scholarly journals Components, design and effectiveness of digital physical rehabilitation interventions for older people: A systematic review

2020 ◽  
pp. 1357633X2092758 ◽  
Author(s):  
Eda Tonga ◽  
Cynthia Srikesavan ◽  
Esther Williamson ◽  
Sarah E Lamb
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Digital Health ◽  
Risk Of Bias ◽  
Bibliographic Databases ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Randomised Controlled ◽  
Health Applications

Background With the rapid advancement in digital technologies, the use of digital health applications is increasing day by day. Although a large number of digital applications have been developed for rehabilitation of older people, there has been no review of the evidence for effectiveness of these interventions. Methods The aim of our study was to review the evidence of digital rehabilitation interventions on outcomes including pain, function and quality of life in older people. We focused on digital interventions that are designed to improve and restore physical functioning. We searched six electronic bibliographic databases and included randomised controlled trials. Cochrane risk of bias tool and Cochrane’s Grading of Recommendations, Assessment, Development and Evaluation approach was used to evaluate the risk of bias and grade the evidence. Results Eight trials were included. The short-term effects of digital rehabilitation interventions on physical activity, quality of life, vertigo symptoms and falls are uncertain. Quality of trials was rated as very low to moderate evidence. Conclusion More research is needed to estimate effectiveness of these interventions.

scholarly journals Elastic-band resistance exercise or vibration treatment in combination with hydroxymethylbutyrate (HMB) supplement for management of sarcopenia in older people: a study protocol for a single-blinded randomised controlled trial in Hong Kong

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034921 ◽  
Author(s):  
Simon Kwoon-Ho Chow ◽  
Yu-Ning Chim ◽  
Keith Yu-Kin Cheng ◽  
Chung-Yan Ho ◽  
Wing-Tung Ho ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Muscle Strength ◽  
Older People ◽  
Controlled Trial ◽  
Elastic Band ◽  
Vibration Treatment ◽  
Time Points ◽  
Randomised Controlled

IntroductionSarcopenia is a geriatric syndrome characterised by progressive loss of skeletal muscle mass and function with risks of adverse outcomes and becomes more prevalent due to ageing population. Elastic-band exercise, vibration treatment and hydroxymethylbutyrate (HMB) supplementation were previously proven to have positive effects on the control of sarcopenia. The purpose of this study is to evaluate the effectiveness of elastic-band exercise or vibration treatment with HMB supplementation in managing sarcopenia. Our findings will provide a safe and efficient strategy to mitigate the progression of sarcopenia in older people and contribute to higher quality of life as well as improved long-term health outcomes of elderly people.Methods and analysisIn this single-blinded, randomised controlled trial (RCT), subjects will be screened for sarcopenia based on the Asian Working Group for Sarcopenia (AWGS) definition and 144 sarcopenic subjects aged 65 or above will be recruited. This RCT will have three groups evaluated at two time points to measure changes over 3 months—the control and the groups with combined HMB supplement and elastic-band resistance exercise or vibration treatment. Changes in muscle strength in lower extremity will be the primary outcome. Muscle strength in the upper extremity, gait speed, muscle mass (based on AWGS definition), functional performance in terms of balancing ability and time-up-and-go test and quality of life will be taken as secondary outcomes. In addition, each participant’s daily activity will be monitored by a wrist-worn activity tracker. Repeated-measures analysis of variance will be performed to compare within-subject changes between control and treatment groups at two time points of pretreatments and post-treatments.Ethics and disseminationThe procedures have been approved by the Joint CUHK-NTEC Clinical Research Management Office (Ref. CREC 2018.602) and conformed to the Declaration of Helsinki. Results will be disseminated through peer-reviewed publications, conferences and workshops.Trial registration numberNCT04028206.

A coaching program to improve quality of life in older people in Japan: a randomised controlled trial

2019 ◽  
Vol 24 (7) ◽  
pp. 315-322
Author(s):  
Junko Ohashi ◽  
Toshiki Katsura
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Improve Quality ◽  
Public Attention ◽  
Randomised Controlled ◽  
Geriatric Center

As the world's population ages, efforts to improve quality of life (QOL) in old age are gaining public attention. In this study, a programme was conducted for older people with the aim of clarifying their life goals related to QOL and the meaning of their existence, and the effect of the programme in improving QOL was evaluated. Participants were randomly assigned to the intervention or control group after registration. The program consisted of four 90-minute classes. The primary outcome was the Philadelphia Geriatric Center Morale Scale score (PGC), and changes in outcomes were compared between groups. The intervention group had significantly improved PGC scores (P<0.003). Further, the scores of PGC subscales ‘Acceptance of one's own ageing’ and ‘Lonely dissatisfaction’ showed significant improvements after the intervention (P<0.001). The findings suggest the effectiveness of the developed program in improving QOL in people aged ≥65 years.

scholarly journals A volunteer-supported walking programme to improve physical function in older people (the POWER Study): study protocol for a randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Grede ◽  
Anja Rieckert ◽  
Julia Muth ◽  
Joana Steinbuck ◽  
Sabine Weissbach ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Older People ◽  
Physical Function ◽  
Medical Attention ◽  
German Population ◽  
Power Study ◽  
Wide Range ◽  
Randomised Controlled

Abstract Background Currently 21% of the German population is older than 65 years. Above this age, the risk of suffering from chronic disease and mental disorders increases rapidly. Therefore, physical inactivity is one of the most important public health concerns among older people. To address this issue, we have conceptualised and evaluated a simple and low-threshold intervention, which requires only minimal demand on the participants, targeting older people with inadequate activity levels. The aim of the POWER Study is to investigate whether volunteer-supported outdoor-walking improves physical function and quality of life in older people. Methods/design In a randomised, controlled interventional superiority-trial, individuals older than 65 years of age living in the community or nursing homes will be randomised into two groups. The study will be conducted in two study centres with assessments at baseline, 6 and 12 months. The intervention group will participate in a supported physical activity intervention for 6 months. An assigned volunteer will visit them three times a week for an outdoor walk between 30 and 50 min, or equivalent indoor activity. Persons in the control group will be invited to two lectures covering topics related to health. Primary endpoint is the physical function measured by the Short Physical Performance Battery (SPPB) at baseline, after 6 and 12 months. Secondary and safety endpoints will be quality of life (EQ. 5D), fear of falling (Falls Efficacy Scale), physical activity (activity diary), cognitive executive function (clock drawing test), falls requiring medical attention, hospitalisation and death. Primary analysis will be carried out by intention to treat. Discussion We expect the intervention to improve the overall health status of the participants in a wide range of health-related outcomes. If effectiveness can be shown, the intervention will close an important gap in current services for older people. We will disseminate our experiences and results in the form of informational documents (training manual) to allow municipalities and health care organisations to implement a similar intervention. Trial registration The trial was registered on 31 Aug 2018; German Clinical Trials Register (www.germanctr.de), Deutsches Register Klinischer Studien: DRKS00015188.

scholarly journals Effectiveness, safety and acceptability of medical abortion at home versus in the clinic: a systematic review and meta-analysis in response to COVID-19

2020 ◽  
Vol 5 (12) ◽  
pp. e003934
Author(s):  
Katherine Gambir ◽  
Camille Garnsey ◽  
Kelly Ann Necastro ◽  
Thoai D Ngo
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Meta Analysis ◽  
Medical Abortion ◽  
Risk Of Bias ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Home Based ◽  
Randomised Controlled ◽  
At Home

BackgroundIncreased access to home-based medical abortion may offer women a convenient, safe and effective abortion method, reduce burdens on healthcare systems and support social distancing during the COVID-19 pandemic. Home-based medical abortion is defined as any abortion where mifepristone, misoprostol or both medications are taken at home.MethodsA systematic review and meta-analysis of randomised controlled trials (RCTs) and non-randomised studies (NRSs) were conducted. We searched databases from inception to 10 July 2019 and 14 June 2020. Successful abortion was the main outcome of interest. Eligible studies were RCTs and NRSs studies with a concurrent comparison group comparing home versus clinic-based medical abortion. Risk ratios (RRs) and their 95% CIs were calculated. Estimates were calculated using a random-effects model. We used the Grading of Recommendations Assessment, Development and Evaluation approach to assess risk of bias by outcome and to evaluate the overall quality of the evidence.ResultsWe identified 6277 potentially eligible published studies. Nineteen studies (3 RCTs and 16 NRSs) were included with 11 576 women seeking abortion up to 9 weeks gestation. Neither the RCTs nor the NRS found any difference between home-based and clinic-based administration of medical abortion in having a successful abortion (RR 0.99, 95% CI 0.98 to 1.01, I2=0%; RR 0.99, 95% CI 0.97 to 1.01, I2=52%, respectively). The certainty of the evidence for the 16 NRSs was downgraded from low to very low due to high risk of bias and publication bias. The certainty of the evidence for the three RCTs was downgraded from high to moderate by one level for high risk of bias.ConclusionHome-based medical abortion is effective, safe and acceptable to women. This evidence should be used to expand women’s abortion options and ensure access to abortion for women during COVID-19 and beyond.PROSPERO registration numberCRD42020183171.

scholarly journals Effects of traditional Chinese exercise on cardiac rehabilitation after percutaneous coronary intervention: study protocol for network meta-analysis of randomised controlled trials

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023096 ◽  
Author(s):  
Chuanjin Luo ◽  
Junmao Wen ◽  
Weipeng Sun ◽  
Ting Li ◽  
Xiaojiang Yu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trials ◽  
Tai Chi ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Percutaneous Coronary ◽  
Randomised Controlled

IntroductionCoronary heart disease (CHD) is the most common cause of death worldwide. Percutaneous coronary intervention (PCI) has been shown to reduce mortality in patients with CHD. However, there are still recurrences of cardiovascular events after PCI. Cardiac rehabilitation (CR) in patients with established CHD is associated with reductions in cardiovascular mortality and hospital admissions, as well as improved quality of life. More and more clinical trials suggest that traditional Chinese exercise (TCE) plays a positive role in patients post-PCI. The primary purposes of the current study are to conduct a network meta-analysis of randomised trials to determine the effects of TCE in patients after PCI, and to separately compare the effects of tai chi, baduanjin and yijinjing on CR after PCI.Methods and analysisStudies will be retrieved from the following databases: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Data, Chinese BioMedical Database and Chinese Science and Technology Periodicals Database, from inception to December 2018. We will include randomised controlled trials that are related to the effects of TCE therapies in patients after PCI. The primary outcomes will be all-cause mortality, revascularisations, health-related quality of life and hospitalisations. Two reviewers will independently select eligible articles. For each included article, two reviewers will independently extract the data and assess the risk of bias by using the Cochrane risk of bias tool. Bayesian network meta-analyses will be conducted to pool all treatment effects. The ranking probabilities for the optimal intervention of various treatments (tai chi, baduanjin or yijinjing) will be estimated by the mean ranks and surface under the cumulative ranking curve. The Grading of Recommendations Assessment, Development and Evaluation System will be used to assess the quality of evidence.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. They will provide consolidated evidence to inform clinicians on the potential functions of TCE in CR, and to provide reliable evidence for the application of TCE.Trial registration numberCRD42018088415.

scholarly journals The effect of preoperative stoma site marking on risk of stoma-related complications in patients with intestinal ostomy—protocol of a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Charlotte Mareike Kugler ◽  
Jessica Breuing ◽  
Tanja Rombey ◽  
Simone Hess ◽  
Peter Ambe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Stoma Site ◽  
Preoperative Marking ◽  
Stoma Site Marking ◽  
Randomised Controlled

Abstract Background An intestinal ostomy is an artificial bowel opening created on the skin. Procedure-related mortality is extremely rare. However, the presence of an ostomy may be associated with significant morbidity. Complications negatively affect the quality of life of ostomates. Preoperative stoma site marking can reduce stoma-related complications and is recommended by several guidelines. However, there is no consensus on the procedure and recommendations are based on low-quality evidence. The objective of the systematic review will be to investigate if preoperative stoma site marking compared to no preoperative marking in patients undergoing intestinal stoma surgery reduces or prevents the rate of stoma-related complications. Methods We will include (cluster-) randomised controlled trials and cohort studies that involve patients with intestinal ostomies comparing preoperative stoma site marking to no preoperative marking and report at least one patient-relevant outcome. For study identification, we will systematically search MEDLINE/PubMed, EMBASE, CENTRAL and CINHAL as well as Google Scholar, trial registries, conference proceedings and reference lists. Additionally, we will contact experts in the field. Two reviewers will independently perform study selection and data extraction. Outcomes will be prioritised based on findings from telephone interviews with five ostomates and five ostomy and wound nurses prior to conducting the review. Outcomes may include but are not limited to stoma-related complications (infection, parastomal abscess, hernia, mucocutaneous separation, dermatological complications, stoma necrosis, stenosis, retraction and prolapse) or other patient-relevant postoperative endpoints (quality of life, revision rate, dependence on professional care, mortality, length of stay and readmission). We will use the ROBINS-I or the Cochrane risk of bias tool to assess the risk of bias of the included studies. We will perform a meta-analysis and assess the certainty of evidence using the GRADE approach. Discussion With the results of the systematic review, we aim to provide information for future clinical guidelines and influence clinical routine with regard to preoperative stoma site marking in patients undergoing ostomy surgery. When the evidence of our systematic review is low, it would still be a useful basis for future clinical trials by identifying data gaps. Systematic review registration PROSPERO registration number: CRD42021226647

scholarly journals BEFRIENding for Depression, Anxiety and Social support in older adults living in Australian residential aged care facilities (BEFRIENDAS): randomised controlled trial protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Colleen Doyle ◽  
Sunil Bhar ◽  
Christina Bryant ◽  
Briony Dow ◽  
David Dunt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Aged Care ◽  
Trial Registration ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Randomised Controlled

Abstract Background This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia. Methods and analysis We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach. Discussion To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people’s mental health. Trial registration Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112, registered 06/05/2019 – retrospectively registered.

scholarly journals O41 Quantifying the burden of survivorship associated with infra-renal abdominal aortic aneurysm repair: a systematic review

2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
K Patel ◽  
V Sounderajah ◽  
P Normahani ◽  
A Acharya ◽  
H Ashrafian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Guidelines ◽  
Meta Analysis ◽  
Case Series ◽  
Abdominal Aortic Aneurysm Repair ◽  
Risk Of Bias ◽  
Patient Decision Making ◽  
Abdominal Aortic ◽  
Randomised Controlled

Abstract Introduction Survivorship encompasses the physical, psychological, social, functional and economic experience of living with a chronic condition for both patients and their caregivers. It comprises 9 distinct domains and remains understudied in non-oncological pathologies, including infra-renal abdominal aortic aneurysmal disease (IRAAA). This review aims to quantify the extent to which existing IRAAA literature addresses the burden of survivorship in patients following surgical intervention. Method The databases; MEDLINE, EMBASE and PsychINFO, were searched from 1989 through to July 2020. Randomised controlled trials, observational studies and case series studies were included. Eligible studies had to detail outcomes related to survivorship following IRAAA surgery. Due to heterogeneity between studies and outcomes, no meta-analysis was conducted. Study quality was assessed with specific risk of bias tools. Result 112 studies were included and only 4 of the 9 domains of survivorship have been previously studied—treatment complications, physical functioning, co-morbidities and caregivers. The available evidence is of variable quality; the majority of studies display a moderate to high risk of bias, are of an observational study design, are based within a limited number of countries and consist of an insufficient follow up period. Conclusion This review highlights the absence of robust evidence regarding survivorship following IRAAA surgery, regardless of repair modality. Consequently, contemporary treatment guidelines are reliant upon historic quality of life data that is narrow in scope and non-representative of contemporary clinical practice. As such, there is an urgent need to re-evaluate the scope and methodology associated with this research theme moving forwards. Take-home Message There is an urgent need to re-evaluate the scope and methodology associated with traditional quality of life centred IRAAA studies moving forwards in order to better empower patient decision making as well as inform treatment guidelines and health policy initiatives.

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