Effects of the @ctivehip tele-rehabilitation program on the quality of life, psychological factors and fitness level of patients with hip fracture: Controlled trial (Preprint)

2021 ◽  
Author(s):  
Marta Mora-Traverso ◽  
Rafael Prieto-Moreno ◽  
Pablo Molina-Garcia ◽  
Zeus Salas-Fariña ◽  
Lydia Martín-Martín ◽  
...  

BACKGROUND Hip fracture has a severe impact on patients’ quality of life, psychological factors and fitness level. Tele-rehabilitation has emerged in the last years as a promising alternative to conduct the rehabilitation process at home. However, there is no studies testing the effects of tele-rehabilitation interventions for patients with hip fracture on quality of life nor psychological factors, whereas the evidence on fitness level is scarce. OBJECTIVE To test the effects of the @ctivehip tele-rehabilitation program on the quality of life, psychological factors and fitness level of patients who had suffered a hip fracture. METHODS It is a non-randomized clinical trial including patients with 65 five years old onwards with a hip fracture as well as their family caregivers. The intervention group received a home-based multidisciplinary tele-rehabilitation intervention called @ctivehip lasting 12 weeks and the control group received the traditional care and rehabilitation provided by the Andalusian Public Health Care System. The outcomes measured were the patients’ quality of life through the EuroQol Quality of Life Questionnaire (EQ-5D), physiological factors (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS), and the fitness level, assessed with the International Fitness Scale (IFIS). Per-protocol (64 participants) and intention-to-treat (71 participants) analyses were performed, being the first one the main analysis. RESULTS The quality of life of the tele-rehabilitation group increased, while the control group scored worst at 3-month follow-up (medium effect size: 0.66 SDs; p = 0.006). The tele-rehabilitation group demonstrated a greater decrease than the control group in the total HADS score (medium effect size: -0.50 SDs; p = 0.015). Lastly, the tele-rehabilitation group recovered a fitness level close to the pre-hip fracture in comparison with the control group (small effect size: 0.49 SDs; p = 0.022). CONCLUSIONS The @ctivehip tele-rehabilitation program seem to be a promising treatment to improve the quality of life and psychological factors (i.e., anxiety and depression) of older adults after a hip fracture, as well as to recover their previous fitness level. CLINICALTRIAL ClinicalTrials.gov (Identifier: NCT02968589).

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1011.2-1011
Author(s):  
Y. Olyunin ◽  
V. Rybakova ◽  
E. Likhacheva ◽  
E. Nasonov

Background:The patient-reported outcomes are important components of quantitative methods of rheumatoid arthritis (RA) activity assessment which are used to choose the appropriate drug therapy. The value of these parameters can be significantly affected not only by the inflammatory process, but also by the psychological characteristics of the patient and, in particular, by hardiness [1].Objectives:To study the relationship between psychological factors and signs of RA activity.Methods:Patients with RA who met the EULAR/ACR 2010 criteria, and observed at the V. A. Nasonova Research Institute of Rheumatology were included. Clinical examination was performed including patient global assessment (PGA), physician global assessment (PhGA), pain measurement on a visual analog scale, tender joint count (TJC), swollen joint count (SJC). The functional status was determined by HAQ, the quality of life – by SF-36 EQ-5D, the nature of pain – by painDETECT, the presence of anxiety and depression – by HADS. Patients also completed Hardiness Survey questionnaire to assess hardiness (HDS) and 3 components of the HDS – commitment (CMT), control (CT) and challenge (CLN). Disease activity was evaluated with DAS28, CDAI, and RAPID3. All patients signed informed consent to participate in the study. Analysis of the data was performed using Spearman’s rank test, Fisher exact test, qui-square and t-tests.Results:85 patients with RA were included. There were 69 women and 16 men. Mean age was 56.7±13.1 years, disease duration – 7.6±2.7 years. 72 patients were positive for rheumatoid factor, 75 – for anti-cyclic citrullinated peptide antibody. CDAI showed high activity in 15, moderate – in 37, low – in 30, and remission in 3 patients, DAS 28 – in 10, 55, 12, and 8, and RAPID3 – in 24, 25, 15, and 21, respectively. 24 patients had subclinically or clinically expressed anxiety and 15 –subclinically or clinically expressed depression (≥8 according to HADS). In 31 patients, the painDETECT questionnaire revealed possible or probable neuropathic pain. Mean HDS was 84.8±21.7, CMT – 38.9±9.2, CT – 29.4±8.6, CLN – 17.3±7.1. These values were comparable with the corresponding population data for this age group. There was a significant inverse correlation between HDS and RA activity measures, including SJC, TJC, DAS28 (p<0.05), pain, PGA, PhGA, CDAI, RAPID3, and HAQ (p<0.01). In addition, HDS and all its components positively correlated with quality of life, assessed by SF-36 and EQ-5D (p<0.01). In patients with subclinically and clinically expressed anxiety and depression, HDS, CMT, and CT were significantly lower than in patients without anxiety and depression (p<0.01), while the values of CLN in these groups did not differ significantly.Conclusion:The results of the present study suggest that low HDS may be one of the significant factors determining RA activity level because it does not allow patients to adapt adequately to a stressful situation produced by the disease.References:[1]Maddi SR. Am Psychol. 2008 Sep;63(6):563-4.Disclosure of Interests:None declared


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Raquel Bravo-Escobar ◽  
Alicia González-Represas ◽  
Adela María Gómez-González ◽  
Ángela Heredia-Torres

AbstractExploring new models of medical care requires evaluating the impact of new care strategies not only on physiological parameters but also on the quality of life of the patient. On the other hand the presence of anxiety together with depression requires further consideration when planning appropriate management strategies. The aim of this study was to examine the effectiveness of a home-based cardiac rehabilitation program incorporating an e-Health technology on health-related quality of life associated with symptoms of anxiety and depression in moderate-risk patients. A multicenter, randomized controlled clinical trial was designed to compare a traditional hospital based cardiac rehabilitation program (n = 38, 35 male) with a mixed home surveillance program where patients exercised at home with a remote electrocardiographic monitoring device (n = 33, 31 male). The Short Form-36 (SF-36) Health Survey and the Goldberg questionnaire were used to evaluate quality of life and the presence of symptoms of anxiety and depression respectively. The results of this study show that the type of cardiac rehabilitation program did not influence the improvement in quality of life (p = 0.854), but the presence of symptoms of anxiety and depression did (p = 0.001). Although both programs achieved a decrease in anxiety and depression symptoms and improved functional capacity (p ≤ 0.001), a significant interaction effect was found between the group with or without anxiety and depression symptoms and the type of program in the bodily pain dimension (p = 0.021). Trial registration: Retrospectively registered NCT02796404 (10/06/2016) in clinialtrials.gov.


Author(s):  
Francisco Javier Amarilla-Donoso ◽  
Raúl Roncero-Martín ◽  
Jesus Lavado-García ◽  
María de la Luz Canal-Macías ◽  
María Pedrera-Canal ◽  
...  

The objective of this study was to determine the impact of a postoperative educational intervention program on the health-related quality of life (HRQoL) of patients with hip fracture using a controlled clinical trial in a randomized, multicenter study. In total, 102 patients (45.5%) from trauma units at the two University Hospitals of the province of Cáceres received the educational program, whereas 122 (54.5%) did not. Patients were consecutively included in either an intervention or a control group. Patients from the intervention group received an educational program during admission and the postoperative period. Patients from the control group did not receive any educational program. These patients were managed according to routine protocols. The patients were predominantly female (76.3%), aged 84.6 years (SD 6.1). All dimensions in both groups at 12 months showed a significant decrease with respect to baseline, except for bodily pain in both groups (p = 0.447; p = 0.827) and social functioning in the intervention group (p = 0.268). Patients receiving the educational program showed higher levels in the dimensions of the Mental Component Summary (MCS-12) (p = 0.043), vitality (p = 0.010), and social functioning (p < 0.001), as well as in the dimensions of the SF-12 health survey questionnaire of HRQoL 12 months after surgery. In conclusion, our study of the intervention group showed that there were significant improvements in MCS-12, vitality, and social function dimensions compared to the control group.


Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 596
Author(s):  
Greta Veličkaitė ◽  
Neringa Jucevičiūtė ◽  
Renata Balnytė ◽  
Ovidijus Laucius ◽  
Antanas Vaitkus

Background and objectives: Even though pain in multiple sclerosis (MS) patients is common and possibly associated with reduced quality of life, its exact prevalence and characteristics remain vaguely understood. We aimed to estimate the true extent of pain and its associations with quality of life in Lithuanian MS patients and to compare this data with that of a control group. Materials and Methods: Data were collected prospectively at the Department of Neurology, Lithuanian University of Health Sciences Kaunas Clinics. A face-to-face structured interview and a questionnaire were used to collect demographic and clinical data of the MS (n = 120) and control (n = 120) groups. The Expanded Disability Status Scale (EDSS) was used to quantify disability in the MS group. Scores ≥4/10 in the Douleur Neuropathique 4 questionnaire were classified as neuropathic pain. Patients were evaluated using the anxiety and depression subsets of the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the physical and mental component subsets of the Short Form-12 questionnaire (PSC-12 and MSC-12). Results: The MS and control groups did not differ in pain prevalence (76.7% vs. 65.9%, p = 0.064) or intensity. Lhermitte sign, lower limb, and face pain were more common in the MS group, whereas subjects in the control group were more often affected by lower back, neck, and joint pain. Neuropathic pain and pain lasting longer than 2 years were more common among pain-affected MS patients than among controls. MS patients with pain had higher EDSS, HADS-D, and HADS-A and lower PSC-12 scores than those without pain; however, no difference was found regarding the duration of MS or age. Males with MS and pain had higher MSC-12 and HADS-D scores in comparison to the same subset of females. Conclusions: Pain affects approximately three out of four patients with MS in Lithuania and is negatively associated with the mental and physical aspects of quality of life.


Author(s):  
Aurelio Arnedillo ◽  
Jose L. Gonzalez-Montesinos ◽  
Jorge R. Fernandez-Santos ◽  
Carmen Vaz-Pardal ◽  
Carolina España-Domínguez ◽  
...  

Objective: The objective was to assess the effects of a nasal restriction device for inspiratory muscle training, called Feelbreathe®, added to a rehabilitation program (RP) on exercise capacity, quality of life, dyspnea and inspiratory muscle strength in patients with stable COPD. Methods: Patients were randomized into three groups, one performed a supervised RP using the Feelbreathe® device (FB group), the second group developed the same RP with oronasal breathing without FB (ONB group) and the third was the control group (CG). We evaluated inspiratory muscle strength (PImax), dyspnea (mMRC), quality of life (CAT) and exercise capacity (6MWT) before and after 8-week of RP. Results: A total of 16 patients completed the study, seven in FB group, five in ONB group and four in the CG. After the RP, the FB group showed a significant increase in PImax (93.3 ± 19.1 vs. 123.0 ± 15.8 mmHg) and in the 6MWT distance (462.9 ± 71.8 m vs. 529.1 ± 50.1 m) and a decrease in the CAT score (9.7 ± 6.5 vs. 5.9 ± 6.0) and in the mMRC dyspnea score. FB provides greater improvement in PImax, dyspnea, quality of life and 6MWT than ONB. Conclusions: The Feelbreathe® device provides greater improvements in quality of life, dyspnea, exercise capacity and inspiratory muscle strength compared to patients that did not use it.


2009 ◽  
Vol 37 (4) ◽  
pp. 1108-1114 ◽  
Author(s):  
Y Chai ◽  
Y Shao ◽  
S Lin ◽  
K-Y Xiong ◽  
W-S Chen ◽  
...  

The potential impact of the surgical correction of strabismus on vision-related quality of life (VRQOL) and the symptoms of anxiety and depression in children with strabismus remain unclear. The present study included 60 children with strabismus: 30 with heterophoria and 30 with heterotropia. A healthy age-and gender-matched control group ( n = 60) was also recruited. The psychological instruments that were used were the short-form 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) and the Hospital Anxiety and Depression Scale (HADS). The results demonstrated that eight of the 12 NEI-VFQ-25 subscales were significantly impaired in children with strabismus compared with matched controls. Compared with pre-operative values, significant improvements were noted after surgery in the NEI-VFQ-25 summary score, and the anxiety and depression scores. This study demonstrated that the NEI-VFQ-25 instrument can be used in strabismus children and that surgical interventions can improve VRQOL, anxiety and depression in strabismus patients.


2017 ◽  
Vol 28 (6) ◽  
pp. 726-743 ◽  
Author(s):  
Mei-Hua Kao ◽  
Pi-Feng Hsu ◽  
Sheng-Fang Tien ◽  
Chie-Pein Chen

This study was to examine the effects of support interventions on anxiety, depression, and quality of life in women hospitalized with preterm labor. A randomized, single-blind experimental design was used. Participants were recruited from maternity wards of one medical center in Taiwan. The control group ( n = 103) received routine nursing care, and intervention group ( n = 140) received interventional support during hospitalization. The Beck Anxiety Inventory, Edinburgh Postnatal Depression Scale, and Quality of Life Enjoyment and Satisfaction Questionnaire were used at admission and 2 weeks of hospitalization. For the control group, anxiety and depression scores increased significantly and quality of life decreased 2 weeks after hospitalization. Participants who received 2 weeks of support intervention had significantly lower anxiety and depression scores than controls. Thus, clinical nurses can offer support interventions to improve anxiety and depression for women with preterm labor during hospitalization.


2020 ◽  
Author(s):  
Katharina Schiller ◽  
Markus Kofler ◽  
Martin Frühwirth ◽  
Michaela Fantur ◽  
Markus Rauchenzauner

Abstract BackgroundThe aim of this study was to examine a possible association of HbA1c, quality of life (QoL), fitness, and electrophysiological parameters in children with type 1 diabetes mellitus (T1DM).MethodsThe study population (n = 34) consisted of patients with T1DM (n = 17) and an age- and BMI-matched healthy control group (n = 17). HbA1c was obtained from patients with T1DM at time of diagnosis (T0), at 6 months (T6), at 12 months (T12), and at time of study inclusion (Tstudy). QoL was determined with a standardized questionnaire (KINDL-R). All children completed a 6-minute walk test (6MWT) to evaluate their fitness level. Electrodiagnostic studies established upper and lower limb motor and sensory nerve conduction velocities (NCV).ResultsHigher HbA1c (Tstudy) was associated with lower QoL showing in the subscales self-esteem, friends and school. Higher HbA1c (T6) and (T12) was associated with lower QoL in the subscale self-esteem. Based on various subscales, perceived problem areas differed significantly between children and their parents. No differences in fitness level and NCV were found between patients and controls except for a significantly slower median motor NCV in patients. HbA1c was not associated with NCVs at this early stage of disease.ConclusionsGood metabolic control reflected by adequate HbA1c values seems to be important for a good QoL in children with T1DM. Early HbA1c analysis serves as predictor for QoL during follow-up.Trial registration: Retrospectively registered


2019 ◽  
Vol 2 (1) ◽  
pp. 39
Author(s):  
Sara Miftari Sadiki

Background: The coronary disease and diabetes are the most common diseases in Tetovo, therefore the aim of this study is the evaluation of quality of life of patients and of the control group under stress, depression and anxiety influence. In this study has been used a purposeful sampling.The research instrument used consists of socio-demographic questions and four tests: Cohen’s stress measurement questionnaire, Beck’s depression measurement questionnaire, Beck’s anxiety measurement questionnaire and the quality of life measurement questionnaire (WHOQOL). The sample of the study consists of N=300, including patients with heart coronary diseases, patients with diabetes and respondents from the control groups. The results of the study proved the hypothesis that: stress, depression, and anxiety have a negative significant impact in quality of life in the study sample (p-.001). The findings of this study reveals the fact that patients with chronic disease have a reduced quality of life under the influence of psychological factors.


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Wei Zheng ◽  
Xiang Yan ◽  
Xiaoxue Song

Objective: To study and analyze the clinical efficacy of gemcitabine combined with Tegafur chemotherapy after radical resection of pancreatic cancer. Methods: The subjects of the study were 200 patients who were admitted to the hospital from January 2018 to February 2021 requiring chemotherapy after radical resection of pancreatic cancer. According to the different treatment methods, they were divided into a experimental group (gemcitabine combined with Tegafur chemotherapy) and a control group (single gemcitabine chemotherapy), and the treatment efficacy of the two groups of patients was observed and compared. Results: Compared with the control group, patients in the experimental group had significantly better treatment efficacy, quality of life scores and post-treatment anxiety and depression scores. The difference between the groups was significant (p<0.05). Conclusion: Gemcitabine combined with Tegafur chemotherapy for patients requiring chemotherapy after radical resection of pancreatic cancer can significantly improve the treatment efficacy for the disease, improve the patient's quality of life, and ensure that the patient's emotional state during treatment is more positive.


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