scholarly journals Long-Term Effect of an Exercise Training Program on Physical Functioning and Quality of Life in Pulmonary Hypertension: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Olga Kagioglou ◽  
Sophia-Anastasia Mouratoglou ◽  
George Giannakoulas ◽  
Dorothea Kapoukranidou ◽  
Maria Anifanti ◽  
...  

The aim of this study was to evaluate the effects of a 6-month combined aerobic and strength exercise training program on functional and psychological aspects and health-related quality of life in patients with PH and to evaluate its longer-term impact. In total, 22 stable patients (mean age 53.9 ± 13.8 , 13 female) with pulmonary hypertension of World Health Organization (WHO) class I-III participated in a nine-month study. They were randomly assigned into two groups: Group A participated in a 6-month combined aerobic and strength exercise training program, whereas Group B remained untrained. All patients underwent physical and psychological assessment at baseline and at month 6 (after completing the exercise program) and physical assessment after 9 months (3 months posttraining). After the 6-month exercise training program, patients of Group A significantly improved their physical (6MWD, STS 10 rep, STS 20 rep, TUG, lower limb strength, cardiopulmonary exercise time, METs, peak VO2, VCO2, and VE/VCO2 slope) and psychological aspects (SF-36, STAI, and BDI). Between the two groups, differences were observed at the 6MWD (95% CI: 36.2-64.6, η 2 = 0.72 ), STS 10 rep (95% CI: 6.6-2.2, η 2 = 0.4 ), STS 20 rep (95% CI: 10.8-2.4, η 2 = 0.34 ), lower limb strength (95% CI: 7.2-3.6, η 2 = 0.38 ), cardiopulmonary exercise time (95% CI: 0.1-3.3, η 2 = 0 . 2 ), and VCO2 (95% CI: 0.1-0.5, η 2 = 0 . 2 ). Additionally, psychological changes were noted at SF-36, PCS (95% CI: 3.6-14.8, η 2 = 0.35 ), MCS (95% CI: 1.3-16.1, η 2 = 0.22 ), TCS (95% CI: 1.3-16.1, η 2 = 0.22 ), and STAI (95% CI: 1.8-28.2, η 2 = 0.18 ). The favorable results of exercise were maintained at the 3-month posttraining follow-up assessment. No exercise-induced complications were observed throughout the study. In conclusion, a long-term exercise training program is a safe and effective intervention to improve functional status, psychological aspects, and health-related quality of life in patients with PH.

2014 ◽  
Vol 58 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Patrícia dos Santos Vigário ◽  
Dhiãnah Santini de Oliveira Chachamovitz ◽  
Patrícia de Fátima dos Santos Teixeira ◽  
Maíra de La Rocque ◽  
Maryna Lobo dos Santos ◽  
...  

Objective : To evaluate if a supervised exercise training program improves the quality of life (QoL) of differentiated thyroid carcinoma (DTC) patients on TSH-suppressive therapy with levothyroxine (L-T4).Subjects and methods : Initially, a cross-sectional study was performed to compare the QoL and the health-related quality of life (HRQoL) between subclinical hyperthyroidism (SCH) patients (n = 33) and euthyroid subjects (EU; n = 49). In the prospective phase of the study, SCH patients were randomized in a non-blinded fashion to either participate (SCH-Tr = trained patients; n = 16) or not (SCH-Sed = untrained patients; n = 17) in a supervised exercise training program. The exercise program consisted of 60 minutes of aerobic and stretching exercises, twice a week, during twelve weeks. The QoL was assessed by the application of the WHOQOL-Bref, and the SF-36 was used to assess the HRQoL.Results : SCH patients had statistically lower scores than EU on the “physical” domain of WHOQOL-Bref, besides “physical function”, “role-physical”, “bodily pain”, “general health”, “vitality”, “role-emotional”, and “mental-health” domains of SF-36. After three months, SCH-Tr patients showed improvement in the “physical” and “psychological” domains of WHOQOL-Bref (p < 0.05), and in the “physical function”, “role-physical”, “bodily pain”, “vitality” and “mental health” domains of SF-36.Conclusion : Patients on TSH-suppressive therapy with L-T4 for DTC had impaired QoL and HRQoL compared to EU, but it was improved after 3-months of an exercise training program. Exercise seems to play an important role in the follow-up of DTC patients, since it seems to minimize the adverse effects of the treatment on QoL and HRQoL. Arq Bras Endocrinol Metab. 2014;58(3):274-81


2018 ◽  
Vol 19 (1) ◽  
pp. 95-105 ◽  
Author(s):  
Cristina Blasco-Lafarga ◽  
Roberto Sanchis-Sanchis ◽  
Gema Sanchis-Soler ◽  
David San Inocencio-Cuenca ◽  
Pere Llorens-Soriano

Introducción: El envejecimiento se acompaña de factores de riesgo cuya reducción mejora la supervivencia. La actividad física incide sobre ellos, lo que realza su papel preventivo y su valor como tratamiento no-farmacológico. Dada la escasez de programas de entrenamiento específicos para ancianos pluripatológicos, sobre todo durante el periodo de inicio de resolución de la actividad clínica de una enfermedad aguda, o de la exacerbación de una o varias de las enfermedades crónicas, el presente estudio piloto analiza la viabilidad y efectos de un programa corto de entrenamiento neuromotor en estos pacientes ingresados en UHD (Unidad de Hospitalización Domiciliaria). Método: 11 ancianos pluripatológicos (82,2±6,9 años, 8 hombres) completaron 4 semanas de entrenamiento funcional con orientación neuromuscular y cognitiva, con evaluación pre-post sobre capacidad funcional (equilibrio, marcha, fuerza de tren inferior y agilidad), composición corporal y calidad de vida -6 semanas, incluida la evaluación-. Se realizaron dos sesiones domiciliarias supervisadas y una tercera autónoma semanalmente. Resultados: Los ancianos mejoraron en equilibrio y marcha (Tinetti-total: 14,0±9,0 vs 17,9±7,3 puntos; p =0,007), fuerza (test sentarse y levantarse 30-s: 3,0±3,7 vs 4,1±4,1 reps.; p =0,034), agilidad (TUG-test categorizado; p =0,001) y peso (82,2±14,0 vs 79,2±13,9 kg; p =0,036), aunque no en calidad de vida relacionada con la salud (SF-36-v2: 32,9±7,8 vs 31,2±7,7 puntos; p =0,722). La presencia del técnico aumentó el cumplimiento un 20%. Conclusiones: El dinamismo de UHD es idóneo para implantar programas de actividad física especializada que frenen los efectos devastadores del binomio envejecimiento-inactividad. Una corta duración no les resta eficacia.   Introduction: Aging is linked to a various risk factors whose reduction improves survival. Physical activity affects many of them, what enhances its preventive role and its value as a non-pharmacological treatment. Given the scarcity of specific training programs for elderly people with multiple pathologies, especially during the start period of resolution of the clinical activity of an acute disease, or the exacerbation of one or several of the chronic diseases, the present pilot study aims to analyze the feasibility and effects of a short neuromotor training program in these patients admitted to UHD (Home Hospitalization Unit). Methods: 11 elderly patients (82.2±6.9 years, 8 men; acute phase of disease) completed 4 weeks of a neuromuscular and cognitive orientated functional training program, with pre-post assessment of functional capacity (i.e. balance, gait speed, lower limb strength and agility), body composition and quality of life -6 weeks, including the evaluation-. There were 2 supervised sessions and a third autonomous session every week. Results: Significant improvements were found in balance and gait (Tinetti-total: 14.0±9.0 vs 17.9±7.3 points; p =0.007), strength (30-seconds Chair Stand Test: 3.0±3; p =0.001), agility (TUG-test categorized; p =0.001) and weight (82.2±14.0 vs. 79.2±13.9 kg; p =0.036), but not in health-related quality of life (SF-36-v2: 32.9±7.8 vs 31.2±7.7 points; p =0.722). The technician’s presence increased adherence to the program by 20%. Conclusions: The dynamism of UHD is ideal for implementing specialized physical activity programs that counteract the devastating effects of the binomial aging-inactivity. A short duration does not reduce effectiveness.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Katarzyna Kotarska ◽  
Ewa Wunsch ◽  
Agnieszka Kempińska-Podhorodecka ◽  
Joanna Raszeja-Wyszomirska ◽  
Dimitrios P. Bogdanos ◽  
...  

Background/Aim.With the improvement of the outcomes after liver transplantation (LTx), health-related quality of life (HRQoL) and physical activity are becoming significant outcome parameters. We prospectively assessed these parameters in patients with autoimmune and nonautoimmune liver disorders undergoing LTx.Materials and Methods.Patients (n=107) were subdivided into 3 groups depending on the time after LTx: group-A (n=21): 6–12 months; group-B (n=48): 13–36 months; and group-C (n=38): >37 months. SF-36 and IPAQ were applied in HRQoL and physical activity assessment.Results.Females had impaired HRQoL in most SF-36 domains. Younger patients showed higher scores at SF-36physical functioningdomain but IPAQ was not influenced by age. Group-B had highergeneral healthandphysical component summarythan group-A (P=0.037,P=0.04, resp.) and total IPAQ than group-C (P=0.047). Thesitting timedomain was longer in group-A than in group-B and group-C (P=0.0157;  P=0.042, resp.). Employed patients had better HRQoL and higher physical activity than those not working. SF-36 and IPAQ were unrelated to the autoimmune etiology of liver disease.Conclusions.These findings show that female and unemployed patients have worse HRQoL, while gender and age at LTx time do not affect IPAQ’s physical activity. The autoimmune etiology of liver disease does not influence HRQoL and physical activity after LTx.


Author(s):  
Eldhose Varghese ◽  
Irrin Poulose ◽  
Chaitanya Sagar G ◽  
Jennifer Ann Jose ◽  
Mintu Mathew Ms

Tuberculosis (TB) is potentially airborne severe infectious disease which requires long term treatment. It considerably affects the physical and mental health quality of the patient’s life. Appropriate patient counselling with the help of Patient Information Leaflet will help to improve the patient’s quality of life and overall treatment outcome. To enhance the health related quality of life in pulmonary tuberculosis patients by providing patient counselling with the aid of patient information leaflet. An interventional study was carried out for six months in 80 patients diagnosed with pulmonary tuberculosis from the OP & IP of Tuberculosis and Chest Department of a medical college hospital. The HRQoL was assessed using the SF-36 questionnaire. Appropriate patient counselling was provided with the help of Patient Information Leaflet. In our study, a total of 80 patients were enrolled, out of which 49[61%] were Out-patients, and 31[39%] were In-patients. All the 8 sub domains of the SF-36 survey show statistical significance with improvement in 2nd Visit (after counselling) when compared with the baseline visit. The demographic variables like smoking, low socioeconomic status, allergies, family history show statistically significant association with overall HRQoL. The HRQOL of the pulmonary tuberculosis patients were initially low before the start of Anti-TB therapy, after providing proper patient counselling using patient information leaflet the HRQoL scores were found to be increased on the subsequent re-visits, which implies the need of proper patient counselling and follow-up in PTB for the better quality of life.


2021 ◽  
pp. 1-24
Author(s):  
Daniela Viramontes-Hörner ◽  
Zoe Pittman ◽  
Nicholas M Selby ◽  
Maarten W Taal

Abstract Health-related quality of life (HRQoL) is severely impaired in persons receiving dialysis. Malnutrition has been associated with some measures of poor HRQoL in cross-sectional analyses in dialysis populations, but no studies have assessed the impact of malnutrition and dietary intake on change in multiple measures of HRQoL over time. We investigated the most important determinants of poor HRQoL and the predictors of change in HRQoL over time using several measures of HRQoL. We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in this prospective study. Nutritional assessments (Subjective Global Assessment [SGA], anthropometry and 24-hour dietary recalls) and HRQoL questionnaires (Short Form-36 [SF-36] mental [MCS] and physical component scores [PCS] and European QoL-5 Dimensions [EQ5D] health state [HSS] and visual analogue scores [VAS]) were performed at baseline, 6 and 12 months. Mean age was 64(14) years. Malnutrition was present in 37% of the population. At baseline, malnutrition assessed by SGA was the only factor independently (and negatively) associated with all four measures of HRQoL. No single factor was independently associated with decrease in all measures of HRQoL over 1 year. However, prevalence/development of malnutrition over one year was an independent predictor of 1-year decrease in EQ5D HSS and 1-year decrease in fat intake independently predicted the 1-year decline in SF-36 MCS and PCS, and EQ5D VAS. These findings strengthen the importance of monitoring for malnutrition and providing nutritional advice to all persons on dialysis. Future studies are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047812
Author(s):  
Takuya Aoki ◽  
Shunichi Fukuhara ◽  
Yasuki Fujinuma ◽  
Yosuke Yamamoto

ObjectivesLongitudinal studies, which consider multimorbidity patterns, are useful for better clarifying the effect of multimorbidity on health-related quality of life (HRQoL) and for identifying the target population with poorer clinical outcomes among patients with multimorbidity. This study aimed to examine the effects of different multimorbidity patterns on the decline in HRQoL.DesignNationwide prospective cohort study.SettingJapanese adult residents.ParticipantsResidents aged ≥50 years selected by the quota sampling method.Primary outcome measureClinically relevant decline in HRQoL was defined as a 0.50 SD (5-point) decrease in the 36-Item Short Form Health Survey (SF-36) component summary scores for 1 year.ResultsIn total, 1211 participants completed the follow-up survey. Among the multimorbidity patterns identified using confirmatory factor analysis, multivariable logistic regression analyses revealed that high cardiovascular/renal/metabolic and malignant/digestive/urologic pattern scores were significantly associated with the clinically relevant decline in SF-36 physical component summary score (adjusted OR (aOR)=1.25, 95% CI: 1.08 to 1.44 and aOR=1.28, 95% CI: 1.04 to 1.58, respectively). High cardiovascular/renal/metabolic pattern score was also significantly associated with the clinically relevant decline in SF-36 role/social component summary score (aOR=1.23, 95% CI: 1.06 to 1.42).ConclusionsOur study revealed that multimorbidity patterns have different effects on the clinically relevant decline in HRQoL for 1 year. These findings can be useful in identifying populations at high risk and with poor clinical outcomes among patients with chronic diseases and multimorbidity for efficient resource allocation.


2021 ◽  
Vol 12 (3) ◽  
pp. 344-351
Author(s):  
Julie Cleuziou ◽  
Anna-Katharina Huber ◽  
Martina Strbad ◽  
Masamichi Ono ◽  
Alfred Hager ◽  
...  

Background: Long-term morbidity and mortality outcomes of the arterial switch operation (ASO) in patients with transposition of the great arteries and Taussig-Bing anomaly are excellent. With an increasing number of patients reaching adolescence and adulthood, more attention is directed toward quality of life. Our study aimed to determine the health-related quality of life (hrQoL) outcomes in patients after the ASO and identify factors influencing their hrQoL. Methods: In this cross-sectional study, hrQoL of patients after ASO was assessed with the German version of the Short Form-36 (SF-36) and the potential association of specified clinical factors was analyzed. Patients of at least 14 years of age who underwent ASO in our institution from 1983 were considered eligible. Results: Of the 355 questionnaires sent to eligible patients, 261 (73%) were available for analysis. Compared to the reference population, patients who had undergone ASO had a significantly higher score in all subscales of the SF-36 except for vitality ( P < .01). Patients with an implanted pacemaker ( P = .002), patients who required at least one reoperation ( P < .001), and patients currently taking cardiac medication ( P < .004) or oral anticoagulation ( P = .036) had lower physical component scores compared to patients without these factors. Conclusions: Patients’ self-assessed and self-reported hrQoL after ASO (using German version of the Short Form 36) is very good. In this population, hrQoL is influenced by reoperation, the need for a pacemaker, and current cardiac medication or anticoagulant use. The development of strategies designed to mitigate or minimize the requirements for, and/or impact of these factors may lead to better hrQoL in this patient population.


2009 ◽  
Vol 89 (5) ◽  
pp. 443-455 ◽  
Author(s):  
Stefania Costi ◽  
Mauro Di Bari ◽  
Paolo Pillastrini ◽  
Roberto D'Amico ◽  
Ernesto Crisafulli ◽  
...  

Background, Objectives, and Measurements Patients with chronic airway obstruction (CAO) frequently experience dyspnea and fatigue during activities performed by accessory muscles of ventilation, which competitively participate in arm elevation. This systematic review of randomized controlled trials (RCTs) concerning patients with CAO addresses the effects of upper-extremity exercise training (UEET), added to lower-extremity training or comprehensive pulmonary rehabilitation, on the following patient-centered outcomes: exercise capacity, symptoms, ability to perform daily activities, and health-related quality of life. Methods Studies were retrieved using comprehensive database and hand-search strategies. Two independent reviewers determined study eligibility based on inclusion criteria. A detailed description of treatments was mandatory. Reviewers rated study quality and extracted information on study methods, design, intervention, and results. Results Forty publications were evaluated. Four RCTs met the inclusion criteria but had serious methodological limitations, which introduce possible biases that reduce their internal validity. The outcomes measured were heterogeneous, and the results were inconsistent regarding maximal exercise capacity, dyspnea, and health-related quality of life. No effect of UEET was demonstrated for measures of arm fatigue. Limitations and Conclusions The limited methodological quality of the studies retrieved prevented us from performing a meta-analysis, the results of which could be misleading. This systematic review shows that there is limited evidence examining UEET and that the evidence available is of poor quality. Therefore, a recommendation for the inclusion or exclusion of UEET in pulmonary rehabilitation programs for individuals with CAO is not possible. Further research is needed to definitively ascertain the effects of this training modality on patient-centered outcomes.


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