Role of Mobile Technology in Multiple Sclerosis Patients' Health Education

ABSTRACT Background Many African and Asian randomized clinical trials stated that mobile health technology is helpful in health education and improvement of patients' compliance to medical treatment especially in chronic diseases like hypertension, diabetes mellitus and obesity. Objectives Mobile health applications can provide a health education method for MS patients and a tool for assessment of patients' compliance to medical treatment among MS patients of the Arabic speaking population. Patients and method Type of Study: Prospective comparative observational study, tool: android MS world App, study setting: arabic speaking communities, study duration: six months, study population: multiple sclerosis patients, sampling method: random, sample size 100 patients, 50 study group using the app, 50 control group non app users. Results In the present study, we revealed that total number of patients on the app of the studied group, 60(51.72%) were male and 56(46.28%) were female, and as regard number of active patients on the app of the studied groups, we found that 19(40.43%) were male and 28(59.57%) were female with 3cases dropped out. We analyzed patients in different Egyptian governments of the studied group, Most of our cases were from Cairo 66(69.47%), 9(9.47%) from Giza, 4(4.21%) from Damietta, 2(2.11%) from Alexandria, 2(2.11%) from Gharbia, 2(2.11%) from Qalyoubia, 2(2.11%) from Suez and 6(6.32%) from Upper Egypt. Regarding age characteristics of the studied group most of our cases in active case group and control group their age was ranged between 21—40 years 25(53.19%) and 27(54%) respectively there was statistically significant difference between study group where P < 0.001. Regarding duration since diagnosis of the studied groups, the present study demonstrated that most of cases in active case group and control group their duration since diagnosis was ranged between 1—5 years 30(63.83%) and 31(62%) respectively, and there was no statistically significant difference between study groups where P = 0.949. Regarding the MS world Application questions, we found that61.70%of studied cases find that the app easy and simple touse,87.23% that app present the information in easy and simple way, 89.36% find that app provide with satisfying answers about MS, 95.74% were confident about information presented in that app, 93.62% find that app increase the knowledge about the drugs are taking for MS and 74.47% reported that app made them not to miss taking their drugs doses regularly. On the other hand, we found that 63.83% of cases saw that app help them overcome the usual fatigue symptoms they used to have with MS, 89.36% of cases saw that doctors in the app are good, 93.62% will use that app again and 95.74% will suggest that app for friends and that app also a tool for storing information about the patient making the doctor able to take a decision and cope with the patient condition. We have found that patients are easy to get answer embarrassing questions like that asking about their sexual condition and satisfaction after being diagnosed with multiple sclerosis the results of the questionnaire revealed that about 19 (40.43%) patients aren’t satisfied while the rest of patients in the active case study group 28 (59.57%) patients reported they are satisfied meaning that all patients in the active group answered the question in contrast to the control group asked through paper questionnaire the results revealed that 23 patients reported they are not satisfied and about 15 patients reported they are satisfied about it meaning that not patients in the control group answered the question with 12 patients didn’t answer the question that could add the advantage of mobile health apps in recording easily embarrassing questions rather than conventional methods. Conclusion Mobile health applications can provide a health education method for MS patients and a tool for assessment of patients' compliance to medical treatment among MS patients of the Arabic speaking population.

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Orem’s Self-Care Model with Multiple Sclerosis Patients’ Balance and Motor Function

Nursing Science Quarterly ◽

10.1177/0894318419881792 ◽

2019 ◽

Vol 33 (1) ◽

pp. 46-54

Author(s):

Ardashir Afrasiabifar ◽

Zahra Mehri ◽

Hamid Reza Ghaffarian Shirazi

Keyword(s):

Multiple Sclerosis ◽

Motor Function ◽

Intervention Group ◽

Self Care ◽

Nursing Intervention ◽

Control Group ◽

Care Model ◽

Significant Difference ◽

The Mean ◽

Multiple Sclerosis Patients

Orem’s self-care model has been introduced as a nursing model to empower participants with chronic diseases. This study aims to investigate the effectiveness of nursing interventions using Orem’s self-care model with multiple sclerosis participants’ balance and motor function. Sixty-three participants with multiple sclerosis were randomly assigned to intervention and control groups. The nursing intervention using Orem’s self-care model was performed for eight sessions of 45–60 minutes in the intervention group. In the intervention group, a significant increase (improvement) was observed in the mean scores of balance before (17.09 ± 1.97) and after the intervention (33.75 ± 6.01). A significant decrease (improvement) was observed in the mean of motor functions before (4.12 ± 0.34) and after the intervention (1.59 ± 0.71) ( p = 0.001). However, no significant difference existed in the mean scores of balance ( p = 0.10) and motor function in the control group ( p = 0.20). The nursing intervention using Orem’s self-care model improved balance and motor function of participants with multiple sclerosis.

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Comparison of mobile health education messages verses face-to-face consultation for weight reduction among overweight female adolescents in Thailand

F1000Research ◽

10.12688/f1000research.51156.1 ◽

2021 ◽

Vol 10 ◽

pp. 635

Author(s):

Supim Wongtongtair ◽

Sompoch Iamsupasit ◽

Ratana Somrongthong ◽

Ramesh Kumar ◽

Khemika Yamarat

Keyword(s):

Social Support ◽

Health Education ◽

Health Behavior ◽

Mobile Health ◽

Weight Reduction ◽

Control Group ◽

Post Intervention ◽

Face To Face ◽

Significant Difference

Background: Obesity is considered a significant public health problem in Thailand. This study was conducted to compare the impact of mobile health education messages verses face-to-face consultation on weight reduction among overweight female university students. Methods: This comparative cross-sectional study comprised three groups: a control group, a group receiving mobile health education, and a group receiving face-to-face consultation. Each group contained 26 participants taking part over a period of 12 weeks, with a 12-week follow-up thereafter. The data analysis used two-way repeated measures ANOVA with least significant difference testing. The study was ethically approved at Chulalongkorn University, Thailand. Results: The results revealed that the group receiving mobile health education had the lowest average body mass index and waist–hip ratio after intervention (p < 0.05). In addition, both intervention groups significantly improved their health belief, social support, and health behavior scores in comparison to the control group (p < 0.001). The results show that the average scores for social support for eating and exercise at baseline were significantly lower than at post-intervention or follow-up (p < 0.001). In addition, the results of both aspects of social support showed that the average social support score at post-intervention was significantly higher than at follow-up. Furthermore, the health behavior score measured post-intervention was higher than at follow-up. There was a statistically significant difference in average metabolism during physical activity (p < 0.001) but no statistical difference in average eating behavior score. Conclusion: The study found that the use of mobile health education to deliver health programs facilitates communication between the healthcare provider and individual, and can empower adolescent females in their pursuit of weight loss by improving their attitudes and knowledge, leading to better health behavior.

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Fatigue and Associated Factors in Multiple Sclerosis Patients in Latvia

Neurologijos seminarai ◽

10.29014/ns.2018.05 ◽

2018 ◽

Vol 22 (75) ◽

pp. 42-48

Author(s):

S. Šetlere ◽

A. Abelsen ◽

D. Pastare ◽

A. Millers

Keyword(s):

Multiple Sclerosis ◽

Cross Sectional Study ◽

Lifestyle Factor ◽

Control Group ◽

Common Symptom ◽

Neurological Disability ◽

Cross Sectional ◽

Study Results ◽

Significant Difference ◽

Multiple Sclerosis Patients

Background and objectives. Fatigue is one of the most common symptoms of multiple sclerosis (MS). The aim of this study was to determine the presence of fatigue in MS patients in Latvia and its relation to lifestyle factors, neurological disability and depression. Material and methods. This cross-sectional study included 117 participants (44 patients with MS and 73 healthy control group). Applied research instruments were: Expanded Disability Status Scale (EDSS), Patient Health Questionnaire (PHQ-9), Fatigue Severity Scale (FSS), and the general questionnaire for the collection of socio-demographic, lifestyle habits and clinical data constructed for the purposes of this study. Results. Mean FSS score was 3,9±1,9 in MS group. 26 (59,1%) patients had FSS score of 3,8 or more and were classified as a fatigue group (MSF) while 18 (40,9%) patients had FSS of 3,7 or less and were classified as a non-fatigue (MSNF) group. There was statistically significant difference between MSF and MSNF groups considering PHQ9 score (p=0,019), FSS score (p&lt;0,001) and EDSS score (p&lt;0,001). Significant correlations of fatigue with depression (r=0,48, p=0,001), fatigue with neurological disability (r=0,49, p=0,001) and fatigue with smoking (r=0,29, p=0,054) were confirmed. Conclusions. Fatigue is a common symptom in MS patients in Latvia. This study supports significant association between fatigue and clinical factors (disability, depression) and modifiable lifestyle factor – smoking.

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Physiotherapy Approaches in the Treatment of Ataxic Multiple Sclerosis: A Pilot Study

Neurorehabilitation and Neural Repair ◽

10.1177/154596830101500308 ◽

2001 ◽

Vol 15 (3) ◽

pp. 203-211 ◽

Cited By ~ 60

Author(s):

Kadriye Armutlu ◽

Rana Karabudak ◽

Gülay Nurlu

Keyword(s):

Multiple Sclerosis ◽

Evoked Potentials ◽

Motor Evoked Potentials ◽

Control Group ◽

Study Group ◽

Conduction Time ◽

Expanded Disability Status Scale ◽

Gait Parameters ◽

Significant Difference ◽

Disability Status

Objective: This study was planned to investigate the efficacy of neuromuscular rehabilitation and Johnstone Pressure Splints in the patients who had ataxic multiple sclerosis. Methods: Twenty-six outpatients with multiple sclerosis were the subjects of the study. The control group (n = 13) was given neuromuscular rehabilitation, whereas the study group (n = 13) was treated with Johnstone Pressure Splints in ad dition. Results: In pre- and posttreatment data, significant differences were found in sensation, anterior balance, gait parameters, and Expanded Disability Status Scale (p < 0.05). An important difference was observed in walking-on-two-lines data within the groups (p < 0.05). There also was a statistically significant difference in pendular movements and dysdiadakokinesia (p < 0.05). When the posttreatment values were compared, there was no significant difference between sensation, anterior balance, gait parameters, equilibrium and nonequilibrium coordination tests, Expanded Disability Status Scale, cortical onset latency, and central conduction time of somatosensory evoked potentials and motor evoked potentials (p > 0.05). Comparison of values re vealed an important difference in cortical onset-P37 peak amplitude of somatosen sory evoked potentials (right limbs) in favor of the study group (p < 0.05). Conclu sions : According to our study, it was determined that physiotherapy approaches were effective to decrease the ataxia. We conclude that the combination of suitable phys iotherapy techniques is effective multiple sclerosis rehabilitation. Key Words: Multi ple sclerosis—Ataxia—Physical therapy.

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Flash Electroretinogram Abnormalities in Patients with Clinically Definite Multiple Sclerosis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100044152 ◽

1982 ◽

Vol 9 (3) ◽

pp. 325-330 ◽

Cited By ~ 9

Author(s):

Stuart G. Coupland ◽

Trevor H. Kirkham

Keyword(s):

Multiple Sclerosis ◽

Optic Nerve ◽

Clinical Evidence ◽

Control Group ◽

Optic Nerve Disease ◽

Significant Difference ◽

Patient Groups ◽

Flash Electroretinogram ◽

Multiple Sclerosis Patients ◽

Nerve Disease

SUMMARY:We studied the flash electroretinograms (ERGs) of 105 patients with multiple sclerosis who were divided into four groups. The first group had no history or clinical evidence of optic nerve dysfunction, the second and third groups had either left or right optic nerve disease respectively, and the fourth group had historical or clinical evidence of bilateral optic nerve disease.Statistical analysis of the data using analysis of variance (ANOVA) showed that the group of patients with no history or clinical evidence of optic nerve disease had no significant difference from the control group for their peak b-wave implicit times but the other three groups were significantly delayed on the affected side(s). Using the Mann-Whitney U-test we found all four patient groups had significantly greater absolute interocular latency differences from the control group. The electroretinal contribution to flash VEP delay was also investigated. In those patients with unilateral or bilateral optic nerve disease we found that in 14–31% of those patients with flash VEP delay there was also abnormal prolongation of the ERG b-wave. These results confirm a high incidence of retinal dysfunction in multiple sclerosis patients and may suggest that transynaptic degeneration of retinal structures occurs in optic nerve demyelination. The significant absolute interocular latency difference in particular may provide another electrophysiological parameter to establish a diagnosis of multiple sclerosis in suspect cases.

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Effect of aerobic training on changes in neuroplasticity marker levels in patients with multiple sclerosis – a pilot study

Aktualności Neurologiczne ◽

10.15557/an.2020.0021 ◽

2020 ◽

Vol 21 (4) ◽

pp. 173-177

Author(s):

Marta Milewska-Jędrzejczak ◽

◽

Dominika Książek-Winiarek ◽

Piotr Szpakowski ◽

Igor A. Bednarski ◽

...

Keyword(s):

Multiple Sclerosis ◽

Aerobic Training ◽

Brain Plasticity ◽

Control Group ◽

Study Group ◽

Internal Factors ◽

Motor Disability ◽

Significant Difference ◽

Before And After ◽

The Central Nervous System

Introduction: Neuroplasticity is the function of the central nervous system that allows structural and functional reorganisation in response to external and internal factors. It is a crucial aspect that allows for the restoration of motor functions in people with limited brain damage. Patients with multiple sclerosis may obtain a special benefit from activities that support brain neuroplasticity. In order to stimulate neuroplasticity, several attempts were made to identify neuroplasticity-influencing factors. Aim: The objective of the study was to measure the effect of aerobic training on plasma neurotrophin levels that are potentially responsible for the brain plasticity phenomenon in patients with multiple sclerosis. Materials and methods: The study was conducted on a group of 22 patients with multiple sclerosis remaining in the drug programs of the National Health Fund. The study group underwent a 4-week rehabilitation scheme that consisted of training on a horizontal ergometer twice a day for 15 minutes 6 days a week, whereas the control group did not participate in any form of training. The plasma levels of neurotrophins (BDNF, PDGF, NGF, GDNF) and fractalkine (chemokine CX3CL1) were tested in all patients, the patients were assessed in the motor disability scale, the cognitive function screening and Beck depression inventory at the beginning of the study and after 4 weeks of rehabilitation. Results: The study showed no statistically significant difference in the levels of neurotrophins assessed before and after 4 weeks of aerobic training. A significant improvement in the clinical condition evaluated with the Expanded Disability Status Scale (EDSS) and Mini-Mental State Examination (MMSE) was observed in patients from the study group. Conclusion: Further studies on larger groups and with more homogenous participants are necessary to gain more insights into this aspect.

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Assessment of biochemical determinants in Multiple Sclerosis patients following the oral administration of β-D-Mannuronic acid [M2000]

Current Drug Discovery Technologies ◽

10.2174/1570163817999200918104333 ◽

2020 ◽

Vol 17 ◽

Author(s):

Mohamad Reza Nikouei Moghaddam ◽

Monireh Movahedi ◽

Maryam Bananej ◽

Soheil Najafi ◽

Nahid Beladi Moghadam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Uric Acid ◽

Vitamin D3 ◽

Chronic Inflammatory Disease ◽

Toxic Effects ◽

Control Group ◽

Therapeutic Effects ◽

Mannuronic Acid ◽

Anti Inflammatory ◽

Multiple Sclerosis Patients

Background: Multiple sclerosis is an autoimmune chronic inflammatory disease of the central nervous system that can lead to some serious disabilities. Despite using various immunomodulatory and anti-inflammatory drugs that have therapeutic effects, they cannot reduce its progression completely, and have some unwanted side effects too. The immunomodulatory and anti-inflammatory effects of the β-D-Mannuronic acid [M2000] have been proven in several surveys, and the present research was designed to determine its toxicity and therapeutic effects in MS patients. Methods: This study was performed on 15 MS patients who took 25 mg/kg/day the oral form of the β-D-Mannuronic acid for six months, and 15 healthy people as a control group. Serum levels of Urea, Creatinine, GGT, Vitamin D3, Uric acid, and Anti-Phospholipids were compared to evaluate the therapeutic and possible toxic effects of this drug after this period. Results: Non- toxic effects through the study of Urea, Creatinine, GGT, and non-significant changes in Uric acid and AntiPhospholipids levels, besides a significant rise in Vitamin, D3 levels in the M2000 treated cases were found. Conclusions: Our results suggested that β-D-Mannuronic acid is a safe drug and has no toxicity when administered orally and also has some therapeutic effects in MS patients.

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Changes in Cerebrospinal Fluid Balance of TNF and TNF Receptors in Naïve Multiple Sclerosis Patients: Early Involvement in Compartmentalised Intrathecal Inflammation

Cells ◽

10.3390/cells10071712 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1712

Author(s):

Roberta Magliozzi ◽

Francesco Pezzini ◽

Mairi Pucci ◽

Stefania Rossi ◽

Francesco Facchiano ◽

...

Keyword(s):

Multiple Sclerosis ◽

Immune Cell ◽

Protein Pattern ◽

Fold Change ◽

Cortical Lesion ◽

Control Group ◽

Lesion Volume ◽

Mri Features ◽

Csf Levels ◽

Multiple Sclerosis Patients

An imbalance of TNF signalling in the inflammatory milieu generated by meningeal immune cell infiltrates in the subarachnoid space in multiple sclerosis (MS), and its animal model may lead to increased cortical pathology. In order to explore whether this feature may be present from the early stages of MS and may be associated with the clinical outcome, the protein levels of TNF, sTNF-R1 and sTNF-R2 were assayed in CSF collected from 122 treatment-naïve MS patients and 36 subjects with other neurological conditions at diagnosis. Potential correlations with other CSF cytokines/chemokines and with clinical and imaging parameters at diagnosis (T0) and after 2 years of follow-up (T24) were evaluated. Significantly increased levels of TNF (fold change: 7.739; p < 0.001), sTNF-R1 (fold change: 1.693; p < 0.001) and sTNF-R2 (fold change: 2.189; p < 0.001) were detected in CSF of MS patients compared to the control group at T0. Increased TNF levels in CSF were significantly (p < 0.01) associated with increased EDSS change (r = 0.43), relapses (r = 0.48) and the appearance of white matter lesions (r = 0.49). CSF levels of TNFR1 were associated with cortical lesion volume (r = 0.41) at T0, as well as with new cortical lesions (r = 0.56), whilst no correlation could be found between TNFR2 levels in CSF and clinical or MRI features. Combined correlation and pathway analysis (ingenuity) of the CSF protein pattern associated with TNF expression (encompassing elevated levels of BAFF, IFN-γ, IL-1β, IL-10, IL-8, IL-16, CCL21, haptoglobin and fibrinogen) showed a particular relationship to the interaction between innate and adaptive immune response. The CSF sTNF-R1-associated pattern (encompassing high levels of CXCL13, TWEAK, LIGHT, IL-35, osteopontin, pentraxin-3, sCD163 and chitinase-3-L1) was mainly related to altered T cell and B cell signalling. Finally, the CSF TNFR2-associated pattern (encompassing high CSF levels of IFN-β, IFN-λ2, sIL-6Rα) was linked to Th cell differentiation and regulatory cytokine signalling. In conclusion, dysregulation of TNF and TNF-R1/2 pathways associates with specific clinical/MRI profiles and can be identified at a very early stage in MS patients, at the time of diagnosis, contributing to the prediction of the disease outcome.

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Frequency-Following Response (FFR) in Military Pilots

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1718525 ◽

2020 ◽

Author(s):

Graziela Maria Martins-Moreira ◽

Alessandra Spada Durante

Keyword(s):

Pure Tone Audiometry ◽

Control Group ◽

Study Group ◽

Aircraft Accidents ◽

Frequency Following Response ◽

Significant Difference ◽

Qualitative Variables ◽

Chi Squared ◽

The Right ◽

Military Pilots

Abstract Introduction Good hearing in pilots, including central auditory skills, is critical for flight safety and the prevention of aircraft accidents. Pure tone audiometry alone may not be enough to assess hearing in the members of this population who, in addition to high noise levels, routinely face speech recognition tasks in non-ideal conditions. Objective To characterize the frequency-following response (FFR) of a group of military pilots compared with a control group. Methods Twenty military pilots in the Study Group and 20 non-pilot military personnel, not exposed to noise in their work, in the Control Group, all with normal hearing, aged between 30 and 40 years old, completed a questionnaire to assess their hearing habits, and their FFRs were measured with a /da/ syllable (duration 40 milliseconds, speed 10.9/s), at 80 dB NA in the right ear. All procedures were approved by the ethical committee of the institution. Statistical analysis was performed using the t-Student or Mann-Whitney tests for quantitative variables, and the Fisher or chi-squared tests for qualitative variables, and a value of p < 0.05 was considered to be statistically significant. Results There was no significant difference between the groups regarding auditory habits. In the FFR, wave amplitudes A (p = 0.01) and C (p = 0.04) were significantly lower in the Study Group. Conclusion Working as a military pilot can be a crucial factor in determining an individual's typical FFR pattern, demonstrated in the present study by statistically significant reductions in the amplitudes of the A and C waves.

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The effect of nutrition and reproductive health education of pregnant women in Indonesia using quasi experimental study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03676-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tria Astika Endah Permatasari ◽

Fauza Rizqiya ◽

Walliyana Kusumaningati ◽

Inne Indraaryani Suryaalamsah ◽

Zahrofa Hermiwahyoeni

Keyword(s):

Health Education ◽

Reproductive Health ◽

Pregnant Women ◽

Intervention Group ◽

Control Group ◽

Attitudes And Practices ◽

Significant Difference ◽

Reproductive Health Education ◽

Post Test ◽

Knowledge Attitudes And Practices

Abstract Background Almost one-third of children under 5 years old in Indonesia suffer from stunting. Stunting can be prevented optimally during pregnancy as the initial phase of the first 1000 days of life. This study aims to determine the effect of nutrition and reproductive health education of pregnant women in Bogor Regency, Indonesia. Methods A quasi-experimental study was conducted among 194 pregnant women from August to November 2019. The pregnant women were randomly selected from four different villages in Bogor Regency. The intervention group (n = 97) received 2 h of nutrition and reproductive health education in small groups (four or five mothers per group) every 2 weeks for 3 consecutive months. This interactive education was given by facilitators using techniques such as lectures, role-playing, simulation, and games. The control group (n = 97) received regular health care services. A structured questionnaire was applied to collect data consisting of maternal characteristics, nutritional and reproductive health knowledge, attitudes, and practices in the intervention and control groups. Data were analysed using t-test and chi-square analysis. Results Pregnant women in the intervention group indicated a significant increase in knowledge, attitudes, and practices regarding nutrition and reproductive health after receiving education. The pre-test and post-test mean scores in the intervention group were 55.1 and 83.1 for overall knowledge, 40.2 and 49.0 for attitudes, and 36.2 and 40.2 for practices, respectively. In the control group, there was no significant difference between the pre-test and post-test mean scores for these three variables. There was a significant difference (P < 0.001) in the post-test mean between the intervention group and the control group, but the difference was not significant (P > 0.05) in the pre-test. Conclusion Providing nutrition and reproductive health education through small groups with interactive methods improves the knowledge, attitudes, and practices of pregnant women. This intervention has the potential to be replicated and developed for large-scale implementation by optimising collaboration between government, non-governmental organizations, and maternal and child health service providers.

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