the BRIDGE-intervention), was compared to usual care. MAIN MEASURES Patient-reported outcomes were collected electronically on admission and discharge from rehabilitation, and after 2, 7, and 12 months. The primary outcome was patients' goal attainment measured by the Patient Specific Functional Scale (0-10, 10 best) at 7 months. Secondary outcome measures included physical function (30-s Sit-To-Stand test), health-related quality of life (EQ-5D-5L-index), and self-assessed health (EQ-VAS). The main statistical analyses were performed on an intention-to-treat basis using linear mixed models. RESULTS No significant treatment effects of the BRIDGE-intervention were found for either primary (Patient Specific Functional Scale mean difference 0.1 [95% CI: -0.5, 0.8], p = 0.70), or secondary outcomes 7 months after rehabilitation. CONCLUSION The BRIDGE-intervention was not shown to be more effective than existing rehabilitation for patients with rheumatic and musculoskeletal diseases. There is still a need for more knowledge about factors that can improve the quality, continuity, and long-term health effects of rehabilitation for this patient group.
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Affiliation(s)
- Gunnhild Berdal
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 11316Diakonhjemmet Hospital, Oslo, Norway
| | - Anne-Lene Sand-Svartrud
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 11316Diakonhjemmet Hospital, Oslo, Norway
| | - Anita Dyb Linge
- 574813Muritunet Rehabilitation Centre, Valldal, Ålesund, Norway
| | | | - Kjetil Tennebø
- 158956Valnesfjord Health Sports Centre, Valnesfjord, Norway
| | - Siv G Eppeland
- Department of Physiotherapy, Sørlandet Hospital, Arendal, Norway
| | | | | | | | - Ingvild Bø
- Department of Rehabilitation, Hospital for Rheumatic Diseases, Lillehammer, Norway
| | - Åse Klokkeide
- Rehabilitering Vest Rehabilitation Centre, Haugesund, Norway
| | - Joseph Sexton
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 11316Diakonhjemmet Hospital, Oslo, Norway
| | - Maryam Azimi
- REMEDY Patient Advisory Board, Diakonhjemmet Hospital, Oslo, Norway
| | - Turid N Dager
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 11316Diakonhjemmet Hospital, Oslo, Norway
| | - Ingvild Kjeken
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 11316Diakonhjemmet Hospital, Oslo, Norway
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Melis MR, El Aoufy K, Bambi S, Bruni C, Guiducci S, Bellando-Randone S, Matucci-Cerinic M, Rasero L. Nursing interventions for patients with rheumatic and musculoskeletal diseases on biological therapies: a systematic literature review. Clin Rheumatol 2023. [PMID: 36801986 DOI: 10.1007/s10067-023-06520-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/21/2023]
Abstract
Investigating unmet needs and identifying the necessary interventions for patients affected by rheumatic and musculoskeletal diseases (RMDs) may help significantly to ensure the continuity and quality of the chronic care pathway. To this aim, the contribution of rheumatology nurses requires further evidence. The aim of our systematic literature review (SLR) was to identify the nursing interventions directed towards patients with RMDs undergoing biological therapy. To retrieve data, a search was carried out in the MEDLINE database, the Cumulative Index to Nursing and Allied Health Literature (CINAHL database), the APA PsycINFO database and the Excerpta Medica Database (EMBASE) from 1990 to 2022. The systematic review was carried out in accordance with the relevant PRISMA guidelines. Inclusion criteria were as follows: (I) adult patients with RMDs, (II) undergoing therapy with Biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs), (III) original and quantitative research papers in English with available abstract, (IV) specific to nursing interventions and/or outcomes. Two independent reviewers screened the identified records for eligibility according to their title and abstract, full texts were subsequently assessed and, finally, data was extracted. Critical Appraisal Skills Programme (CASP) tools were used to evaluate the quality of the studies included. Among the 2348 records retrieved, 13 articles met the inclusion criteria. These consisted of six randomised controlled trials (RCTs), one pilot study and six observational studies on RMDs. In a total population of 2004 patients, 43% (862/2004) of the cases concerned rheumatoid arthritis (RA) and 56% (1122/2004) of the cases concerned spondyloarthritis (SpA). Three major nursing interventions were identified, namely education, patient-centred care and data collection/nurse monitoring, which were correlated with high satisfaction rates regarding care, increased self-care capacity and treatment adherence among patients. All interventions followed a protocol defined in collaboration with rheumatologists. The large degree of heterogeneity in the interventions did not allow the performance of a meta-analysis. Rheumatology nurses are part of a multidisciplinary team caring for patients with RMDs. Following an accurate initial nursing evaluation, rheumatology nurses can plan and standardise their interventions focusing primarily on patient education and personalised care based on actual needs, such as psychological well-being and disease control. However, the training for rheumatology nurses should define and standardise, as much as possible, the competencies required for the detection of disease parameters. Key Points • This SLR provides an overview of nursing interventions for patients with RMDs. • This SLR considers the specific population of patients on biological therapies. • Training for rheumatology nurses should standardise, as much as possible, the knowledge and methods required for detecting disease parameters. • This SLR highlights the various competencies of rheumatology nurses.
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Valaas HL, Klokkerud M, Hildeskår J, Hagland AS, Kjønli E, Mjøsund K, Øie L, Wigers SH, Eppeland SG, Høystad TØ, Klokkeide Å, Larsen M, Kjeken I. Follow-up care and adherence to self-management activities in rehabilitation for patients with rheumatic and musculoskeletal diseases: results from a multicentre cohort study. Disabil Rehabil 2022; 44:8001-8010. [PMID: 34846264 DOI: 10.1080/09638288.2021.2008523] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Follow-up care (FU-care) and self-management are recognized as important to ensure prolonged effects of rehabilitation. Objectives of this study were to explore current FU-care and self-management after specialized rehabilitation for patients with rheumatic and musculoskeletal diseases. MATERIALS AND METHODS This multicentre cohort study included 523 patients who self-reported need and plans for FU-care and plans for self-management activities (SMAs) at rehabilitation discharge. The FU-care received and adherence to SMA were self-reported after 4-, 8-, and 12-months. Predictors for received FU-care and adherence to SMA were explored in multiple logistic regression models. RESULTS Plans for FU-care were significantly associated with received FU-care. Younger age, better coping skills, and performing regular social activities and hobbies were significant predictors for received FU-care. Throughout the follow-up year, 221 (51%) participants had adherence to their SMA plans. Older age, regular physical activity, more severe pain, and performing regular social activities and hobbies were significant predictors for adherence to SMA. Participants with SMA adherence more often reported planned FU-care, and more frequently received the FU-care they needed. CONCLUSIONS Planning FU-care should be integrated in specialized rehabilitation. Patients with poor coping skills and sedentary lifestyle may need more support over longer time to implement behavioral changes for healthy self-management.Implications for rehabilitationPlanning follow-up should be integrated in specialized rehabilitation as it supports self-management and receiving follow-up at home.Patients with sedentary lifestyle, poor coping skills, and depression may need more support over longer time to implement healthy self-management.Structure and routines in daily life enhance self-management.
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Affiliation(s)
- Helene Lindtvedt Valaas
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Mari Klokkerud
- Regional Center for Knowledge Translation in Rehabilitation, Sunnaas Hospital, Oslo, Norway
| | | | | | | | | | - Lars Øie
- North-Norway Rehabilitation Centre, Tromsø, Norway
| | | | | | | | | | - Mona Larsen
- The Norwegian Rheumatism Association, Oslo, Norway
| | - Ingvild Kjeken
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Valaas HL, Klokkerud M, Hildeskår J, Hagland AS, Kjønli E, Mjøsund K, Øie L, Wigers SH, Eppeland SG, Høystad TØ, Klokkeide Å, Larsen M, Kjeken I. Rehabilitation goals described by patients with rheumatic and musculoskeletal diseases: content and attainment during the first year after rehabilitation. Disabil Rehabil 2022; 44:7947-7957. [PMID: 34854330 DOI: 10.1080/09638288.2021.2003879] [Citation(s) in RCA: 2] [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] [Indexed: 01/18/2023]
Abstract
PURPOSE We explored the content and attainment of rehabilitation goals the first year after rehabilitation among patients with rheumatic and musculoskeletal diseases. METHODS Participants (n = 523) recorded goals in the Patient Specific Functional Scale at admission and reported goal attainment at admission, discharge, and 12 months after rehabilitation on an 11-point numeric rating scale. Goal content was linked to the ICF coding system and summarized as high, maintained, or no attainment. Changes in absolute scores were investigated using paired samples t-tests. RESULTS Goals had high attainment with a significant positive change (-1.83 [95% CI -2.0, -1.65], p > 0.001) during rehabilitation, whereas goals had no attainment with a significant negative change (0.36 [0.14, 0.57], p > 0.001) between discharge and 12 months after rehabilitation. Goals focusing on everyday routines, physical health, pain management, and social or work participation were highly attained during rehabilitation. Goals that were difficult to enhance or maintain after rehabilitation addressed everyday routines, physical health, and work participation. CONCLUSION The positive changes in goal attainment largely occurred during rehabilitation, but they appeared more difficult to maintain at home. Therefore, rehabilitation goals should be reflected in the follow-up care planned at discharge.Implications for rehabilitationThe contents of rehabilitation goals reflect the complexity and wide range of challenges patients with rheumatic and musculoskeletal diseases experience.Positive changes in goal attainment largely occur during rehabilitation and appear to be more difficult to enhance or maintain at home.Rehabilitation interventions and follow-up care should be tailored to support patients in maintaining their attained goals for healthy self-management.Rehabilitation goals should be reflected in the follow-up care planned at discharge.
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Affiliation(s)
- Helene Lindtvedt Valaas
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Mari Klokkerud
- Regional Center for Knowledge Translation in Rehabilitation, Sunnaas Hospital, Oslo, Norway
| | | | | | | | | | - Lars Øie
- North-Norway Rehabilitation Centre, Tromsø, Norway
| | | | | | | | | | - Mona Larsen
- The Norwegian Rheumatism Association, Oslo, Norway
| | - Ingvild Kjeken
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Luque-Reca O, Soriano-Maldonado A, Gavilán-Carrera B, Acosta-Manzano P, Ariza-Vega P, Del Paso GAR, Álvarez-Gallardo IC, Estévez-López F. Longitudinal associations of physical fitness and affect with depression, anxiety and life satisfaction in adult women with fibromyalgia. Qual Life Res 2022; 31:2047-2058. [PMID: 35098387 DOI: 10.1007/s11136-021-03058-y] [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] [Accepted: 11/28/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE This study analysed the longitudinal associations of physical fitness and affect with depression, anxiety and life satisfaction at 2- and 5-year follow-up. METHODS In 312 adult women with fibromyalgia, physical fitness was measured by performance-based tests and affect, depression, anxiety and life satisfaction were self-reported using the Positive and Negative Affect Schedule (PANAS), Beck Depression Inventory-second edition (BDI-II), State Trait Anxiety Inventory-I (STAI) and Satisfaction with Life Scale (SWLS), respectively. We conducted sequential linear regression analyses adjusted for baseline levels of depression, anxiety, life satisfaction, age, body fat percentage and education. RESULTS At the 2-year follow-up, all the associations under study were significant. At the 5-year follow-up, a number of associations remained significant. First, lowering negative affect was independently associated with lower depression, anxiety and higher life satisfaction (β's from 0.14 to 0.31). Second, favourable changes in positive affect were independently associated with lower anxiety (β = 0.21) and higher life satisfaction (β = 0.28). Third, enhancing physical fitness was related to higher life satisfaction (β = 0.16). CONCLUSION Reductions in negative affect were associated with more favourable depression, anxiety and life satisfaction at the 2- and 5-year follow-up. Improvements in positive affect were associated with more favourable anxiety and life satisfaction and enhancements in physical fitness were associated with higher life satisfaction. If corroborated in clinical-experimental research, these findings may guide the development of interventions that are tailored to the levels of physical fitness, affect and the outcome of interest (i.e. depression, anxiety or life satisfaction) in women with fibromyalgia.
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Affiliation(s)
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain.
| | - Blanca Gavilán-Carrera
- Physical Activity for Health Promotion Research Group (PA-HELP), Department of Physical Education and Sport, Faculty of Sport Sciences and Sport and Health University Research Institute (iMUDS), Granada, Spain.,Department of Physical Education, Faculty of Education Sciences and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain
| | - Pedro Acosta-Manzano
- Physical Activity for Health Promotion Research Group (PA-HELP), Department of Physical Education and Sport, Faculty of Sport Sciences and Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Patrocinio Ariza-Vega
- Occupational Therapy Division, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Inmaculada C Álvarez-Gallardo
- Department of Physical Education, Faculty of Education Sciences and Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Cádiz, Spain
| | - Fernando Estévez-López
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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11
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Gobejishvili N, Gogilashvili T, Khechuashvili S, Nikoladze S, Shanava Z, Tserodze A, Kukuladze T, Bakradze M, Makaridze L. Rheumatic and Musculoskeletal Diseases (RMDs) Public Awareness Program of Georgia 2019-2020. Clin Rheumatol 2021; 41:935-937. [PMID: 34779966 DOI: 10.1007/s10067-021-05987-y] [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: 03/08/2021] [Revised: 10/31/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
The program's goal is to launch the platform of positive perspectives for people who are suffering from/working in rheumatic and musculoskeletal diseases through the "Don't Delay, Connect Today" campaign. The original campaign toolkit 2018 was primarily used to guide the design of the program. A questionnaire and special sheets were created to measure the program's expected outcomes/effectiveness and the possible distribution of rheumatic diseases across Georgia. All targeted sides were engaged during the program, including the governmental bodies, more than 30 municipalities, and several clinical bases of regional and central Georgia. A total of 873 people in general have been made aware during the program. A total of 37,539 of disease-suspected cases in total were calculated from the 6 regions of Georgia within the program. National-level communications are currently ongoing. The program raised public awareness, promoted "umbrella" interconnection among the interconnected sides, and increased the possibility of effective outcomes through national advocacy actions with a primary emphasis on timely diagnosis and access to appropriate care.
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Affiliation(s)
- Nino Gobejishvili
- Health Center, Tbilisi, Georgia. .,Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.
| | - Tamar Gogilashvili
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,High Technology Medical Center, University Clinic, Tbilisi, Georgia
| | - Sofio Khechuashvili
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,EVEX CLINICS, Tbilisi, Georgia
| | - Sopio Nikoladze
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,LJ Clinic, Kutaisi, Georgia
| | - Zita Shanava
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,EVEX CLINICS, Zugdidi, Georgia
| | - Ana Tserodze
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,SAGITTARIUS Marine Medical Center, Batumi, Georgia
| | - Tea Kukuladze
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,Aversi Clinic, Tbilisi, Georgia
| | - Marika Bakradze
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,Aversi Clinic, Tbilisi, Georgia
| | - Lali Makaridze
- Georgian Young Rheumatologists Union (SARG), Tbilisi, Georgia.,St. Nicholas Center for Surgery, Kutaisi, Georgia
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12
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Maxwell LJ, Beaton DE, Boers M, D'Agostino MA, Conaghan PG, Grosskleg S, Shea BJ, Bingham Iii CO, Boonen A, Christensen R, Choy E, Doria AS, Hill CL, Hofstetter C, Kroon FP, Leung YY, Mackie S, Meara A, Touma Z, Tugwell P, Wells GA. The evolution of instrument selection for inclusion in core outcome sets at OMERACT: Filter 2.2. Semin Arthritis Rheum 2021; 51:1320-1330. [PMID: 34544617 DOI: 10.1016/j.semarthrit.2021.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 05/03/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION OMERACT uses an evidence-based framework known as the 'OMERACT Filter Instrument Selection Algorithm' (OFISA) to guide decisions in the assessment of outcome measurement instruments for inclusion in a core outcome set for interventional and observational clinical trials. METHODS A group of OMERACT imaging and patient-centered outcome methodologists worked with imaging outcome groups to facilitate the selection of imaging outcome measurement instruments using the OFISA approach. The lessons learned from this work influenced the evolution to Filter 2.2 and necessitated changes to OMERACT's documentation and processes. RESULTS OMERACT has revised documentation and processes to incorporate the evolution of instrument selection to Filter 2.2. These revisions include creation of a template for detailed definitions of the target domain which is a necessary first step for instrument selection, modifications to the Summary of Measurement Properties (SOMP) table to account for sources of variability, and development of standardized reporting tables for each measurement property. CONCLUSIONS OMERACT Filter 2.2 represents additional modifications of the OMERACT guide for working groups in their rigorous assessment of measurement properties of instruments of various types, including imaging outcome measurement instruments. Enhanced reporting aims to increase the transparency of the evidence base leading to judgements for the endorsement of instruments in core outcome sets.
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Affiliation(s)
- Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Dorcas E Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Maarten Boers
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maria Antonietta D'Agostino
- Università Cattolica del Sacro Cuore, Rome, Italy; Rheumatology UOC, IRCSS, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy; Inserm U1173, Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay UVSQ, Montigny-le-Bretonneux, France
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, UK
| | | | - Beverley J Shea
- Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Clifton O Bingham Iii
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | - Ernest Choy
- CREATE Centre and Section of Rheumatology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Andrea S Doria
- The Hospital for Sick Children, Medical Imaging Department, University of Toronto, Toronto, Canada
| | - Catherine L Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | | | - Féline Pb Kroon
- Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ying Ying Leung
- Department of Rheumatology & Immunology, Singapore General Hospital; Duke-NUS Medical School, Singapore
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alexa Meara
- Division of Rheumatology and Immunology, Ohio State University, Wexner Medical Centre, Columbus, Ohio, United States
| | - Zahi Touma
- Division of Rheumatology, Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Peter Tugwell
- Division of Rheumatology, Department of Medicine, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - George A Wells
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
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13
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Bos WH, van Tubergen A, Vonkeman HE. Telemedicine for patients with rheumatic and musculoskeletal diseases during the COVID-19 pandemic; a positive experience in the Netherlands. Rheumatol Int 2021; 41:565-573. [PMID: 33449162 PMCID: PMC7809638 DOI: 10.1007/s00296-020-04771-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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: 10/27/2020] [Accepted: 12/10/2020] [Indexed: 12/14/2022]
Abstract
To describe the delivery of care for patients with rheumatic and musculoskeletal diseases (RMDs) from the perspective of rheumatologists in the Netherlands during the first months of the COVID-19 pandemic. A mixed methods design was used with quantitative and qualitative data from a cross-sectional survey sent to all members of the Dutch Rheumatology Society in May 2020. The survey contained questions on demographics, the current way of care delivery, and also on usage, acceptance, facilitators and barriers of telemedicine. Quantitative data were analyzed descriptively. The answers to the open questions were categorized into themes. Seventy-five respondents completed the survey. During the COVID-19 pandemic, continuity of care was guaranteed through telephone and video consultations by 99% and 9% of the respondents, respectively. More than 80% of the total number of outpatient visits were performed exclusively via telephone with in-person visits only on indication. One-quarter of the respondents used patient reported outcomes to guide telephone consultations. The top three facilitators for telemedicine were less travel time for patients, ease of use of the system and shorter waiting period for patients. The top three barriers were impossibility to perform physical examination, difficulty estimating how the patient is doing and difficulty in reaching patients. During the COVID-19 epidemic, care for patients with RMDs in the Netherlands continued uninterrupted by the aid of telemedicine. On average, respondents were content with current solutions, although some felt insecure mainly because of the inability to perform physical examination and missing nonverbal communication with their patients.
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Affiliation(s)
- Wouter H Bos
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands.
| | - Astrid van Tubergen
- Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Harald E Vonkeman
- Centre for eHealth and Well-Being Research, Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands.,Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherlands
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14
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Akintayo RO, Bahiri R, El Miedany Y, Olaosebikan H, Kalla AA, Adebajo AO, Migowa AN, Slimani S, Koussougbo OD, Kawther BA, Akpabio AA, Ghozlani I, Dey D, Hassan WA, Govind N, Makan K, Mohamed A, Genga EK, Ghassem MKA, Mortada M, Hamdi W, Wabi MO, Tikly M, Ngandeu-Singwe M, Scott C. African League Against Rheumatism (AFLAR) preliminary recommendations on the management of rheumatic diseases during the COVID-19 pandemic. Clin Rheumatol 2021; 40:3445-54. [PMID: 32876786 DOI: 10.1007/s10067-020-05355-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 12/15/2022]
Abstract
Objectives To develop recommendations for the management of rheumatic and musculoskeletal diseases (RMDs) during the COVID-19 pandemic. Method A task force comprising of 25 rheumatologists from the 5 regions of the continent was formed and operated through a hub-and-spoke model with a central working committee (CWC) and 4 subgroups. The subgroups championed separate scopes of the clinical questions and formulated preliminary statements of recommendations which were processed centrally in the CWC. The CWC and each subgroup met by several virtual meetings, and two rounds of voting were conducted on the drafted statements of recommendations. Votes were online-delivered and recommendations were pruned down according to predefined criteria. Each statement was rated between 1 and 9 with 1–3, 4–6 and 7–9 representing disagreement, uncertainty and agreement, respectively. The levels of agreement on the statements were stratified as low, moderate or high according to the spread of votes. A statement was retired if it had a mean vote below 7 or a ‘low’ level of agreement. Results A total of 126 initial statements of recommendations were drafted, and these were reduced to 22 after the two rounds of voting. Conclusions The preliminary statements of recommendations will serve to guide the clinical practice of rheumatology across Africa amidst the changing practices and uncertainties in the current era of COVID-19. It is recognized that further updates to the recommendations will be needed as more evidence emerges.Key Points • AFLAR has developed preliminary recommendations for the management of RMDs in the face of the COVID-19 pandemic. • COVID-19 is an unprecedented experience which has brought new concerns regarding the use of some disease-modifying anti-rheumatic drugs (DMARDs), and these recommendations seek to provide guidelines to the African rheumatologists. • Hydroxychloroquine shortage has become rampart across Africa as the drug is being used as prophylaxis against COVID-19 and this may necessitate a review of treatment plan for some patients with RMDs. • Breastfeeding should continue for as long as possible if a woman is positive for SARS-CoV-2 as there is currently no evidence that the infection can be transmitted through breast milk. |
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15
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Lunt LE, Bosworth A, Bezzant M, Walker-Bone K, Hyrich KL, Thomson W, McDonagh JE, Verstappen SMM. A UK study: vocational experiences of young adults with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17:54. [PMID: 31387599 PMCID: PMC6683541 DOI: 10.1186/s12969-019-0357-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 07/22/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Laura E. Lunt
- 0000000121662407grid.5379.8Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK ,0000 0004 0581 2008grid.451052.7NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust,, Manchester, UK
| | - Ailsa Bosworth
- National Rheumatoid Arthritis Society, (NRAS), Maidenhead, UK
| | - Matthew Bezzant
- National Rheumatoid Arthritis Society, (NRAS), Maidenhead, UK
| | - Karen Walker-Bone
- 0000 0004 1936 9297grid.5491.9Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Kimme L. Hyrich
- 0000000121662407grid.5379.8Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK ,0000 0004 0581 2008grid.451052.7NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust,, Manchester, UK
| | - Wendy Thomson
- 0000 0004 0581 2008grid.451052.7NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust,, Manchester, UK ,0000000121662407grid.5379.8Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK
| | - Janet E. McDonagh
- 0000000121662407grid.5379.8Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK ,0000 0004 0581 2008grid.451052.7NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust,, Manchester, UK
| | - Suzanne M. M. Verstappen
- 0000000121662407grid.5379.8Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK ,0000 0004 0581 2008grid.451052.7NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust,, Manchester, UK ,0000 0004 1936 9297grid.5491.9Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
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16
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Pulido-Martos M, Luque-Reca O, Segura-Jiménez V, Álvarez-Gallardo IC, Soriano-Maldonado A, Acosta-Manzano P, Gavilán-Carrera B, McVeigh JG, Geenen R, Delgado-Fernández M, Estévez-López F. Physical and psychological paths toward less severe fibromyalgia: A structural equation model. Ann Phys Rehabil Med 2019; 63:46-52. [PMID: 31386910 DOI: 10.1016/j.rehab.2019.06.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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: 12/13/2018] [Revised: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Previous research suggested isolated associations of physical and psychological factors with fibromyalgia severity. Integration of physical and psychological, experienced and observed, modifiable factors associated with fibromyalgia severity in a single model will reveal therapeutic paths toward less severity of disease. We aimed to examine an encompassing model of determinants of fibromyalgia severity. METHODS This observational, population-based cross-sectional study included 569 people with fibromyalgia. An integrative model of fibromyalgia severity was tested by using structural equation modelling. This model included 8 factors: resilience, catastrophizing, active lifestyle, declarative memory, subjective fitness, objective fitness, psychological distress, and physical fatigue. RESULTS Two core paths were associated with reduced fibromyalgia severity: 1) a psychological path connecting high resilience and low catastrophizing with low distress and 2) a physical path, connecting a more active lifestyle (directly and via high objective and subjective physical fitness) with low fatigue. Additional interconnecting paths especially suggested a connection from the psychological to physical path. Our model explained 83% of the fibromyalgia severity. CONCLUSIONS The present model integrated the complexity of mutually influencing factors of fibromyalgia severity, which may help to better understand the disease. It emphasised the importance of: 1) physical factors and psychological factors and their interconnections, 2) patients' experiences and clinical measurements, and 3) positive and negative signs such as physical fitness and distress. Future longitudinal and experimental research should aim at testing the causal direction of the associations in the model as well as the clinical implications suggested by the model. For instance, to reduce fatigue, exercise should enhance not only objective fitness but also fitness-related perceptions. Reducing distress and fatigue seems crucial for lowering fibromyalgia severity.
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Affiliation(s)
- Manuel Pulido-Martos
- Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaén, Jaén, Spain
| | - Octavio Luque-Reca
- Facultad de Educación y Psicología, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain.
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | | | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain; SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Joseph G McVeigh
- Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Rinie Geenen
- Department of Psychology, Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- Department of Psychology, Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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17
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Lamprecht J, Thyrolf A, Mattukat K, Schöpf AC, Schlöffel M, Farin E, Mau W. Disease-related everyday communication of persons with rheumatic and musculoskeletal diseases-Results of a participatory research project. Patient Educ Couns 2017; 100:667-672. [PMID: 27839889 DOI: 10.1016/j.pec.2016.10.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/05/2016] [Accepted: 10/30/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of the present study is to describe and analyse significant factors of disease-related everyday communication of persons with RMDs in a nationwide project in Germany funded by the Deutsche Rheumaliga Bundesverband e.V. (German League against Rheumatism). METHODS In this participatory research project four persons with RMDs are involved. An online questionnaire addressing context, difficulties, and burden of disease-related everyday communication was answered by 1.015 persons with RMDs. Social and communication skills were recorded by questionnaires to capture social insecurity and patient communication competence. RESULTS More than half of the participants reported difficulties in disease-related conversations across various situations. The majority of these persons suffer from this experience particularly in conversations at the work environment or with staff members of authorities. They feel unconfident especially in situations which require saying "no". Furthermore, compared to the general population persons with RMDs have more anxiety about contact with others. CONCLUSION Strengthening the social skills of persons with RMDs in conversations related to everyday situations can promote a self-determined life and contribute to the maintenance of social participation. PRATICE IMPLICATIONS Based on the results, a communication skills training for persons with RMDs will be developed.
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Affiliation(s)
- J Lamprecht
- Institute for Rehabilitation Medicine, Martin-Luther-University Halle-Wittenberg, Germany.
| | - A Thyrolf
- Institute for Rehabilitation Medicine, Martin-Luther-University Halle-Wittenberg, Germany
| | - K Mattukat
- Institute for Rehabilitation Medicine, Martin-Luther-University Halle-Wittenberg, Germany
| | - A C Schöpf
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - M Schlöffel
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - E Farin
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - W Mau
- Institute for Rehabilitation Medicine, Martin-Luther-University Halle-Wittenberg, Germany
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18
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Mandl P, Kainberger F, Friberg Hitz M. Imaging in osteoporosis in rheumatic diseases. Best Pract Res Clin Rheumatol 2016; 30:751-765. [PMID: 27931966 DOI: 10.1016/j.berh.2016.08.010] [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] [Received: 05/05/2016] [Revised: 06/06/2016] [Accepted: 08/04/2016] [Indexed: 12/25/2022]
Abstract
Osteoporosis is a common comorbidity of all major rheumatic diseases, and manifests itself both systemically and locally. Systemic bone loss manifests because of several factors, primarily inflammation, immobility, and commonly used medical treatment for rheumatic diseases. Local bone loss manifests as periarticular demineralization and bone erosion due to local release of inflammatory agents and cytokines, which promote bone resorption. All these factors contribute to the phenomenon of arthritis-associated osteoporosis. This review summarized the currently available and used methods that play a role in the diagnosis and monitoring of osteoporosis and in the detection of osteoporotic fractures.
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Affiliation(s)
- Peter Mandl
- Division of Rheumatology, 3rd Department of Internal Medicine, Medical University of Vienna, 18-20 Währinger Gürtel, 1090 Vienna, Austria.
| | - Franz Kainberger
- Division of Neuro- and Musculoskeletal Radiology, Department of Radiology and Nuclear Medicine, Medical University of Vienna, 18-20 Währinger Gürtel, 1090 Vienna, Austria.
| | - Mette Friberg Hitz
- Department of Medicine, Endocrinology, Zealand University Hospital, Lykkebaekvej 1, 4600 Koege, Denmark.
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