Novel protocol combining physical and nutrition therapies, Intensive Goal-directed REhabilitation with Electrical muscle stimulation and Nutrition (IGREEN) care bundle

Abstract Background Although the combination of rehabilitation and nutrition may be important for the prevention of intensive care unit (ICU)-acquired weakness, a protocolized intervention of this combination has not yet been reported. We herein developed an original combined protocol and evaluated its efficacy. Methods In this single-center historical control study, we enrolled adult patients admitted to the ICU. Patients in the control group received standard care, while those in the intervention group received the protocol-based intervention. The ICU mobility scale was used to set goals for early mobilization and a neuromuscular electrical stimulation was employed when patients were unable to stand. The nutritional status was assessed for nutritional therapy, and target calorie delivery was set at 20 or 30 kcal/kg/day and target protein delivery at 1.8 g/kg/day in the intervention group. The primary endpoint was a decrease in femoral muscle volume in 10 days assessed by computed tomography. Results Forty-five patients in the control group and 56 in the intervention group were included in the analysis. Femoral muscle volume loss was significantly lower in the intervention group (11.6 vs 14.5%, p = 0.03). The absolute risk difference was 2.9% (95% CI 0.1–5.6%). Early mobilization to a sitting position by day 10 was achieved earlier (p = 0.03), and mean calorie delivery (20.1 vs. 16.8 kcal/kg/day, p = 0.01) and mean protein delivery (1.4 vs. 0.8 g/kg/day, p < 0.01) were higher in the intervention group. Conclusion The protocolized intervention, combining early mobilization and high-protein nutrition, contributed to the achievement of treatment goals and prevention of femoral muscle volume loss. Trial registration number The present study is registered at the University Hospital Medical Information Network-clinical trials registry (UMIN000040290, Registration date: May 7, 2020).

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Effect of dental intervention on improvements in metabolic syndrome patients: a randomized controlled clinical trial

BMC Oral Health ◽

10.1186/s12903-020-01373-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Midori Doke ◽

Yuriko Komagamine ◽

Manabu Kanazawa ◽

Maiko Iwaki ◽

Hiroyuki Suzuki ◽

...

Keyword(s):

Metabolic Syndrome ◽

Medical Information ◽

Controlled Trial ◽

Intervention Group ◽

University Hospital ◽

Control Group ◽

Controlled Clinical Trial ◽

Randomized Controlled ◽

Dental Intervention ◽

Water Rate

Abstract Background Metabolic syndrome (MetS), caused by the accumulation of visceral fat, is considered a major cause of cardiovascular disease. This randomized controlled trial aimed to clarify the effect of dental intervention, including prosthodontics and/or periodontal treatment, combined with dietary and exercise guidance on MetS. Methods In total, 112 patients who met the Japanese waist circumference criteria of MetS were recruited. The intervention group (ITG) received dental intervention along with dietary and exercise guidance, while the control group (CTG) received dietary and exercise guidance alone. Three outcome measurements were obtained before intervention (BL), 1 month after intervention (1M), and 3 months after intervention (3M). Results Body water rate (p = 0.043) was significantly higher in ITG than in CTG at 1M. Simultaneously, fasting blood sugar level (p = 0.098) tended to be lower in ITG than in CTG. Lean mass (p = 0.037) and muscle mass (p = 0.035) were significantly higher and body weight (p = 0.044) significantly lower in ITG than in CTG at 3M. Body mass index (p = 0.052) tended to be lower in ITG than in CTG. Conclusions Dental intervention combined with lifestyle guidance may improve anthropometric status and reduce the risk of MetS. Trial registration University Hospital Medical Information Network Center Unique UMIN000022753. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026176.

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Effect of electromyostimulation on intramyocellular lipids of the vastus lateralis in older adults: a randomized controlled trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04456-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Maya Hioki ◽

Nana Kanehira ◽

Teruhiko Koike ◽

Akira Saito ◽

Hideyuki Takahashi ◽

...

Keyword(s):

Older Adults ◽

Plasma Glucose ◽

Medical Information ◽

Vastus Lateralis ◽

Intervention Group ◽

University Hospital ◽

Control Group ◽

Resonance Spectroscopy ◽

Vastus Lateralis Muscle ◽

Link Type

Abstract Background Excessive intramyocellular lipid (IMCL) accumulation is a primary cause of skeletal muscle insulin resistance, especially in older adults, and interventions that reduce IMCL contents are important to improve insulin sensitivity. Electromyostimulation (EMS)-induced changes in IMCL content in older adults remain unknown. The purpose of this study was to clarify the effects of a single bout of EMS on the IMCL content of the vastus lateralis muscle in older adults. Methods Twenty-two physically active, non-obese older men and women were randomly assigned to an EMS intervention group (69.0 ± 5.2 years, n = 12) or a control group (68.4 ± 3.5 years, n = 10). EMS was applied to the vastus lateralis (7 s on and 7 s off) for 30 min; control participants sat quietly for 30 min. IMCL content within the vastus lateralis was quantified with 1H-magnetic resonance spectroscopy (n = 7 per group). Fasting plasma glucose and insulin values were determined from blood samples collected before and after the EMS intervention. Results EMS induced a significant reduction in plasma glucose (93.1 ± 9.6 to 89.5 ± 9.1 mg/dL, p < 0.01), but not IMCL content (15.7 ± 15.7 to 15.8 ± 13.1 mmol/kg wet weight, p = 0.49) or insulin (5.4 ± 2.4 to 4.7 ± 2.7 μIU/mL, p = 0.18). In the control group, no changes in IMCL content in the vastus lateralis was observed after prolonged quiet sitting. Conclusion EMS intervention for 30 min induces changes in plasma glucose, but no changes in IMCL content in older adults. Trial registration University hospital Medical Information Network (UMIN) Center ID: UMIN000020126. Retrospectively registered on December 222,015. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023242

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Effectiveness of a virtual-reality anti-stigma application to reduce the stigma of depression: a randomized controlled trial (Preprint)

10.2196/preprints.28072 ◽

2021 ◽

Author(s):

Wey Guan Lem ◽

Ayako Kohyama-Koganeya ◽

Toki Saito ◽

Hiroshi Oyama

Keyword(s):

Virtual Reality ◽

Medical Information ◽

Intervention Group ◽

University Hospital ◽

Control Group ◽

Public Stigma ◽

Control Groups ◽

Post Intervention ◽

Significant Difference ◽

And Control

BACKGROUND Public stigma against depression contributes to low employment rates among individuals with depression and self-stigmatization of people with depression. Contact-based educational (CBE) interventions, either using in-person contact or video-based contact, have been shown to reduce stigma against mental illness effectively. In-person contacts can stimulate empathy in participants but are challenging to arrange, while video-based contact is cost-effective but encounters difficulty stimulating empathy towards the patient. In this paper, we examined the usefulness of the virtual-reality anti-stigma (VRAS) application to reduce public stigma. OBJECTIVE To develop and evaluate a VRAS application that could provide CBE intervention without using real patients. METHODS Sixteen medical students were recruited and randomized 1:1 to intervention and control groups. Participants in the intervention group (VRAS group) used the VRAS application, while those in the control group watched video material on depression. Participants' depression stigma score was assessed using the Depression Stigma Scale (DSS) and Attitudinal Social Distance (ASD), both pre-and post-intervention. The feasibility of both the VRAS application and video, and the utility of the VRAS application was also evaluated post-intervention. RESULTS Feasibility score was significantly higher in the intervention group (mean 5.63, SD 0.74) than in the control group (mean 3.88, SD 1.73; P=.03). This result indicates that the VRAS application promoted an understanding of stigma in participants. However, no significant differences were apparent between the intervention and control groups for DSS (intervention: mean 35.13, SD 5.30; control: mean 35.38, SD 4.50; P=.92) or ASD (intervention: mean 12.25, SD 3.33; control: mean 11.25, SD 1.91; P=.92). Stigma scores tended to decrease, but the stigma-reducing effects of the VRAS application were not statistically significant for either DSS (pre: mean 33.00, SD 4.44; post: mean 35.13, SD 5.30; P=.12) or ASD (pre: mean 13.25, SD 3.92; post: mean 12.25, SD 3.33; P=.12). CONCLUSIONS No significant differences in mean DSS or ASD were seen between VRAS and control groups. However, one item in the feasibility score showed a significant difference, and feedback comments suggested that VRAS was effective in educating about the stigma of depression. CLINICALTRIAL University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) UMIN000043020; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000049109

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Effect of physician prescribed information on hospital readmission and death after discharge among patients with health failure: A randomized controlled trial

Health Informatics Journal ◽

10.1177/1460458221996409 ◽

2021 ◽

Vol 27 (1) ◽

pp. 146045822199640

Author(s):

Faranak Kazemi Majd ◽

Vahideh Zarea Gavgani ◽

Ali Golmohammadi ◽

Ali Jafari-Khounigh

Keyword(s):

Randomized Controlled Trial ◽

Hospital Readmission ◽

Medical Information ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Randomized Controlled ◽

Long Term Follow Up ◽

Oral Information

In order to understand if a physician prescribed medical information changes, the number of hospital readmission, and death among the heart failure patients. A 12-month randomized controlled trial was conducted (December 2013–2014). Totally, 120 patients were randomly allocated into two groups of intervention ( n = 60) and control ( n = 60). Accordingly, the control group was given the routine oral information by the nurse or physician, and the intervention group received the Information Prescription (IP) prescribed by the physician as well as the routine oral information. The data was collected via telephone interviews with the follow-up intervals of 6 and 12 months, and also for 1 year after the discharge. The patients with the median age of (IQR) 69.5 years old (19.8) death upon adjusting a Cox survival model, [RR = 0.67, 95%CI: 0.46–0.97]. Few patients died during 1 year in the intervention group compared to the controls (7 vs 15) [RR = 0.47, 95%CI: 0.20–1.06]. During a period of 6-month follow-up there was not statistically significant on death and readmission between two groups. Physician prescribed information was clinically and statistically effective on the reduction of death and hospital readmission rates among the HF patients in long term follow-up.

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The effect of postoperative early mobilization on healing process and quality of life following radical cystectomy and ileal conduit: A randomized prospective controlled trial

10.22541/au.161545934.45040085/v1 ◽

2021 ◽

Author(s):

Sevgi Peker ◽

Özgür Çakmak ◽

Talha Muezzinoglu ◽

Guven Aslan ◽

Hakan Baydur

Keyword(s):

Quality Of Life ◽

Radical Cystectomy ◽

Ileal Conduit ◽

Healing Process ◽

Intervention Group ◽

Early Mobilization ◽

Controlled Study ◽

Control Group ◽

Sf 36

Aim: This study was conducted to evaluate the effect of postoperative early mobilization in patients who underwent radical cystectomy (RC) and ileal conduit in terms of healing process and QOL. Methods: This multicenter prospective randomized controlled study was conducted with 40 patients who were randomly divided into two groups. The intervention group was mobilized within the first 16 hours postoperatively in accordance with the mobilization procedure which determined according to literature. Data were collected using the case report form, HADS and SF-36 QoL scale. Results: Postoperative hospitalization, duration of narcotic analgesic administration, first oral food intake, flatus, defecation and NG tube termination time were shorter in the intervention group. In the control group blood glucose and pulse values were higher after mobilization. SF-36 physical function, physical role difficulty and general perception of health were higher in intervention group at the postoperative first and third month (p <0.05). Conclusion: Our study showed that early mobilization contributed to the healing process positively and improved the quality of life in the patients who underwent radical cystectomy (RC) and ileal conduit surgery. Keywords: Early Mobilization, Radical Cystectomy, Ileal conduit, Quality of Life, Convalescence

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Early Mobilization in Ischemic Stroke: A Pilot Randomized Trial of Safety and Feasibility in a Public Hospital in Brazil

Cerebrovascular Diseases Extra ◽

10.1159/000381417 ◽

2015 ◽

Vol 5 (1) ◽

pp. 31-40 ◽

Cited By ~ 10

Author(s):

Simone Rosa Poletto ◽

Letícia Costa Rebello ◽

Maria Júlia Monteiro Valença ◽

Daniele Rossato ◽

Andrea Garcia Almeida ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Public Hospital ◽

Controlled Trial ◽

Pilot Trial ◽

Intervention Group ◽

Total Duration ◽

Early Mobilization ◽

Functional Independence ◽

Control Group

Background: The effect of early mobilization after acute stroke is still unclear, although some studies have suggested improvement in outcomes. We conducted a randomized, single-blind, controlled trial seeking to evaluate the feasibility, safety, and benefit of early mobilization for patients with acute ischemic stroke treated in a public teaching hospital in Southern Brazil. This report presents the feasibility and safety findings for the pilot phase of this trial. Methods: The primary outcomes were time to first mobilization, total duration of mobilization, complications during early mobilization, falls within 3 months, mortality within 3 months, and medical complications of immobility. We included adult patients with CT- or MRI-confirmed ischemic stroke within 48 h of symptom onset who were admitted from March to November 2012 to the acute vascular unit or general emergency unit of a large urban emergency department (ED) at the Hospital de Clínicas de Porto Alegre. The severity of the neurological deficit on admission was assessed by the National Institutes of Health Stroke Scale (NIHSS). The NIHSS and modified Rankin Scale (mRS, functional outcome) scores were assessed on day 14 or at discharge as well as at 3 months. Activities of daily living (ADL) were measured with the modified Barthel Index (mBI) at 3 months. Results: Thirty-seven patients (mean age 65 years, mean NIHSS score 11) were randomly allocated to an intervention group (IG) or a control group (CG). The IG received earlier (p = 0.001) and more frequent (p < 0.0001) mobilization than the CG. Of the 19 patients in the CG, only 5 (26%) underwent a physical therapy program during hospitalization. No complications (symptomatic hypotension or worsening of neurological symptoms) were observed in association with early mobilization. The rates of complications of immobility (pneumonia, pulmonary embolism, and deep vein thrombosis) and mortality were similar in the two groups. No statistically significant differences in functional independence, disability, or ADL (mBI ≥85) were observed between the groups at the 3-month follow-up. Conclusions: This pilot trial conducted at a public hospital in Brazil suggests that early mobilization after acute ischemic stroke is safe and feasible. Despite some challenges and limitations, early mobilization was successfully implemented, even in the setting of a large, complex ED, and without complications. Patients from the IG were mobilized much earlier than controls receiving the standard care provided in most Brazilian hospitals.

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MOBILISASI DINI TERHADAP PEMULIHAN PERISTALTIK USUS DAN SKALA NYERI PASIEN POST PEMBEDAHAN

Journal of Holistic Nursing Science ◽

10.31603/nursing.v7i1.2987 ◽

2020 ◽

Vol 7 (1) ◽

pp. 21-31

Author(s):

Arianti Arianti ◽

Nadila Putri Mayna ◽

Yuda Hidayat

Keyword(s):

Health Workers ◽

Intervention Group ◽

Early Mobilization ◽

Sampling Technique ◽

Pain Scale ◽

Control Group ◽

Cross Sectional ◽

Adult Age ◽

Comparison Research ◽

Intestinal Peristalsis

Postoperative complications such as pain, malnutrition, delayed wound healing and ileus were frequently found and become a challenge for health workers. Early mobilization is recognized as an approach that may help in preventing as well as decreasing the further effect of those complications. However, the implementation of early mobilization in hospitals were still limited to verbal commands without providing direct assistance to postoperative patients. Therefore, this study tries to give evidence-based nursing in PKU Muhammadiyah Gamping Hospital in improving nursing care to postoperative patient outcomes by giving early mobilization. The purpose of this study was to find the effect of early mobilization on the recovery time of intestinal peristalsis and pain scale in post-operative patients. This research was pre-experimental research using a static group comparison research design with a cross-sectional approach. The sampling technique used purposive sampling with specific criteria who was in adult age and received regional anesthesia. This study found 40 subjects consisting of 20 subjects in the intervention group and 20 subjects in the control group. The Mann-Whitney statistical test proved a significant effect on early mobilization on intestinal peristalsis recovery (p = 0.000) Gand pain scale (p = 0.001).

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To the Operating Room! Positive Effects of a Healthcare Clown Intervention on Children Undergoing Surgery

Frontiers in Public Health ◽

10.3389/fpubh.2021.653884 ◽

2021 ◽

Vol 9 ◽

Author(s):

Gabriela Markova ◽

Lukas Houdek ◽

Zuzana Kocabova

Keyword(s):

Quality Of Life ◽

Positive Emotions ◽

Intervention Group ◽

University Hospital ◽

Control Group ◽

Parent Child Relationship ◽

Treatment As Usual ◽

Positive Effects ◽

Parent Child

In the present study we examined the positive effects of a healthcare clown intervention on children undergoing surgeries, and the role parent-child relationships may play in their effectiveness. Children between 5 and 12 years, who were scheduled to undergo elective surgical procedures in a large university hospital, were randomly assigned to an intervention group (IG; n = 35) that was visited by a healthcare clown, and a control group (CG; n = 27) that received treatment as usual (i.e., company of parents before the surgery). Children in both groups were videotaped and the videos were later used to rate their activity, arousal, emotional expressivity, and vocalizations. Additionally, children and parents rated their mood and perceived quality of life at several points during the procedure, and parents reported their perceptions of the relationship with their children. Results showed that children in the IG showed more positive emotions and vocalizations than children in the CG. Parents of children in the IG also reported more positive mood than parents of children in the CG. In contrast, children in the CG reported higher quality of life than children in the IG. Importantly, analyses showed considerable effects of the parent-child relationship on all outcome measures. Results of the present study demonstrate that a healthcare clown intervention had some positive effects on behaviors and mood of hospitalized children and their parents. Importantly, our findings also suggest that we need to consider the pre-existing “relationship microcosmos” that the clowns enter when assessing their effectiveness in the hospital.

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Pengaruh Mobilisasi Dini terhadap Penyembuhan Luka dan Peningkatan Aktivitas Pasien Postoperasi Laparatomi

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v10i1.355 ◽

2021 ◽

Vol 10 (1) ◽

pp. 238

Author(s):

Yuliana Yuliana ◽

Andrew Johan ◽

Nana Rochana

Keyword(s):

Wound Healing ◽

Physical Function ◽

Intervention Group ◽

Early Mobilization ◽

Sampling Technique ◽

Wilcoxon Test ◽

Control Group ◽

Chi Square ◽

Chi Square Test ◽

Increased Activity

Laparatomy is surgery of the abdomen to open the lining of the abdomen. The treatment reduces complications due to surgery, accelerates healing and restores the patient's function to the maximum extent possible before surgery. Returns physical function immediately after surgery with early mobilization. The purpose of this study was to look at the effect of early mobilization on wound healing and increased patient activity postoperatively in laparotomy. This type of research is quantitative with quasy eksperiment with control gruop designs. The number of samples was 88 Laparatomi patients, taken using purposive sampling technique. Tool of data using observation sheets. Data were analyzed using chi-square test and Wilcoxon test. The results of the study stated that there were significant differences between the control group and the intervention group on wound healing (p= 0.047) and on increased activity (p= 0.005). The results of the study it can be concluded that there is an influence of early mobilization on wound healing and increased patient activity. The results of this study recommend early mobilization using progressive mobility procedures in accordance with client activity intolerance

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Effect of Foot Reflexology Practice on Acute Pain and Anxiety of Critically ill Patients after Cardiothoracic Surgery

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i08/01 ◽

2018 ◽

Vol 3 (08) ◽

Author(s):

Fayza Ahmed Abdou ◽

Amal Ismael Abd El-Hafez

Keyword(s):

Critically Ill ◽

Research Design ◽

Acute Pain ◽

Critically Ill Patients ◽

Intervention Group ◽

Cardiothoracic Surgery ◽

Anxiety Level ◽

Anxiety Score ◽

University Hospital ◽

Control Group

Background: One of complementary therapy is foot reflexology practice which is effortlessly, un-costly and with little risks or complications and can be considered as part of nursing procedures for acute pain and anxiety after cardiothoracic surgery. Objective: evaluate the effect of foot reflexology practice on acute pain and anxiety of critically ill patients after cardiothoracic surgery. Research hypothesis: The pain and anxiety score among the interventional group who receiving the foot reflexology practice is lower than that of the control group. Research design: a quasi-experimental research design was used. Setting: This study was conducted in Cardiothoracic and Post-Operative Intensive Care Units at Assuit University Hospital. Subjects: sixty patients were enrolled in this study and assigned equally to intervention and control groups during the period of data collection from February 2015 to February 2016. Results: There were significant differences between the mean of pain and anxiety score of both groups at immediately, and 45 minutes indicating lower mean of pain and anxiety level among intervention group who received foot reflexology practice than control group. Conclusion: The intervention group who received foot reflexology practice had lower pain and anxiety level than the control group who didn’t received foot reflexology practice after cardiothoracic surgery.

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