Effectiveness of home-based electronic cognitive therapy in patients with Alzheimer’s disease dementia: A Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Anna Marin ◽  
Renée DeCaro ◽  
Kylie Schiloski ◽  
Ala’a Elshaar ◽  
Brigid Dwyer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Active Control ◽  
Cognitive Training ◽  
Therapy Group ◽  
Control Group ◽  
Active Control Group ◽  
Computerized Cognitive Training ◽  
Home Based

BACKGROUND Can home-based computerized cognitive training programs be a useful tool to sustain cognition and quality of life in patients with Alzheimer’s disease (AD) dementia? Until now, the progressive nature of the disease and the variability in intervention periods has resulted in discrepant findings. We investigated a potential tool to offset the challenges usually found when evaluating the effectiveness of home-based computerized trainings in the AD population. Constant Therapy is a remotely-delivered, cloud-based program developed for patients with speech and cognitive deficits. OBJECTIVE We aimed to assess the feasibility and effectiveness of a 24-week individualized Constant Therapy intervention program in patients with AD in the MCI and mild dementia stages. METHODS Data were collected over a 48-week period. Participants were assigned to either the Constant Therapy or Active Control group. The Constant Therapy group completed an individualized tablet-based training during the first 24 weeks; the second 24 weeks of computerized training were optional. The Active Control group completed paper and pencil games (e.g., sudokus, crosswords) during the first 24 weeks, and then completed the Constant Therapy training during the second 24 weeks. At weeks 0, 24 and 48, participants completed a neuropsychological battery to assess changes in cognition and functioning. In addition, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was administered every 6 weeks. We measured Constant Therapy rate of adherence and task performance, as well as RBANS scores differences between the Constant Therapy and Active Control groups over the first 24 weeks of training. RESULTS Data for 19 patients were analyzed, with 44% of the Constant Therapy group and 22% of the Active Control group completing the entire 48-week training program. Due to the high drop-out rate, further analysis was only computed for participants who completed 24 weeks of training. The Constant Therapy group spent on average 121 days across the 24 weeks, and an average 27 minutes daily on the app. These participants showed an overall improvement in accuracy and latency in the Constant Therapy tasks scores, as well as specific improvements in the Constant Therapy tasks of visual and auditory memory, attention, and arithmetic. The Constant Therapy group also improved in the RBANS coding subtest compared to the Active Control group. CONCLUSIONS Long term (e.g., 24 weeks) computerized cognitive training using the Constant Therapy platform is feasible in patients with AD in the MCI and mild dementia stages. AD patients showed improvements on the Constant Therapy tasks over the 24 weeks and improved in one of the 12 RBANS subtests. These findings support the need for future research investigating the effects of long term individualized computerized programs as tools to sustain cognitive function and potentially quality of life in patients with AD. CLINICALTRIAL ClinicalTrials.gov NCT02521558

scholarly journals Evaluating the effects of mindfulness-based stress reduction on cognitive function and quality of life in nondemented older adults : a pilot study.

2021 ◽  
Author(s):  
Sasha Mallya
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Pilot Study ◽  
Executive Functioning ◽  
Active Control ◽  
Perceived Stress ◽  
Stress Reduction ◽  
Control Group ◽  
Active Control Group

Adults over the age of 65 years are now the fastest growing segment of the Canadian population. Although individual differences exist, aging is commonly associated with impairments in executive function. The present pilot study investigated the effectiveness of a mindfulness-based stress reduction (MBSR) program on improving executive functioning in older adults, while additionally decreasing perceived stress and improving psychological wellbeing. It was hypothesized that compared with an active control group, the MBSR group would display significant improvements in executive functioning, mood, self-esteem, and perceived stress. Participants were randomly assigned to either MBSR (n=40) or an active control group (n=32). Results suggest that MBSR is associated with significantly enhanced quality of life compared with the control condition. No additional significant results were found. A full-scale study will be necessary to clarify the present results.

scholarly journals KONTAKT© in Australian Adolescents on the Autism Spectrum: Protocol of a Randomized Control Trial

2019 ◽  
Author(s):  
Bahareh Afsharnejad ◽  
Marita Falkmer ◽  
Melissa H Black ◽  
Tasha Alach ◽  
Fabian Lenhard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Active Control ◽  
Randomized Control Trial ◽  
Autism Spectrum ◽  
Social Goals ◽  
Control Group ◽  
Active Control Group ◽  
Randomized Control

Abstract Background: Individuals diagnosed with Autism Spectrum Disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (i) replication of effects in additional clinical and cultural contexts, (ii) designs which employ active control groups, (iii) calculation of health economic benefits, (iv) identification of the optimal training duration, and (v) measurement of individual goal and quality of life outcomes. Method: With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12 to17 years (N=90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking program. Participants will attend both programs in groups of 6 to 8 adolescents, over 16 one and a half hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, and loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and health care costs. Discussion: The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents’ personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12617001117303, registered 31 July 2017, anzctr.org.au; ClinicalTrials.gov: NCT03294668 registered 22 September 2017, https://clinicaltrials.gov. Keywords: Social Skills, Adolescents, KONTAKT, Autism Spectrum Disorder, Training.

scholarly journals KONTAKT© in Australian Adolescents on the Autism Spectrum: Protocol of a Randomized Control Trial

2019 ◽  
Author(s):  
Bahareh Afsharnejad ◽  
Marita Falkmer ◽  
Melissa H Black ◽  
Tasha Alach ◽  
Fabian Lenhard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Active Control ◽  
Randomized Control Trial ◽  
Autism Spectrum ◽  
Social Goals ◽  
Control Group ◽  
Active Control Group ◽  
Randomized Control

Abstract Background: Individuals diagnosed with Autism Spectrum Disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (i) replication of effects in additional clinical and cultural contexts, (ii) designs which employ active control groups, (iii) calculation of health economic benefits, (iv) identification of the optimal training duration, and (v) measurement of individual goal and quality of life outcomes. Method/design: With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12 to17 years (N=90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking program. Participants will attend both programs in groups of 6 to 8 adolescents, over 16 one and a half hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, and loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and health care costs. Discussion: The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents’ personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigours evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD.

scholarly journals KONTAKT© for Australian adolescents on the autism spectrum: protocol of a randomized control trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Bahareh Afsharnejad ◽  
Marita Falkmer ◽  
Melissa H. Black ◽  
Tasha Alach ◽  
Fabian Lenhard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Active Control ◽  
Randomized Control Trial ◽  
Autism Spectrum ◽  
Social Goals ◽  
Control Group ◽  
Active Control Group ◽  
Randomized Control

Abstract Background Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes. Method/design With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12–17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6–8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs. Discussion The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents’ personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov

scholarly journals Evaluating the effects of mindfulness-based stress reduction on cognitive function and quality of life in nondemented older adults : a pilot study.

2021 ◽  
Author(s):  
Sasha Mallya
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Pilot Study ◽  
Executive Functioning ◽  
Active Control ◽  
Perceived Stress ◽  
Stress Reduction ◽  
Control Group ◽  
Active Control Group

Adults over the age of 65 years are now the fastest growing segment of the Canadian population. Although individual differences exist, aging is commonly associated with impairments in executive function. The present pilot study investigated the effectiveness of a mindfulness-based stress reduction (MBSR) program on improving executive functioning in older adults, while additionally decreasing perceived stress and improving psychological wellbeing. It was hypothesized that compared with an active control group, the MBSR group would display significant improvements in executive functioning, mood, self-esteem, and perceived stress. Participants were randomly assigned to either MBSR (n=40) or an active control group (n=32). Results suggest that MBSR is associated with significantly enhanced quality of life compared with the control condition. No additional significant results were found. A full-scale study will be necessary to clarify the present results.

Effectiveness of mobile applications on healthy lifestyles aimed at diabetic patients: review of systematic reviews. (Preprint)

2019 ◽  
Author(s):  
Francisco Jesús Represas Carrera Sr ◽  
Ángel Alfredo Martínez Ques Sr ◽  
Ana Clavería Fontán Sr
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Systematic Reviews ◽  
Mobile Applications ◽  
Control Group ◽  
Diabetic Patients ◽  
Healthy Lifestyles ◽  
Major Public Health Problem

BACKGROUND Diabetes mellitus is currently a major public health problem worldwide. It is traditionally approached in a clinical inpatient relationship between the patient and the healthcare professional. However, the rise of new technologies, particularly mobile applications, is revolutionizing the traditional healthcare model through the introduction of telehealthcare. OBJECTIVE (1) To assess the effects of mobile applications for improving healthy lifestyles on the quality of life and metabolic control of diabetes mellitus in adult patients. (2) To describe the characteristics of the mobile applications used, identify the healthy lifestyles they target, and describe any adverse effects their use may have. METHODS Review of systematic reviews and meta-analysis, following the guidelines of the Cochrane Collaboration and the Joanna Briggs Institute. We included studies that used any mobile application aimed at helping patients improve self-management of diabetes mellitus by focusing on healthy lifestyles. Studies needed to include a control group receiving regular care without the use of mobile devices. In May 2018, a search was conducted in Medline, Embase, Cochrane, LILACS, PsychINFO, Cinahl and Science Direct, updated in May 2019. The methodological quality of the studies was assessed using the Amstar-2 tool. RESULTS Seven systematic reviews of 798 articles were initially selected for analysis. The interventions had a duration of between 1 and 12 months. Mobile applications focused singly or simultaneously on different lifestyles aspects (diet, physical exercise, motivation, blood glucose levels, etc.). There are significant changes in HbA1c values, body weight and BMI, although in others, such as lipid profile, quality of life, or blood pressure, there is no clear improvement. CONCLUSIONS There is clear evidence that the use of mobile applications improves glycemic control in diabetic patients in the short term. There is a lack of evidence in its long-term benefits. It is thus necessary to carry out further studies to learn about the long-term effectiveness of mobile applications aimed at promoting the healthy lifestyles of diabetic patients. CLINICALTRIAL PROSPERO Register: CRD42019133685

scholarly journals Effect of mobile guided cardiac rehabilitation on quality of life – the EU-CaRE randomised clinical trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Houben ◽  
J.A Snoek ◽  
E Prescott ◽  
N Mikkelsen ◽  
A.E Van Der Velde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Control Group ◽  
Funding Source ◽  
Multi Centre Study ◽  
Old Patients ◽  
Home Based ◽  
Significant Difference

Abstract Background and purpose Although participation in cardiac rehabilitation (CR) improves quality of life (QoL), participation in CR, especially among elderly, is limited. We conducted this study to assess whether mobile home-based CR (mCR) increases QoL in elderly (≥65 years old) patients with coronary artery disease (CAD) or a valvular intervention who decline participation in conventional CR. Methods It is designed as a randomised multi-centre study with two parallel arms. Randomisation assigned patients either to mCR or a control group. mCR Consisted of six months of home-based CR with telemonitoring and coaching. Control-group patients did not receive any form of CR throughout the study period. Quality of life was measured with the SF-36v2 questionnaire at 0, 6 and 12 months. Results A total of 179 patients were included in this study (90 control, 89 mCR). A flowchart of the trial is presented in Figure 1. Patients were predominantly male (81.1%). Baseline characteristics can be found in Table 1. Patients using mCR improved on physical QoL after 6 (p=0.026) and 12 (p=0.008) months. There was no difference on mental QoL for both groups (mCR 6 months p=0.563, 12 months p=0.945; control 6 months p=0.589, 12 months p=0.542). No difference existed in QoL between the mCR and control group (physical: 6 months p=0.070, 12 months p=0.150; mental: 6 months p=0.355, 12 months p=0.625). Conclusion Although there is no significant difference in QoL between the control and mCR group, mCR increases physical QoL after 6 and 12 months in elderly patients who decline participation in conventional CR. Therefore E-Health tools should be considered as an alternative for conventional CR when (elderly) patients decline to participate in conventional CR. Figure 1. Flow chart of all eligible patients Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme

scholarly journals Affective Temperaments and Illness Severity in Patients with Bipolar Disorder

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 54
Author(s):  
Mario Luciano ◽  
Luca Steardo ◽  
Gaia Sampogna ◽  
Vito Caivano ◽  
Carmen Ciampi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Protective Factor ◽  
Psychiatric Symptoms ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Affective Temperaments

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitationo of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.

Impact of a 12-month web and smartphone-based intervention initiated during spa therapy to improve long-term physical activity of patients with chronic diseases: randomized controlled trial. (Preprint)

2021 ◽  
Author(s):  
Florie FILLOL ◽  
Ludivine PARIS ◽  
Sébastien PASCAL ◽  
Aurélien MULLIEZ ◽  
Christian-François ROQUES ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Waist Circumference ◽  
Controlled Trial ◽  
Intervention Group ◽  
Group Versus ◽  
Control Group ◽  
Spa Therapy

BACKGROUND Lack of physical activity (PA) and sedentary behaviors are leading risk factors for non-communicable diseases (NCD). Web-based interventions are effective in increasing PA in older adults and in NCD patients. In many countries a course of spa therapy is commonly prescribed to NCD patients and represents an ideal context to initiating lifestyle changes. OBJECTIVE The main objective of this study was to evaluate in NCD patients the effectiveness of an intervention combining an individual face-to-face coaching during spa therapy and, when returning home, a web- and smartphone-based PA program including a connected wrist pedometer and a connected weighing scale, on the achievement of physical activity guidelines (PAG) 12 months after the end of spa therapy. METHODS This was a 12-month, prospective, parallel-group, randomized controlled trial. Patients were enrolled during spa therapy and randomized 1:1 to intervention or control group who received usual advices about PA. From the end of spa therapy, PA, weight, waist circumference, and quality of life of the participants in both groups, were assessed by phone every 2 months. Primary outcome was meeting PAG (PA≥600 METs) at 12 months after the end of spa therapy. Secondary outcomes were: meeting current PAG at 6 months of follow-up; sedentary time, weight and waist circumference, PA and quality of life, at 6 and 12 months. Objective use data of the web-and smartphone-based PA program were collected. Analytic methods include intention-to-treat and constrained longitudinal data analyses. RESULTS The study sample was 228 patients (female : 77.2% (176/228), mean age: 62.4 years (SD 6.7), retired: 53.9% (123/228), mean BMI = 28.2 kg.m-2 (SD 4.2)). No group differences were found for any baseline variable. At 12 months, the proportion of patients achieving PAG was significantly higher in intervention group versus control group (81% vs 67% respectively, OR = 2.34 (95% CI 1.02- 5.38; P=.045). No difference between intervention and control group was found neither in achieving PAG at 6 months nor for sedentary time, weight and waist circumference, at 6 and 12 months. Regarding quality of life, the physical component subscale score was significantly higher at 12 months in intervention group versus control group (mean difference: 4.1 (95% CI 1.9-6.3; P<.001). The mean duration use of the program was 7.1 months (SD 4.5). Attrition rate during the first 2 months of the program was 20.4% (23/113) whereas 39.8% (45/113) of the participants used the program for at least 10 months. CONCLUSIONS The results showed significantly more participants meeting PAG at one year in the intervention group compared to controls. A course of spa therapy offers the ideal time and setting to implement education in PA. Digital coaching seems to be more efficient than usual coaching for increasing the level of PA and decreasing sedentariness on the long term. CLINICALTRIAL ClinicalTrials.gov NCT02694796; https://clinicaltrials.gov/ct2/show/NCT02694796.

The Effect of Telerehabilitation on Quality of Life, Exercise Capacity, and Spirometry Indexes in Patients with Chronic Obstructive Pulmonary Disease in Masih Daneshvari Hospital

2021 ◽  
Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
And Control

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.

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