scholarly journals Warrior Wellness: A Randomized Controlled Pilot Trial of the Effects of Exercise on Physical Function and Clinical Health Risk Factors in Older Military Veterans With PTSD

2019 ◽  
Vol 75 (11) ◽  
pp. 2130-2138
Author(s):  
Katherine S Hall ◽  
Miriam C Morey ◽  
Jean C Beckham ◽  
Hayden B Bosworth ◽  
Richard Sloane ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Physical Performance ◽  
Wait List ◽  
Cohen’S D ◽  
Supervised Exercise ◽  
Related Quality ◽  
Health Related ◽  
Cohen's D

Abstract Background Military veterans living with post-traumatic stress disorder (PTSD) face significant physical and functional health disparities, which are often aggravated over time and in the context aging. Evidence has shown that physical activity can positively impact age-related health conditions, yet exercise trials in older adults with mental disorders are rare. Our study was a tailored and targeted pilot exercise intervention for older veterans with PTSD. Methods Fifty-four older veterans with PTSD (mean age = 67.4 years, 90.7% male, 85.2% non-white) were randomized to supervised exercise (n = 38) or wait-list usual care (n = 18) for 12 weeks. Physical activity (MET-min/wk) and aerobic endurance (assessed with the 6-minute walk test) were primary outcomes. Secondary outcomes were physical performance (strength, mobility, balance), cardiometabolic risk factors (eg, waist circumference), and health-related quality of life. Results At 12 weeks, a large effect of the intervention on physical activity levels (Cohen’s d = 1.37) was observed compared to wait-list usual care. Aerobic endurance improved by 69 m in the exercise group compared to 10 m in wait-list group, reflecting a moderate between-group effect (Cohen’s d = 0.50). Between-group differences on 12-week changes in physical performance, cardiometabolic risk factors, and health-related quality of life ranged from small to large effects (Cohen’s d = 0.28–1.48), favoring the exercise arm. Conclusion Participation in supervised exercise improved aerobic endurance, physical performance, and health-related clinical factors in older veterans with PTSD; a medically complex population with multiple morbidity. Group exercise is a low-cost, low-stigma intervention, and implementation efforts among older veterans with PTSD warrants further consideration.

510 A Profile of Physical Performance Variables in an Out-Patient Adult Population with Narcolepsy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A201-A201
Author(s):  
Ragy Tadrous ◽  
Julie Broderick ◽  
Niamh Murphy ◽  
Lisa Slattery ◽  
Gillian Quinn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Physical Performance ◽  
Symptom Severity ◽  
Health Related Quality ◽  
Cardiopulmonary Fitness ◽  
Performance Variables ◽  
Related Quality ◽  
Health Related

Abstract Introduction Narcolepsy can significantly impact the physical and mental wellbeing of people with narcolepsy, and has been associated with significant reductions in quality of life and physical performance. People with narcolepsy demonstrate many barriers to being physically fit and active, such as sleepiness and social isolation. Despite physical functioning and vitality being the most affected domains of health-related quality of life in this cohort, little is known about how physical performance variables are affected in people with narcolepsy. Methods This cross-sectional study profiled the physical performance of adults with narcolepsy attending the Narcolepsy Centre located in St. James’s Hospital. Participants underwent a physical performance test battery that investigated cardiopulmonary fitness, physical activity, muscle strength and endurance. Furthermore, health-related quality of life (HRQoL), symptom severity and sedentary behaviour was ascertained through self-report questionnaires. Results A total of 23 participants were recruited in this study. The majority of participants were female (n=13, 56.52%) and the mean age was 31.53 (± 13.17) years. Physical performance was generally found to be lower than age-and-gender matched normative values for cardiopulmonary fitness, physical activity and muscle strength and endurance. Participants’ completed 42.20 ± 21.41 minutes of moderate-vigorous physical activity daily as measured by actigraphy. Considerable sedentary behaviour was objectively measured in this sample (10.21 hours). Symptom severity was high as measured by the Epworth Sleepiness Scale and the Narcolepsy Severity Scale, and participants reported reduced quality of life when compared to general population norms (US, UK, France and Norway). Conclusion Markedly reduced physical performance was identified in this sample of people with narcolepsy, irrespective of participant age, gender and BMI. Future research should explore the role of exercise in improving the physical fitness in people with narcolepsy, and the influence of exercise on HRQoL and symptom severity in this cohort. Support (if any) This study was completed as part of Mr Ragy Tadrous’ Master of Science (MSc) degree in Trinity College Dublin. This degree was co-sponsored by the Physiotherapy Department in St. James’s Hospital, Dublin.

scholarly journals Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma

2019 ◽  
Vol 132 (5-6) ◽  
pp. 124-131 ◽  
Author(s):  
Fadime Cenik ◽  
Mohammad Keilani ◽  
Timothy Hasenöhrl ◽  
Dominikus Huber ◽  
Bianca Stuhlpfarrer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Performance ◽  
Handgrip Strength ◽  
Anxiety And Depression ◽  
Risk Of Falling ◽  
Self Help ◽  
Related Quality ◽  
Health Related ◽  
Self Help Groups

Summary Purpose This pilot study aimed to describe physical performance, self-reported physical activity, health-related quality of life, anxiety and depression in patients who were assigned from Austrian self-help groups for multiple myeloma patients. These parameters were then discussed in the context of clinical decision-making concerning the recommended type of regular physical activity and exercise. Methods Members of the self-help groups were invited to participate. Physical performance and physical activity were assessed with the 6 min walk test (6MWT), handgrip strength test, timed up and go test (TUG), Tinetti performance oriented mobility assessment (POMA), falls efficacy scale (FES), international physical activity questionnaire (IPAQ), health-related quality of life (EORTC QLQ-C30) and the hospital anxiety and depression scale (HADS). Results A total of 40 patients (female:male = 15:25, mean age: 63.8 ± 9.0 years, range 41–80 years) were identified. In total 20 (50%) reached the performance of healthy peers in the tests 6MWT, handgrip strength, TUG and POMA, while 50% showed at least 1 result below the reference value or cut-off-point for each test. Self-reported activity levels were high. Patients showed a tendency to overestimate the risk of falling but a case by case analysis revealed a tendency for underestimating the actual performance in the respective tests (TUG, POMA). Conclusion The performance of healthy peers was reached by a substantial number of the participants in tests of physical performance and they reported high levels of physical activity. Nevertheless, they tended to overestimate the specific risk of falling. Patients with notably impaired physical performance might be suitable to perform regular physical activity and exercise in an individual therapy, whereas those with good physical performance are suited for training in exercise groups; however, individual contraindications and clinical considerations should be noted in a multiprofessional and interdisciplinary setting.

scholarly journals Effect of Neoadjuvant Chemoradiotherapy on Health-Related Quality of Life in Esophageal or Junctional Cancer: Results From the Randomized CROSS Trial

2018 ◽  
Vol 36 (3) ◽  
pp. 268-275 ◽  
Author(s):  
Bo Jan Noordman ◽  
Mathilde G.E. Verdam ◽  
Sjoerd M. Lagarde ◽  
Maarten C.C.M. Hulshof ◽  
Pieter van Hagen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neoadjuvant Chemoradiotherapy ◽  
Health Related Quality ◽  
End Points ◽  
Treatment Groups ◽  
Cohen’S D ◽  
Related Quality ◽  
Health Related ◽  
Cohen's D

Purpose To compare pre-agreed health-related quality of life (HRQOL) domains in patients with esophageal or junctional cancer who received neoadjuvant chemoradiotherapy (nCRT) followed by surgery or surgery alone. Secondary aims were to examine the effect of nCRT on HRQOL before surgery and the effect of surgery on HRQOL. Patients and Methods Patients were randomly assigned to nCRT (carboplatin plus paclitaxel with concurrent 41.4-Gy radiotherapy) followed by surgery or surgery alone. HRQOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (QLQ-C30) and –Oesophageal Cancer Module (QLQ-OES24) questionnaires pretreatment and at 3, 6, 9, and 12 months postoperatively. The nCRT group also received preoperative questionnaires. Physical functioning (PF; QLQ-C30) and eating problems (EA; QLQ-OES24) were chosen as predefined primary end points. Predefined secondary end points were global QOL (GQOL; QLQ-C30), fatigue (FA; QLQ-C30), and emotional problems (EM; QLQ-OES24). Results A total of 363 patients were analyzed. No statistically significant differences in postoperative HRQOL were found between treatment groups. In the nCRT group, PF, EA, GQOL, FA, and EM scores deteriorated 1 week after nCRT (Cohen’s d: −0.93, P < .001; 0.47, P < .001; −0.84, P < .001; 1.45, P < .001; and 0.32, P = .001, respectively). In both treatment groups, all end points declined 3 months postoperatively compared with baseline (Cohen’s d: −1.00, 0.33, −0.47, −0.34, and 0.33, respectively; all P < .001), followed by a continuous gradual improvement. EA, GQOL, and EM were restored to baseline levels during follow-up, whereas PF and FA remained impaired 1 year postoperatively (Cohen’s d: 0.52 and −0.53, respectively; both P < .001). Conclusion Although HRQOL declined during nCRT, no effect of nCRT was apparent on postoperative HRQOL compared with surgery alone. In addition to the improvement in survival, these findings support the view that nCRT according to the Chemoradiotherapy for Esophageal Cancer Followed by Surgery Study–regimen can be regarded as a standard of care.

The Italian Spine Youth Quality of Life questionnaire measures health-related quality of life of adolescents with spinal deformities better than the reference standard, the Scoliosis Research Society 22 questionnaire

2019 ◽  
Vol 33 (8) ◽  
pp. 1404-1415 ◽  
Author(s):  
Antonio Caronni ◽  
Sabrina Donzelli ◽  
Fabio Zaina ◽  
Stefano Negrini
Keyword(s):  
Quality Of Life ◽  
Research Society ◽  
Spinal Deformities ◽  
Scoliosis Research Society ◽  
Cohen’S D ◽  
Related Quality ◽  
Health Related ◽  
Cohen's D ◽  
Better Than

Objective: To compare the validity of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire with that of the Scoliosis Research Society 22 (SRS22) questionnaire, the criterion standard for health-related quality of life (HRQOL) measurement in adolescents with spinal deformities. Design: Cross-sectional study. Setting: Outpatient clinic. Subjects: Consecutive adolescents (10–18 years; 541 wearing brace) affected by idiopathic scoliosis (642 females, 100 males) or hyperkyphosis (87 females, 109 males). Interventions: NA. Main measures: The Spearman’s correlation coefficient (rho) between ISYQOL and SRS22 was used to assess ISYQOL concurrent validity. Sex, age, severity, bracing, trunk appearance and deformity type were assessed for known-groups validity. Cohen’s d quantified between-groups differences. Multiple linear regression exploring the effect of sex, age, body mass index (BMI), severity, bone age, trunk appearance, physiotherapy, bracing and sport on HRQOL of scoliosis patients was used to assess concurrent validity further. Results: Satisfactory correlations were found between ISYQOL and SRS22 (scoliosis, rho = 0.71; kyphosis, rho = 0.56). Known-groups validity analysis showed that ISYQOL detects all the between-groups differences detected by SRS22 and a males-females difference undetected by SRS22. ISYQOL Cohen’s d was larger than SRS22 Cohen’s d in three between-groups comparisons and similar in the others. Brace, sport and scoliosis severity were independently related to ISYQOL (linear regression: R2 = 0.23; p < 0.001). Brace, sport and physiotherapy were related to SRS22 ( R2 = 0.17). Conclusions: ISYQOL showed high validity when used to measure HRQOL in adolescents with spinal deformities. Moreover, ISYQOL performs better than SRS22, having better known-groups validity and (contrary to SRS22) detecting the impact of disease severity on HRQOL.

scholarly journals In-Treatment Changes in Quality of Life-Related Variables in Therapeutic Communities for Cocaine Abusers: Are These Changes Associated with Clinical Outcomes?

2021 ◽  
Vol 18 (14) ◽  
pp. 7442
Author(s):  
Francisco González-Saiz ◽  
Esperanza Vergara-Moragues
Keyword(s):  
Quality Of Life ◽  
Treatment Outcomes ◽  
Beck Depression Inventory ◽  
Drug Abusers ◽  
Health Related Quality ◽  
Cohen’S D ◽  
Related Quality ◽  
Health Related ◽  
Cohen's D

Background: Few studies have explored changes in quality of life during the first three months of admission to a therapeutic community for addictions. The objective of this study was to determine the relationship between these changes and treatment outcomes at discharge. Methods: We undertook a prospective longitudinal study of 142 cocaine-dependent patients treated at a therapeutics community. All of these patients reached the 3-month evaluation and were subsequently followed until discharge. All participants completed the following measures: Health-Related Quality of Life for Drug Abusers Test; Beck Depression Inventory; State–Trait Anxiety Inventory; Opiate Treatment Index; Dual Diagnosis and Discharge Checklist. Results: At the 3-month assessment, scores on the Health-Related Quality of Life for Drug Abusers Test had increased significantly (Cohen’s d: 0.92), while scores on the Opiate Treatment Index (Cohen’s d: 0.86) and Beck Depression Inventory (Cohen’s d: 0.20) scales both decreased significantly. A higher proportion of the patients considered to have achieved “clinically relevant” treatment outcomes at discharge versus those without clinically relevant outcomes were considered “recovered” according to the Reliable Change Index. Conclusions: An improvement in quality of life-related variables from baseline to the 3-month assessment was associated with better outcomes at discharge from the therapeutic community. The findings of this study may help us to optimise therapeutic interventions.

259 FEATURES PREDICTING WORSE POSTOPERATIVE HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH ESOPHAGEAL CANCER: RESULTS FROM THE CROSS-TRIAL

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
B Van Der Wilk ◽  
B Eyck ◽  
R Timman ◽  
L Kranenburg ◽  
S Lagarde ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Physical Functioning ◽  
Prior Treatment ◽  
Eating Problems ◽  
Tumor Characteristics ◽  
Cohen’S D ◽  
Related Quality ◽  
Health Related ◽  
Cohen's D

Abstract   Currently, trials are investigating active surveillance in esophageal cancer compared to standard esophagectomy after neoadjuvant chemoradiotherapy (nCRT). If non-inferiority is reported, on patients the choice will be imposed choice between active surveillance or immediate esophagectomy. The aim of this study was to identify clinical- and tumor characteristics that are predictive for a worse health-related quality of life (HR-QoL) after esophagectomy. Methods HR-QoL was measured using EORTC-QLQ-C30 and QLQ-OES24 questionnaires prior treatment and three, six, nine and twelve months postoperatively. Subgroups were predefined from patients with different clinical (global HR-QoL, WHO-status) and tumor characteristics (histology, disease stage and location of the tumor). High and low global HR-QoL were defined as global health scores ≥75 and &lt; 75, respectively. Cohen’s d effect-sizes were determined, 0.5–0.8 was considered a medium and &gt; 0.8 considered a large effect. The primary endpoints were physical functioning and eating problems. Secondary endpoints were global HRQOL, fatigue and emotional problems. Exploratory, the effect of age and gender on HR-QoL was assessed. Results In total, 363 patients received HR-QoL questionnaires. Patients who reported a high global HR-QoL prior treatment had a significantly worse deterioration in HR-QoL after esophagectomy than patients who reported a low HR-QoL prior treatment, on all endpoints except for physical functioning. Corresponding Cohen’s d scores were 0.85 for eating problems, −1.25 for global HR-QoL, 0.75 for fatigue and 0.65 for emotional problems. No additional differences between subgroups were identified. All predefined subgroups had impaired HR-QoL up to twelve months postoperatively for both physical functioning and fatigue with a medium to large Cohen’s d effect size. Conclusion Patients reporting high global HR-QoL prior treatent have worse deteriotation in HR-QoL than patients reporting low global HR-QoL prior treatment. No additional characteristics were identified that were predictive for worse HR-QoL after esophagectomy. This emphazises the need for shared-decision making in case active surveillance proves non-inferior compared to standard esophagectomy. All subgroups had deterioration in physical functioning and eating problems up to twelve months postoperatively.

scholarly journals The “Super-Fontan” Phenotype: Characterizing Factors Associated With High Physical Performance

2021 ◽  
Vol 8 ◽  
Author(s):  
Derek L. Tran ◽  
David S. Celermajer ◽  
Julian Ayer ◽  
Leeanne Grigg ◽  
Carley Clendenning ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Physical Performance ◽  
Exercise Performance ◽  
Self Efficacy ◽  
Work Rate ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Background: People with a Fontan circulation usually have moderately impaired exercise performance, although a subset have high physical performance (“Super-Fontan”), which may represent a low-risk phenotype.Methods: People with a “Super-Fontan” phenotype were defined as achieving normal exercise performance [≥80% predicted peak oxygen uptake (VO2) and work rate] during cardiopulmonary exercise testing (CPET) and were identified from the Australian and New Zealand Fontan Registry. A Fontan control group that included people with impaired exercise performance (&lt;80% predicted VO2 or work rate) was also identified based on a 1:3 allocation ratio. A subset of participants were prospectively recruited and completed a series of physical activity, exercise self-efficacy, and health-related quality of life questionnaires.Results: Sixty CPETs (“Super-Fontan”, n = 15; control, n = 45) were included. A subset (“Super-Fontan”, n = 10; control, n = 13) completed a series of questionnaires. Average age was 29 ± 8 years; 48% were males. Exercise capacity reflected by percent predicted VO2 was 67 ± 17% in the entire cohort. Compared to the “Super-Fontan” phenotype, age at Fontan completion was higher in controls (4.0 ± 2.9 vs. 7.2 ± 5.3 years, p = 0.002). Only one (7%) person in the “Super-Fontan” group had a dominant right ventricle compared to 15 (33%) controls (p = 0.043). None of those in the “Super-Fontan” group were obese, while almost a quarter (22%) of controls were obese based on body mass index (p = 0.046). Lung function abnormalities were less prevalent in the “Super-Fontan” group (20 vs. 70%, p = 0.006). Exercise self-efficacy was greater in the “Super-Fontan” group (34.2 ± 3.6 vs. 27.9 ± 7.2, p = 0.02). Self-reported sports participation and physical activity levels during childhood and early adulthood were higher in the “Super-Fontan” group (p &lt; 0.05). The total average time spent participating in structured sports and physical activity was 4.3 ± 2.6 h/wk in the “Super-Fontan” group compared to 2.0 ± 3.0 h/wk in controls, p = 0.003. There were no differences in self-reported current total physical activity score or health-related quality of life between groups (p ≥ 0.05).Conclusions: The “Super-Fontan” phenotype is associated with a healthy weight, lower age at Fontan completion, better exercise self-efficacy, and higher overall levels of sport and physical activity participation during physical development.

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