scholarly journals Jaw exercise therapy for the treatment of trismus in head and neck Cancer: a prospective three-year follow-up study

2020 ◽  
Author(s):  
Ove Karlsson ◽  
Therese Karlsson ◽  
Nina Pauli ◽  
Paulin Andréll ◽  
Caterina Finizia
Keyword(s):  
Quality Of Life ◽  
Exercise Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq

Abstract Purpose This study aims to examine effects of jaw exercise on trismus 3 years following completion of a post-radiotherapy jaw exercise intervention. Methods Prospective study including 50 patients with head-and-neck cancer receiving radiotherapy and/or chemotherapy, plus a matched control group. The intervention group underwent 10 weeks of jaw exercise training. Patients were followed pre-and postintervention and 3 years postintervention completion. Outcome measures were maximal interincisal opening (MIO), trismus-related symptoms, and health-related quality-of-life as measured by Gothenburg Trismus Questionnaire, EORTC QLQ-C30, and EORTC QLQ-H&N35. Results The intervention group had a statistically significantly higher mean MIO compared with the control group (40.1 mm and 33.9 mm, respectively, p < 0.001), reported less trismus-related problems and had an improved health-related quality-of-life when compared with the control group at the 3-year follow-up. These differences were all statistically significant. Conclusion Jaw exercise therapy resulted in increased MIO, less trismus-related symptoms, and improved health-related quality-of-life. Jaw exercise therapy should be initiated early, in a structured manner and continued long-term.

Effects of a nine-month occupational intervention on health-related quality of life

2017 ◽  
Vol 45 (4) ◽  
pp. 452-458
Author(s):  
Birgitta Ojala ◽  
Clas-Håkan Nygård ◽  
Heini Huhtala ◽  
Seppo T. Nikkari
Keyword(s):  
Quality Of Life ◽  
Intervention Group ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Base Line ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

The aim of this study was to evaluate the effectiveness of vocationally outpatient oriented rehabilitation on an intervention group, compared with a control group that did not take part in the intervention. The groups were compared for health-related quality of life (HRQoL) by the quantitative indicator RAND 36. Data were obtained by a self-report at baseline and at nine months follow-up. Differences between base-line and follow-up were analyzed within group and between the groups. The study population consisted of 751 municipal employees aged between 26 and 64 years; an intervention with 463 women and 115 men ( n = 578), and a control group with 138 women and 35 men ( n = 173). In this study we focused on those who had answered to all questions in RAND 36, thus 581 remained. Of these, 388 were in the intervention group (mean age 49.0 years) and 110 in the control group (mean age 48.4 years). Intervention was based on cognitive behavioral therapy. Participants in the 9-month outpatient intervention group showed statistically significant increase in all eight RAND 36 areas. Most improvement was seen in the psychosocial functioning index ( p = 0.002). Although there were no statistically significant changes in RAND 36 components in the control group, difference in changes between groups were seen in energy and fatigue ( p < 0.001), social functioning ( p = 0.032) and general health perceptions 0.027 in favor of the intervention group. The results suggest that a cognitive behavioral intervention as an early rehabilitation program is effective in increasing employees’ quality of life, as measured by RAND 36.

scholarly journals The course of peripheral neuropathy and its association with health-related quality of life among colorectal cancer patients

2020 ◽  
Author(s):  
Cynthia S. Bonhof ◽  
Lonneke V. van de Poll-Franse ◽  
Dareczka K. Wasowicz ◽  
Laurens V. Beerepoot ◽  
Gerard Vreugdenhil ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Peripheral Neuropathy ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
The Impact

Abstract Purpose To gain more insight into the course of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on health-related quality of life (HRQoL) in a population-based sample of colorectal cancer (CRC) patients up to 2 years after diagnosis. Methods All newly diagnosed CRC patients from four hospitals in the Netherlands were eligible for participation in an ongoing prospective cohort study. Patients (n = 340) completed questions on CIPN (EORTC QLQ-CIPN20) and HRQoL (EORTC QLQ-C30) before initial treatment (baseline) and 1 and 2 years after diagnosis. Results Among chemotherapy-treated patients (n = 105), a high sensory peripheral neuropathy (SPN) level was reported by 57% of patients at 1 year, and 47% at 2-year follow-up, whereas a high motor peripheral neuropathy (MPN) level was reported by 47% and 28%, at years 1 and 2, respectively. Linear mixed model analyses showed that SPN and MPN symptoms significantly increased from baseline to 1-year follow-up and did not return to baseline level after 2 years. Patients with a high SPN or MPN level reported a worse global quality of life and a worse physical, role, emotional, cognitive, and social functioning compared with those with a low SPN or MPN level. Conclusions Future studies should focus on understanding the mechanisms underlying CIPN so targeted interventions can be developed to reduce the impact of CIPN on patient’s lives. Implications for cancer survivors Patients need to be informed of both CIPN and the impact on HRQoL.

scholarly journals Integrated multidisciplinary diagnostic approach for dementia care: Randomised controlled trial

2008 ◽  
Vol 192 (4) ◽  
pp. 300-305 ◽  
Author(s):  
Claire A. G. Wolfs ◽  
Alfons Kessels ◽  
Carmen D. Dirksen ◽  
Johan L. Severens ◽  
F. R. J. Verhey
Keyword(s):  
Quality Of Life ◽  
Multidisciplinary Approach ◽  
Intervention Group ◽  
Dementia Care ◽  
Clinical Effects ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

BackgroundAn integrated multidisciplinary approach to dementia is often recommended but has rarely been evaluated.AimsTo evaluate the clinical effects of an integrated multidisciplinary diagnostic facility for psychogeriatric patients.MethodPatients suspected of having complex psychogeriatric problems were randomly allocated to the intervention (n=137) or to treatment as usual (n=93). They were assessed at baseline, and at 6 months and 12 months follow-up by means of personal interviews with the patient's proxy. The primary outcome was health-related quality of life, assessed using the visual analogue scale (VAS) of the EuroQd measure, EQ-5D.ResultsHealth-related quality of life had improved at 6 months in the intervention group, whereas that of the control group had decreased. Furthermore, more patients in the intervention group experienced a clinically relevant improvement of 10 points or more on the VAS at both follow-up measurements.ConclusionsAn integrated multidisciplinary approach improves dementia care.

scholarly journals Comparison of the Effectiveness of MindfulnessBased Stress Reduction Group Therapy With Acceptance and Commitment Therapy on Severity of Pain and Health-Related Quality of Life in Patients With Migraine

2019 ◽  
Vol 6 (3) ◽  
pp. 111-117
Author(s):  
Tahereh Haji Seyed Javadi ◽  
Najmeh Aghareb Parast ◽  
Sahar Shahsavani ◽  
Mir Javad Chehraghi ◽  
Leila Razavi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stress Reduction ◽  
Control Group ◽  
Health Related Quality ◽  
Acceptance And Commitment ◽  
Post Test ◽  
Related Quality ◽  
Health Related

Background: Considering the prevalence of migraine and its detrimental effects on functioning, physical health, and quality of life as well as its psychosocial and social risks. The purpose of this study was to compare the effectiveness of mindfulness-based stress reduction treatment with treatment based on acceptance and commitment to the severity of pain and health-related quality of life in migraine patients. Methods: In this study, a semi-experimental design used with pre-test, post-test, a 3-month follow-up, and a control group. Using purposive sampling and considering the inclusion criteria, 45 patients with migraine diagnosis selected from among those referring to the neurology department of Imam Hossein hospital in Tehran. They were then randomly assigned to two experimental groups and a control group. The first experimental group received group therapy based on mindfulness (n = 15; 90-minute sessions), the second experimental group received acceptance and commitment based intervention (n = 15; 90-minute sessions), and the control group (n = 15) received no intervention. All subjects responded to pain intensity and health-related quality of life questionnaires before the intervention (pre-test), after the intervention (post-test), and 3 months after the intervention (follow-up). One-way ANOVA analyzed the collected data. Results: The findings showed that mean scores for the 2 experimental groups were significantly different from the control group in the post-test and follow-up phases in terms of severity of pain and health-related quality of life, while the mean scores for the two experimental groups did not differ significantly. The results emphasize the importance of these interventions for chronic diseases and offer new horizons in clinical interventions. Conclusion: The results of this study showed that mindfulness-based stress reduction therapy and acceptance and commitment therapy could positively affect the severity of pain and health-related quality of life in migraine patients, and any of them can be used to improve the variables mentioned above.

scholarly journals Health-related quality of life after posterior vertebral column resection in children: comparison with healthy controls

2021 ◽  
Author(s):  
Johanna Syvänen ◽  
Linda Helenius ◽  
Arimatias Raitio ◽  
Paul Gerdhem ◽  
Elias Diarbakerli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Control Group ◽  
Healthy Controls ◽  
Health Related Quality ◽  
Curve Correction ◽  
Vertebral Column Resection ◽  
Related Quality ◽  
Health Related

Abstract Purpose Vertebral column resection (VCR) is a technique performed for short, angular spinal deformities. Several studies have reported good radiographic results with VCR regarding curve correction. However, only a few studies have reported the impact of this technique on the health-related quality-of-life measures (HRQoL). Methods A single surgeon series of 27 consecutive children (mean age at surgery 12.3 years, range 1.1–20.7 years) undergoing posterior VCR with a minimum of 2-year follow-up. The comparison was made to age- and gender-matched healthy controls. Outcome measures included Scoliosis Research Society (SRS) questionnaire both pre- and postoperatively, radiographic outcomes, and complications. Results The average major curve correction was 60.3% in the VCR patients. Complications were noted in 12 out of 27 (44%) of the VCR patients but all patients recovered fully during follow-up. The SRS pain domain scores improved significantly after VCR (p = 0.0002). The SRS total and domain scores were significantly lower than in the healthy controls especially in the self-image and function domains, but the pain and activity domains improved from preoperative to similar level than in the control group. Conclusions HRQoL showed significant improvement in pain scores despite 44% risk of transient complications after VCR in pediatric patients. This health-related quality-of-life improvement remained at a significantly lower level than in the healthy control group. Level of Evidence Therapeutic Level III.

scholarly journals Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on health-related quality of life among post-acute coronary syndrome patients: A randomized controlled trial

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Aliya Hisam ◽  
Zia Ul Haq ◽  
Sohail Aziz ◽  
Patrick Doherty ◽  
Jill Pell
Keyword(s):  
Quality Of Life ◽  
Cardiac Rehabilitation ◽  
Mobile Health ◽  
Control Group ◽  
Health Related Quality ◽  
Coronary Syndrome ◽  
Related Quality ◽  
Health Related

Objectives: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome (post-ACS) patients. Methods: At the Armed Forces Institute of Cardiology (AFIC), a tertiary care hospital in Rawalpindi, Pakistan, a two-arm randomised controlled trial was conducted in which mobile health augmented cardiac rehabilitation (MCard) was developed and implemented on post-ACS patients from January 2019 until March 2021. The trial conforms to the CONSORT statement 2010. The post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counselling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three time points (baseline, 12 weeks and 24 weeks). Results: At baseline, 160 patients (80 in each group; mean age 52.66±8.46 years; 126 male, 78.75%) were recruited, of which 121(75.62%) continued and were analysed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs control 43.87, p<.001) and 24 weeks (53.52 vs 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is an effective and acceptable intervention at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting. doi: https://doi.org/10.12669/pjms.38.3.4724 How to cite this:Hisam A, Zia-ul-Haq, Aziz S, Doherty P, Pell J. Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on health-related quality of life among post-acute coronary syndrome patients: A randomized controlled trial. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4724 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals 35. Health-related quality of life in COVID-19 survivors after 12 months, a prospective cohort study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S25-S26
Author(s):  
Sebastiaan Siegerink ◽  
Marië Nijpels ◽  
Sander Albers ◽  
Frédérique Jurgens ◽  
Felix K Pettai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Healthy Control ◽  
One Year

Abstract Background The long-term effects of COVID-19 are still unknown. This study aims to assess the impact of COVID-19 among survivors after one year. Methods All confirmed COVID-19 cases who presented at OLVG hospital in Amsterdam during the first wave of the COVID-19 pandemic were invited to participate in our prospective observational cohort study. The participants were divided into three subgroups: patients not admitted, admitted to the general ward and admitted to the ICU. Questionnaires were sent at 3, 6 and 12 months after presentation. We used the Research and Development – 36-item health survey, the Hospital Anxiety and Depression Scale and the PTSS Checklist for DSM-5. We compared the RAND-36 scores at the timepoints with a Dutch healthy control population in 2020 and between the three subgroups using the Kruskal-Wallis test and the Mann-Whitney U test. Results Of the 466 confirmed cases, 75 patients died of COVID-19, 64 patients were lost to follow up and 12 patients were excluded because they were unable to complete the questionnaires due to mental illness or cognitive impairment, they moved back to their home country or refused to participate. Of the remaining 315 patients, 182 (57.8%) completed the questionnaires at 3 months. Subsequently, 163 patients provided informed consent for follow up. At 6 and 12 months, 98 (60.1%) and 131 (80.4%) completed the survey. The average score of all domains at 3 months was 58, compared to 79 at twelve months and 81 in the control group. There was a statistically significant increase from 3 and 12 and 6 and 12 months (figure 1). At twelve months participants recovered to levels of the healthy control group (N=459), except for the ICU group, who still experienced bodily pain and decreased physical function. The improvement was most noticeable in the domains of social functioning, role limitations – physical and role limitations – emotional. The percentage of patients with abnormal total HADS scores (cutoff at 16) and PCL5- scores (cutoff at 33) at 3 months decreased from 27.8 to 22.1% and 18.9 to 7.6% at 12 months, respectively (figure 2 and 3). Figure 1. RAND-36: Health-related quality of life after COVID-19 of all patients. Blue line is after 3 months, orange line is after 6 months, green line is after 12 months, yellow line is healthy control. The p-value in the right-upper corner shows statistical significant difference between all total scores, the asterisks indicate significance between groups. PF = physical functioning; SF = social functioning; RP = role limitations–physical; RE = role limitations–emotional; MH = mental health; VT = vitality; BP = pain; GH = general health; HC = health change. Figure 2 The blue column is after 3 months, the orange after 6 months and the green after 12 months. The numbers above the columns are percentages per group. Figure 3 The blue column is after 3 months, the orange after 6 months and the green after 12 months. The numbers above the columns are percentages per group. Conclusion Although, COVID-19 may cause a decreased health-related quality of life and impaired mental health, this study shows important recovery up to normal levels after one year. Disclosures All Authors: No reported disclosures

scholarly journals 2203It is more than simple interventions needed to improve heart failure patients health related quality of life

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Lambrinou ◽  
A Protopapas ◽  
V Barberis ◽  
L Paikousis ◽  
M Kyriakou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Social Dimension ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Background In order to improve health-related quality of life (HR-QoL) of heart failure (HF) patients, different disease management programs have been developed at the discharged and follow-up phase. Aim To determine the effectiveness of a three-month telephone follow-up, a telephone follow-up with education before discharge, or education only before discharge (all performed by nurse specialists) on HR-QoL in HF patients. The results of the randomized clinical trial (RCT) MEETinCY are presented. Method This is a multicenter RCT with 3 different intervention groups (IGs) and one control group (CG) The first IG included only patients' education before discharge (E). The second IG included patients' education and telephone follow-up after discharge for three months (ET). The third IG included only telephone follow-up for three months (T). The Greek version of the MLHFQ was used. The statistical analysis of the impact of the intervention was done using ANCOVA. The magnitude of the effect of the intervention was studied with the Cohen's d coefficient for repeated measurements. The exploration of clinical and demographic factors in the relationship of HR-QoL was done by using linear coefficients of regression. The investigation of the robustness of the results and the intention to treat was carried out by sensitivity analysis. The management of missing value of the MLHFQ was done by using multiple imputation. Results The study included 334 patients. The analysis demonstrated that the study groups differentiates the level of HR-QoL post-intervention measurement in terms of the Overall QoL (F=2.8, 47, p=0.04). The mean level of Overall HR-QoL adjusted for the pre-intervention measurement, in the T: 40.3 (SE=2.2) and ET: 42 (2.2) groups was higher than that of the E group: 39 (2.2) and the CG: 47 (2). Study group differences were also detected statistically in the Social dimension (F=3.4, p=0.02) but not in in the Physical dimension (F=1.9, p=0.11) or the Emotional dimension (F=0.99, p=0.40). However, in the ET and T groups, higher adjusted average levels of the Physical and Social dimension are observed compared to the E and Control group. Overall, IGs exhibited low to moderate effect size improvements (drm = 0.4) while the CG had negligible improvement (drm = 0.02). Women exhibit lower overall HR-QoL scores compared to men by 13.9 points in the MLHFQ scale (b=13.9, p<0.015). NYHA IV (38.5, p<0.001), NYHA III (29.5, p<0.001) and NYHA II (9.15, p<0.001) patients exhibit worse overall HR-QoL compared to NYHA I patients. Conclusion Patients' education before discharge was not found to have an important role over the three- months telephone follow-up after discharge. On the other hand, improvement was found in patients who had the telephone intervention and the possibility to call researchers (nurses) whenever they needed. Patients seem to need continuing communication and support and to feel the availability of contacting and seeking help when needed. Acknowledgement/Funding Cyprus University of Technology's state funded budget [Startup Fund EX2007 (04)]

scholarly journals A Web-Based Self-Titration Program to Control Blood Pressure in Patients With Primary Hypertension: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Chi-Wen Kao ◽  
Ting-Yu Chen ◽  
Shu-Meng Cheng ◽  
Wei-Shiang Lin ◽  
Yue-Cune Chang
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Intervention Group ◽  
Primary Hypertension ◽  
Control Group ◽  
Health Related Quality ◽  
Web Based ◽  
Related Quality ◽  
Health Related

BACKGROUND Hypertension is a major cause of mortality in cardiac, vascular, and renal disease. Effective control of elevated blood pressure has been shown to reduce target organ damage. A Web-based self-titration program may empower patients to control their own disease, share decisions about antihypertensive dose titration, and improve self-management, ultimately improving health-related quality of life. OBJECTIVE Our primary aim was to evaluate the effects of a Web-based self-titration program for improving blood pressure control in patients with primary hypertension. Our secondary aim was to evaluate the effects of that program on improving health-related quality of life. METHODS This was a parallel-group, double-blind, randomized controlled trial with assessments at baseline, 3 months, and 6 months. We included patients with primary hypertension (blood pressure&gt;130/80 mm Hg) from a cardiology outpatient department in northern Taiwan and divided them randomly into intervention and control groups. The intervention group received the Web-based self-titration program, while the control group received usual care. The random allocation was concealed from participants and outcome evaluators. Health-related quality of life was measured by the EuroQol five-dimension self-report questionnaire. We used generalized estimating equations to evaluate the effects of the intervention. RESULTS We included 222 patients and divided them equally into intervention (n=111) and control (n=111) groups. Patients receiving the Web-based self-titration program showed significantly greater improvement in the systolic and diastolic blood pressure control than those who did not receive this program, at 3 months (–21.4 mm Hg and –5.4 mm Hg, respectively; <italic>P</italic>&lt;.001) and 6 months (–27.8 mm Hg and –9.7 mm Hg, respectively; <italic>P</italic>&lt;.001). Compared with the control group, the intervention group showed a significant decrease in the overall defined daily dose at both 3 (–0.202, <italic>P</italic>=.003) and 6 (–0.236, <italic>P</italic>=.001) months. Finally, health-related quality of life improved significantly in the intervention group compared with the control group at both 3 and 6 months (both, <italic>P</italic>&lt;.001). CONCLUSIONS A Web-based self-titration program can provide immediate feedback to patients about how to control their blood pressure and manage their disease at home. This program not only decreases mean blood pressure but also increases health-related quality of life in patients with primary hypertension. CLINICALTRIAL ClinicalTrials.gov NCT03470974; https://clinicaltrials.gov/ct2/show/NCT03470974

scholarly journals Improvements in health-related quality of life and function in middle-aged women with chronic diseases of lifestyle after participating in a non-pharmacological intervention programme: A pragmatic randomised controlled trial

2019 ◽  
Vol 8 ◽  
Author(s):  
Roline Y. Barnes ◽  
Jennifer Jelsma ◽  
Romy Parker
Keyword(s):  
Quality Of Life ◽  
Chronic Diseases ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Randomised Controlled

Background: Musculoskeletal diseases consume a large amount of health and social resources and are a major cause of disability in both low- and high-income countries. In addition, patients frequently present with co-morbid chronic diseases of lifestyle. The area of musculoskeletal disease is restricted by a lack of epidemiological knowledge, particularly in low- and middle-income countries.Objectives: This pragmatic randomised controlled trial assessed the benefits of a 6-week physiotherapy intervention for middle-aged women with musculoskeletal conditions compared to usual care.Method: A weekly 2-h educational programme utilising a workbook, discussion group and exercise class was presented for the intervention group, while the control group received usual care. The primary outcome was health-related quality of life. Parametric and non-parametric data were used to determine the equivalence between the groups.Results: Twenty-two participants were randomised to the intervention and 20 to the control group. The control group demonstrated no within-group improvement in health-related quality of life items, compared to significant improvements in two items in the intervention group. The change in median utility score within the intervention group was twice as large as the change in the control group. With regard to self-efficacy, the intervention group demonstrated significant within-group changes in perceived management of fatigue and discomfort.Conclusion: The positive impact of the intervention on the participants suggests that the programme should continue at the clinic in question, but should be presented at a more convenient time for participants who work, as recruitment to the study was less than anticipated. Primary health care systems in South Africa urgently need to put structures in place for effective management of the functional impact of chronic diseases of lifestyle and musculoskeletal conditions. It is time for physiotherapists and possibly other health care professionals to participate in the development of appropriate community level interventions to address the functioning and quality of life of individuals living with the diseases.

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