scholarly journals The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Naghmeh Ebrahimi ◽  
Zahra Rojhani-Shirazi ◽  
Amin Kordi Yoosefinejad ◽  
Mohammad Nami

Abstract Background Virtual reality training (VRT) is a new method for the rehabilitation of musculoskeletal impairments. However, the clinical and central effects of VRT have not been investigated in patients with patellofemoral pain (PFP). To comprehensively assess the effects of VRT on clinical indices and brain function, we used a randomized clinical trial based on clinical and brain mapping assessment. Methods Twenty-six women with PFP for more than 6 months were randomly allocated to 2 groups: intervention and control. The intervention consisted of lifestyle education + 8 weeks VRT, in 24 sessions each lasting 40 min of training, whereas the control group just received lifestyle education. The balance was the primary outcome and was measured by the modified star excursion balance test. Secondary outcomes included pain, function, quality of life, and brain function which were assessed by visual analogue scale, step down test and Kujala questionnaire, SF-36, and EEG, respectively. Pre-intervention, post-intervention and follow-up (1 month after the end of the intervention) measurements were taken for all outcome measures except EEG, which was evaluated only at pre-intervention and post-intervention). Analyses of variance was used to compare the clinical outcomes between the two groups. The independent t-test also was used for between group EEG analyses. Results Balance score (P < 0.001), function (P < 0.001), and quality of life (P = 0.001) improved significantly at post-intervention and 1 month follow-up in the VRT group compared with the control group. VRT group showed a significantly decreased pain score (P = 0.004). Alpha (P < 0.05) and theta (P = 0.01) power activity also increased in the brain of the VRT group. Conclusion This study demonstrated that long term VRT was capable of improving both clinical impairments and brain function in patients with PFP. Therefore, therapists and clinicians can use this method as a more holistic approach in the rehabilitation of PFP. Trial registration IRCT, IRCT20090831002391N40. Registered 23 / 10 / 2019.

Author(s):  
Michael A Catalano ◽  
Shahryar G Saba ◽  
Bruce Rutkin ◽  
Greg Maurer ◽  
Jacinda Berg ◽  
...  

Abstract Aims Up to 40% of patients with aortic stenosis (AS) present with discordant grading of AS severity based on common transthoracic echocardiography (TTE) measures. Our aim was to evaluate the utility of TTE and multi-detector computed tomography (MDCT) measures in predicting symptomatic improvement in patients with AS undergoing transcatheter aortic valve replacement (TAVR). Methods and results A retrospective review of 201 TAVR patients from January 2017 to November 2018 was performed. Pre- and post-intervention quality-of-life was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Pre-intervention measures including dimensionless index (DI), stroke volume index (SVI), mean transaortic gradient, peak transaortic velocity, indexed aortic valve area (AVA), aortic valve calcium score, and AVA based on hybrid MDCT-Doppler calculations were obtained and correlated with change in KCCQ-12 at 30-day follow-up. Among the 201 patients studied, median KCCQ-12 improved from 54.2 pre-intervention to 85.9 post-intervention. In multivariable analysis, patients with a mean gradient &gt;40 mmHg experienced significantly greater improvement in KCCQ-12 at follow-up than those with mean gradient ≤40 mmHg (28.1 vs. 16.4, P = 0.015). Patients with MDCT-Doppler-calculated AVA of ≤1.2 cm2 had greater improvements in KCCQ-12 scores than those with computed tomography-measured AVA of &gt;1.2 cm2 (23.4 vs. 14.1, P = 0.049) on univariate but not multivariable analysis. No association was detected between DI, SVI, peak velocity, calcium score, or AVA index and change in KCCQ-12. Conclusion Mean transaortic gradient is predictive of improvement in quality-of-life after TAVR. This measure of AS severity may warrant greater relative consideration when selecting the appropriateness of patients for TAVR.


Author(s):  
José Antonio Mingorance ◽  
Pedro Montoya ◽  
José García Vivas Miranda ◽  
Inmaculada Riquelme

Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Elizabeth A Asbury ◽  
Nasim Kanji ◽  
Edzard Ernst ◽  
Mahmoud Barbir ◽  
Peter Collins

Background: Women with angina pectoris, a positive exercise ECG for myocardial ischaemia and angiographically smooth coronary arteries (Cardiac Syndrome X), suffer increased psychological morbidity, debilitating symptomology and a poor quality of life. Autogenic Training (AT), a hypnosis-based auto-suggestive relaxation technique improved anxiety and quality of life in patients with CHD, multiple sclerosis and breast cancer. An exploration of AT as a treatment for Syndrome X was therefore undertaken. Methods: Fifty three female Syndrome X patients (mean ± SD; 57.4 ± 8.0 yrs) were randomised to an 8-week group-based AT and symptom diary program or symptom diary only control. Weekly group AT sessions were supported by an individual home program. The Hospital Anxiety and Depression Scale (HADS) Spielberger State-Trait Anxiety Inventory (STAI) Cardiac Anxiety Questionnaire (CAQ) and the Ferrans & Powers Quality of Life Index (QLI) were completed pre- and post-intervention and at 8-week follow-up. Results : Post-intervention, AT patients had reduced symptom severity (2.08 ± 1.03 vs. 1.23 ± 1.36, p=0.02) and frequency (6.11 ± 3.17 vs. 1.66 ± 2.19, p<0.001) with improved severity (8.04 ± 10.08 vs. 1.66 ± 2.19, p<0.001) and a trend toward reduced symptom frequency (1.95 ± 1.19 vs. 1.23 ± 1.36, p=0.063) compared to controls. Following AT, improved QLI health functioning (17.80 ± 5.74 vs. 19.41 ± 5.19, p=0.04) and CAQ fear (1.53 ± 0.61 vs. 1.35 ± 0.56, p=0.02) were found, with improvements in QLI health functioning (17.80 ± 5.74 vs. 20.09 ± 5.47, p=0.01), CAQ fear (1.53 ± 0.61 vs. 1.30 ± 0.67, p=0.002) CAQ total (1.42 ± 0.54 vs. 1.29 ± 0.475, p=0.04), STAI trait anxiety (42.95 ± 11.19 vs. 38.68 ± 11.47, p=0.01) and QLI quality of life (20.67 ± 5.37 vs. 21.9 ± 4.89, p=0.02) at follow-up. Post-monitoring changes in HADS depression (5.1 ± 3.3 vs. 4.2 ± 3.2, p=0.01), total HADS (13.95 ± 6.84 vs. 12.22 ± 5.75, p=0.02), CAQ avoidance (1.51 ± 0.92 vs. 1.24 ± 0.89, p=0.03), attention (1.33 ± 0.78 vs. 1.16 ± 0.57. p=0.05) and CAQ total (1.39 ± 0.6 vs. 1.23 ± 0.52, p=0.01) were shown in the control group. None were maintained at follow-up. Conclusion : An 8-week AT program has been shown to improve symptom severity and frequency, psychological morbidity and quality of life in women with Cardiac Syndrome X.


2010 ◽  
Vol 16 (4) ◽  
pp. 480-490 ◽  
Author(s):  
U. Dalgas ◽  
E. Stenager ◽  
J. Jakobsen ◽  
T. Petersen ◽  
HJ Hansen ◽  
...  

Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity. Fatigue (Fatigue Severity Scale, FSS), mood (Major Depression Inventory, MDI) and quality of life (physical and mental component scores, PCS and MCS, of SF36) were scored at start, end and follow-up of a randomized controlled clinical trial of 12 weeks of progressive resistance training in moderately disabled (Expanded Disability Status Scale, EDSS: 3—5.5) multiple sclerosis patients including a Control group ( n = 15) and an Exercise group ( n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS—SF36 and MCS—SF36 were comparable at start of study in the two groups. Fatigue improved during exercise by —0.6 (95% confidence interval (CI) —1.4 to 0.4) a.u. vs. 0.1 (95% CI —0.4 to 0.6) a.u. in controls ( p = 0.04), mood improved by —2.4 (95% CI —4.1 to 0.7) a.u. vs. 1.1 (—1.2 to 3.4) a.u. in controls ( p = 0.01) and quality of life (PCS—SF36) improved by 3.5 (95% CI 1.4—5.7) a.u. vs. —1.0 (95% CI —3.4—1.4) a.u. in controls ( p = 0.01). The beneficial effect of progressive resistance training on all scores was maintained at follow-up after further 12 weeks. Fatigue, mood and quality of life all improved following progressive resistance training, the beneficial effect being maintained for at least 12 weeks after end of intervention.


2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Sheida Jabalameli ◽  
Hamid Taher Neshat Doost ◽  
Mohammad Bagher Kajbaf ◽  
Hossein Molavi

Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. It has been reported that psychological treatments like Cognitive-Behavioral Therapy (CBT) is effective for patients with GAD. The purpose of the present research was to investigate the effectiveness of CBT on Quality of Life (QOL) and worry in patients with GAD. A sample of 30 patients with GAD who had been referred to psychiatry offices in Isfahan, Iran were selected and assigned into an experimental group (n=15) and a control group (n=15) randomly.  The experimental group received CBT in 8 weekly sessions. All participants completed the World Health Organization Quality Of Life-Brief (WHOQOL-BREF) questionnaire and the Penn State Worry Questionnaire (PSWQ) at pretest, posttest and follow up. The results of MANCOVA showed that the mean scores of QOL in the experimental group was significantly higher than the control group at the posttest and follow up (P<0.05) and the mean scores of worry in the experimental group was significantly lower than the control group at the posttest and follow up (P<0.05) It is concluded that CBT can be applied for the patients with GAD as a useful psychological treatment. In general, CBT can improve QOL and decrease worry in patients with GAD.


2019 ◽  
Vol 6 (3) ◽  
pp. 111-117
Author(s):  
Tahereh Haji Seyed Javadi ◽  
Najmeh Aghareb Parast ◽  
Sahar Shahsavani ◽  
Mir Javad Chehraghi ◽  
Leila Razavi ◽  
...  

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.


Author(s):  
Qi-Liang Zhang ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hua Cao ◽  
Qiang Chen

Abstract Background The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease surgery after discharge. Methods A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with congenital heart disease surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. Results One month after discharge, the SAS and SDS scores of parents in the intervention group were significantly lower than those in the control group (P&lt;0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at one month after discharge (P&lt;0.05), while the scores of parents in the control group were similar at one month after discharge (P&gt;0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P&gt;0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents’ educational levels were, the higher their SAS and SDS scores were (P&lt;0.05). One month after discharge, in the control group, the lower the parents’ education levels were, the higher their SAS and SDS scores (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the WHOQOL-BREF scale showed that the scores of the physiological, psychological, social and environmental fields at one month after discharge in the intervention group were significantly higher than those in the control group (P&lt;0.05). Conclusion Providing health education and medical support to the parents of infants with congenital heart disease surgery after discharge via telemedicine can effectively relieve the parents’ anxiety and depression and improve their quality of life.


2020 ◽  
Author(s):  
Fatemeh Pyri ◽  
Parvin Abedi ◽  
Elham Maraghi ◽  
Maryam Gholamzadeh Jashreh

Abstract Background: Premature menopause may impair the quality of life and expose women to disorders such as cardiovascular disease, osteoporosis, and depression. This study aimed to evaluate the effectiveness of mindfulness on the quality of life of women with premature menopause. Methods: This was a quasi-experimental study in which 62 women were recruited and randomly allocated in two groups of mindfulness and control. The mindfulness group received eight sessions of training. A demographic questionnaire, Menopause-Specific Quality of Life (MENQOL) and a checklist (for assessing frequency and intensity of hot flashes) were used to collect data. The quality of life, frequency, and intensity of hot flashes measured at baseline, after eight weeks and in three months follow-up. The Independent t-test, the chi-square test, and the repeated measure test were used for analyzing data. Results: The score of quality of life was significantly improved after the intervention and in three months follow-up in the mindfulness group compared to the control group (p<0.001). The scores of vasomotor, psychological, physical, and sexual domains also improved significantly in the mindfulness group compared to the control group. The severity and the frequency of hot flashes were significantly reduced in the mindfulness group in comparison to the control group. Conclusion: The results of this study showed that eight weeks of mindfulness training could significantly improve the quality of life and also could reduce the frequency and intensity of hot flashes in women with premature menopause. Using mindfulness for women with premature menopause is recommended.


2019 ◽  
Author(s):  
Anna María Pálsdóttir ◽  
Kjerstin Stigmar ◽  
Bo Norrving ◽  
Patrik Grahn ◽  
Ingemar F Petersson ◽  
...  

Abstract Fatigue is common after stroke and contributes to disability and impaired quality of life. Currently, there is insufficient evidence on the efficacy of any intervention for post-stroke fatigue. The aim of the study was to examine whether 10 weeks Nature-based rehabilitation (NRB) as add-on to standard care may improve post-stroke fatigue, perceived value of everyday occupations, function, activity and participation compared to standard care only (Clinical Trial.gov Identifier: NCT02435043, 2012/352, 05-06-2015). The study was carried out as a single blinded two-armed randomised controlled trial. Stroke survivors identified through routine 3-month follow-up visit (sub-acute) or medical records (chronic stroke > 1 year earlier) were randomised to Standard care + NBR or Standard care only. Blinded evaluations were conducted at follow-up 8 and 14 months after randomisation. The primary outcomes were post-stroke fatigue (Mental Fatigue Scale, total score) and perceived value of everyday occupations (Oval-pd) 8 months after randomisation. About a quarter of the screened patients were eligible; half accepted to participate and 101 were randomised, mean age 67 years, 60% female. The patients with sub-acute stroke were highly compliant with the intervention. Fatigue decreased to a value below the suggested cut-off for mental fatigue (<10.5) in the intervention group but not in the control group; no statistically significant differences were found though between the groups. Conclusion: NASTRU is the first randomised study on NBR for patients with post stroke fatigue. NBR was feasible and well tolerated. The study was underpowered due to difficulties in recruiting participants. No significant differences were detected between intervention and control group. A larger RCT is warranted. Keywords: clinical trial, enriched environment, everyday occupations, horticulture therapy, quality of life.


2020 ◽  
Vol 34 (4) ◽  
pp. 533-544
Author(s):  
Petra Pohl ◽  
Ewa Wressle ◽  
Fredrik Lundin ◽  
Paul Enthoven ◽  
Nil Dizdar

Objective: To evaluate a group-based music intervention in patients with Parkinson’s disease. Design: Parallel group randomized controlled trial with qualitative triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinson’s disease were randomized into intervention group ( n = 26), which received training with the music-based intervention, and control group ( n = 20) without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7’s (dual-task ability). Secondary outcomes were cognition, balance, concerns about falling, freezing of gait, and quality of life. All outcomes were evaluated at baseline, post-intervention, and three months post-intervention. Focus groups and individual interviews were conducted with the intervention group and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability. Between-group differences were observed for Falls Efficacy Scale (mean difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0, P = 0.001) and for Parkinson Disease Questionnaire-39 items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when compared to the control group post-intervention, but these were not maintained at three months post-intervention. Three themes were derived from the interviews: Expectations versus Results, Perspectives on Treatment Contents, and Key Factors for Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music intervention adds value to mood, alertness, and quality of life in patients with Parkinson’s disease. The study does not support the efficacy in producing immediate or lasting gains in dual-tasking, cognition, balance, or freezing of gait.


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