Improving Postoperative Care Through Mindfulness-Based Cognitive Therapy and Isometric Exercise Interventions: A Systemic Review (Preprint)

2021 ◽  
Author(s):  
Allie Reynolds ◽  
Alireza Hamidian Jahromi
Keyword(s):  
Cognitive Therapy ◽  
Physical Functioning ◽  
Postoperative Care ◽  
Muscular Atrophy ◽  
Isometric Exercise ◽  
Joint Stiffness ◽  
Systemic Review ◽  
Exercise Interventions ◽  
Lack Of Information ◽  
Care Outcomes

BACKGROUND This review identifies the impacts of mindfulness-based cognitive therapy (MBCT) and isometric exercise interventions (IEIs) in postoperative care settings. Both interventions are relatively new approaches to maintain physical functioning, alleviate pain, prevent joint stiffness and muscular atrophy, and positively influence other postoperative care outcomes. OBJECTIVE To our knowledge, a review of the impacts of these interventions and, more specifically, of their combination has not been done before. This review will be the first to do so. METHODS Studies were identified by searching “PubMed” and “Cochrane databases” within PPRISMA algorithm format and using the relevant keyword combinations, which resulted in 39 studies meeting the inclusion criteria. RESULTS In general, MBCT was shown to positively impact both pain relief and physical functioning while IEIs positively impacted physical functioning. Numerous other benefits were also described from both interventions and further research is needed to confirm these findings as well as to determine other possible benefits. However, no studies were found that combined MBCT and IEIs. CONCLUSIONS While there are many positive results from each individual intervention, there is a lack of information about how the combination of MBCT and IEIs might impact postoperative care. The combination of the two interventions might prove to be more effective than each individual intervention alone and the findings from this review show that they could even be complementary. Going forward, research should be expanded to study the possible benefits of the combination of MBCT and IEIs in postoperative care routines as well as other possible combinations.

scholarly journals Effectiveness of Social Stories on Social Skills for Elementary-Aged Students with Autism: A Literature Review

2020 ◽  
Vol 12 (4) ◽  
pp. 12
Author(s):  
Alexandra Christiane Daub ◽  
Tonya Huber
Keyword(s):  
Ethnic Identity ◽  
Social Skills ◽  
Social Stories ◽  
Autism Spectrum ◽  
Cultural Bias ◽  
Systemic Review ◽  
Professional Literature ◽  
Large Variability ◽  
Lack Of Information ◽  
Racial Ethnic

Deficits in social interactions is one of the characteristics of individuals with Autism Spectrum Disorder (ASD). There are numerous interventions that aim at establishing social skills--social stories being one of them. This review of professional literature focuses on the effectiveness of social stories on social skills of elementary-aged students with ASD. The authors identified nine peer-reviewed journal articles from the systemic review of three search engines and analyzed them through different categorizations that provide information on the methodologies used, effectiveness of social stories, the implementation of social stories, and demographic information provided on participants. Effectiveness and implementation of social stories were characterized by a large variability of findings. Effectiveness ranged from lasting behavior changes to no measurable change at all. Implementation differed regarding the mode of presentation, the use of guidelines for developing the stories, setting and reader, and other intervention strategies implemented alongside. The authors identified disparities regarding gender and racial/ethnic identity across studies, with a majority of participants being male and a lack of information concerning the racial/ethnic identity of participants. The potential gender and racial/ethnic/cultural bias needs to be addressed in further research to ensure that findings can be generalized to a larger and representative population.

scholarly journals The Effect of an App for Day-to-Day Postoperative Care Education on Patients With Total Knee Replacement: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Thomas Timmers ◽  
Loes Janssen ◽  
Walter van der Weegen ◽  
Dirk Das ◽  
Willem-Jan Marijnissen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Physical Functioning ◽  
Postoperative Care ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Health Care Consumption ◽  
Perceived Involvement

BACKGROUND Patients who undergo primary Total Knee Replacement surgery (TKR) are often discharged within 1-3 days after surgery. With this relatively short length of hospital stay, a patient’s self-management is a crucial factor in optimizing the outcome of their treatment. In the case of TKR, self-management primarily involves adequate pain management, followed by physiotherapy exercises and daily self-care activities. Patients are educated on all these topics by hospital staff upon discharge from the hospital but often struggle to comprehend this information due to its quantity, complexity, and the passive mode of communication used to convey it. OBJECTIVE This study primarily aims to determine whether actively educating TKR patients with timely, day-to-day postoperative care information through an app could lead to a decrease in their level of pain compared to those who only receive standard information about their recovery through the app. In addition, physical functioning, quality of life, ability to perform physiotherapy exercises and daily self-care activities, satisfaction with information, perceived involvement by the hospital, and health care consumption were also assessed. METHODS A multicenter randomized controlled trial was performed in five Dutch hospitals. In total, 213 patients who had undergone elective, primary, unilateral TKR participated. All patients had access to an app for their smartphone and tablet to guide them after discharge. The intervention group could unlock day-to-day information by entering a personal code. The control group only received weekly, basic information. Primary (level of pain) and secondary outcomes (physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption) were measured using self-reported online questionnaires. All outcomes were measured weekly in the four weeks after discharge, except for physical functioning and quality of life, which were measured at baseline and at four weeks after discharge. Data was analyzed using Student <italic>t</italic> tests, chi-square tests, and linear mixed models for repeated measures. RESULTS In total, 114 patients were enrolled in the intervention group (IG) and 99 in the control group (CG). Four weeks after discharge, patients in the IG performed significantly better than patients in the CG on all dimensions of pain: pain at rest (mean 3.45 vs mean 4.59; <italic>P</italic>=.001), pain during activity (mean 3.99 vs mean 5.08; <italic>P</italic>&lt;.001) and pain at night (mean 4.18 vs mean 5.21; <italic>P</italic>=.003). Additionally, significant differences were demonstrated in favor of the intervention group for all secondary outcomes. CONCLUSIONS In the four weeks following TKR, the active and day-to-day education of patients via the app significantly decreased their level of pain and improved their physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption compared to standard patient education. Given the rising number of TKR patients and the increased emphasis on self-management, we suggest using an app with timely postoperative care education as a standard part of care. CLINICALTRIAL Netherlands Trial Register NTR7182; https://www.trialregister.nl/trial/6992

The influence of isometric exercise on endogenous pain modulation: comparing exercise-induced hypoalgesia and offset analgesia in young, active adults

2018 ◽  
Vol 18 (3) ◽  
pp. 513-523 ◽  
Author(s):  
Samuel Harris ◽  
Michele Sterling ◽  
Scott F. Farrell ◽  
Ashley Pedler ◽  
Ashley D. Smith
Keyword(s):  
Cervical Spine ◽  
Tibialis Anterior ◽  
Isometric Exercise ◽  
Pain Modulation ◽  
Exercise Interventions ◽  
Pressure Pain Thresholds ◽  
Pain Ratings ◽  
Exercise Induced ◽  
Active Adults ◽  
Endogenous Analgesia

Abstract Background and aims Impairment of endogenous analgesia has been associated with the development, maintenance and persistence of pain. Endogenous analgesia can be evaluated using exercise-induced hypoalgesia (EIH) and offset analgesia (OffA) paradigms, which measure temporal filtering of sensory information. It is not clear if these paradigms are underpinned by common mechanisms, as EIH and OffA have not previously been directly compared. A further understanding of the processes responsible for these clinically relevant phenomena may have future diagnostic and therapeutic utility in management of individuals with persistent pain conditions. The primary aim of this study was to investigate if there is a correlation between the magnitudes of EIH and OffA. The secondary aim of the study was to examine whether exercise influences OffA. Methods Thirty-six healthy, pain-free participants were recruited. EIH was evaluated using pressure pain thresholds (PPT) and pain ratings to suprathreshold pressure stimuli over tibialis anterior and the cervical spine. OffA evaluation utilised a three-step protocol, whereby individualised heat pain thermal stimuli [Numerical Rating Scale (NRS)=50/100] were applied (T1), before increasing 1 °C (T2), followed by 1 °C reduction (T3). The magnitude of OffA was calculated as the percentage reduction in the NRS from T2 to T3. PPT/suprathreshold pain ratings and OffA measures were recorded, before and after 5 min of isometric quadriceps exercise performed at 20–25% maximum voluntary contraction (MVC); and following a 15 min rest period. Data were analysed using repeated measures (RM) ANCOVA and correlational analyses. Results There was no correlation between EIH measures (PPTs or pain ratings to suprathreshold pressure stimuli over tibialis anterior or the cervical spine) and OffA (p>0.11 for all). OffA was induced and not modulated by exercise (p=0.28). Conclusions Five minutes of 20–25% MVC lower limb isometric exercise provided non-pharmacological pain modulation in young, active adults. Magnitude of EIH was not correlated with that of OffA, and exercise did not influence magnitude of OffA. Implications These results suggest that in young, pain-free individuals, separate testing of these two paradigms is required to comprehensively evaluate efficacy of endogenous analgesia. If these results are replicated in patient populations, alternative or complementary methods to exercise interventions may be required to modulate impaired OffA.

Indoor Wall Climbing with Childhood Cancer Survivors: An Exploratory Study on Feasibility and Benefits

2020 ◽  
Vol 232 (03) ◽  
pp. 159-165
Author(s):  
Julia Däggelmann ◽  
Aram Prokop ◽  
Vivien Lösse ◽  
Volker Maas ◽  
Sarah Otten ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Pediatric Oncology ◽  
Physical Functioning ◽  
Exploratory Study ◽  
Childhood Cancer Survivors ◽  
Post Intervention ◽  
Exercise Interventions ◽  
Positive Effects ◽  
Study Participants

Abstract Background Exercise interventions in pediatric oncology include primarily traditional types of physical activity (PA) such as endurance and strength training, while there is a growing interest in recreational types of PA for pediatric cancer survivors, as well. One of these motivating and fun activities is indoor wall climbing. Therefore, this exploratory study aims to evaluate the feasibility and beneficial effects of a 10-week indoor wall climbing intervention in pediatric oncology. Patients Thirteen childhood cancer survivors aged 6–21 years were included after cessation of their inpatient medical treatment of whom eleven completed the study. Methods Study participants completed measurements of physical functioning at baseline (t0) and post-intervention (t1), as well as a questionnaire on program satisfaction at t1. Results Survivors participated in 57.43±31.77% of the climbing sessions and no adverse events occurred. Most study participants evaluated the climbing experience to be fun and motivational. One child stated that the climbing intervention was too exhausting/overstraining. Significant positive effects were found in terms of ankle DF-ROM and ankle DF strength. Discussion Indoor wall climbing seems feasible with childhood cancer survivors and suggests beneficial potentials on physical functioning. However, some preconditions (i. e. close supervision; slow increase of intensity; sufficient breaks) must be ensured. Conclusion Indoor wall climbing could be a motivational adjunct to traditional types of exercise in pediatric oncology.

scholarly journals Prevalence of Kinesiophobia in Patients with Osteoarthritis Knee: A Cross Sectional Study

2021 ◽  
Vol 9 (4) ◽  
pp. 3907-3912
Author(s):  
Subha Pragathi Kanniappan ◽  
◽  
Vishnu Vardhan G.D ◽  
Keyword(s):  
Physical Functioning ◽  
Pearson Correlation ◽  
Joint Stiffness ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Cross Sectional ◽  
Correlation Test ◽  
Osteoarthritis Knee ◽  
Pearson Correlation Test

Background: Osteoarthritis (OA) is one of the commonest forms of joint disease, and the knee is one of the most commonly affected joints. OA is clinically associated with pain, joint stiffness, joint deformity and swelling. Kinesiophobia is a condition in which a patient has an excessive, irritational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or reinjury. This study addresses the influence of biological (eg: X-ray changes) as well as severity of pain, kinesiophobia in individual physical functioning. The purpose of the study aims to know the prevalence of kinesiophobia in patients with OA knee. Methodology: A simple random sampling of 30 patients with diagnosed OA knee who visited Pravara Rural hospital (Loni) was included. The patients included were between the age group of 40 - 80 years and were screened according to inclusion and exclusion criteria. The data collection includes the application of scales (Tampa scale of Kinesiophobia-11) which includes 11 items, WOMAC (3 components), VAS to all the 30 subjects and was taken by the principal investigator. The total scores of each scale were analyzed mean and standard deviation were taken. Pearson correlation test was performed to know the correlation between each component. Result: Pearson correlation test was performed which showed a positive correlation between all the four variables i.e. stage of OA, VAS, TSK 11, WOMAC with r= 0.0312. Conclusion: The present study concluded that as there is progression in level or stage of OA there is increase in severity of pain which leads to further increase in level of kinesiophobia in individuals with OA of knee. This all components furthers leads to decrease in physical functioning in individuals with OA knee. KEY WORDS: Osteoarthritis, knee, Kinesiophobia, TSK11, WOMAC, VAS.

scholarly journals The effect of exercise and nutrition interventions on physical functioning in patients undergoing haematopoietic stem cell transplantation: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Marianne C. Prins ◽  
Gerben van Hinte ◽  
Niek Koenders ◽  
Anne Lieke Rondel ◽  
Nicole M. A. Blijlevens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Functioning ◽  
Haematopoietic Stem Cell Transplantation ◽  
Meta Analysis ◽  
Haematopoietic Stem Cell ◽  
Negative Consequences ◽  
Nutrition Interventions ◽  
High Quality ◽  
Exercise Interventions

Abstract Purpose Haematopoietic stem cell transplantation (HSCT) is potentially lifesaving. However, it comes with negative consequences such as impaired physical functioning, fatigue and poor quality of life. The aim of this systematic review and meta-analysis is to determine the effect of exercise and nutrition interventions to counteract negative consequences of treatment and improve physical functioning in patients receiving HSCT. Methods This systematic review and meta-analysis included randomised controlled trials from three electronic databases between 2009 and 2020. The trials included adult patients receiving HSCT and an exercise or nutrition intervention. Study selection, bias assessment and data extraction were independently performed by two reviewers. Physical functioning outcomes were meta-analysed with a random-effects model. Results Thirteen studies were included using exercise interventions (n = 11) and nutrition interventions (n = 2); no study used a combined intervention. Meta-analysis of the trials using exercise intervention showed statistically significant effects on 6-min walking distance (standardised mean difference (SMD) 0.41, 95% CI: 0.14–0.68), lower extremity strength (SMD 0.37, 95% CI 0.12–0.62) and global quality of life (SMD 0.27, 95% CI: 0.08–0.46). Conclusion Our physical functioning outcomes indicate positive effects of exercise interventions for patients receiving HSCT. Heterogeneity of the exercise interventions and absence of high-quality nutrition studies call for new studies comparing different types of exercise studies and high quality studies on nutrition in patients with HSCT.

Exercise interventions to improve physical functioning

2010 ◽  
pp. 204-239
Author(s):  
Stephen R. Lord ◽  
Catherine Sherrington ◽  
Hylton B. Menz ◽  
Jacqueline C. T. Close
Keyword(s):  
Physical Functioning ◽  
Exercise Interventions

scholarly journals The Effectiveness of Nutrition Interventions Combined with Exercise in Upper Gastrointestinal Cancers: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2842
Author(s):  
Fatemeh Sadeghi ◽  
David Mockler ◽  
Emer M. Guinan ◽  
Juliette Hussey ◽  
Suzanne L. Doyle
Keyword(s):  
Quality Of Life ◽  
Physical Functioning ◽  
Muscle Wasting ◽  
Cochrane Library ◽  
Exercise Interventions ◽  
Upper Gi ◽  
Gi Cancer ◽  
Upper Gi Cancer ◽  
Upper Gastrointestinal

Malnutrition and muscle wasting are associated with impaired physical functioning and quality of life in oncology patients. Patients diagnosed with upper gastrointestinal (GI) cancers are considered at high risk of malnutrition and impaired function. Due to continuous improvement in upper GI cancer survival rates, there has been an increased focus on multimodal interventions aimed at minimizing the adverse effects of cancer treatments and enhancing survivors’ quality of life. The present study aimed to evaluate the effectiveness of combined nutritional and exercise interventions in improving muscle wasting, physical functioning, and quality of life in patients with upper GI cancer. A comprehensive search was conducted in MEDLINE, EMBASE, Web of Science, Cochrane Library, and CINHAL. Of the 4780 identified articles, 148 were selected for full-text review, of which 5 studies met the inclusion criteria. Whilst reviewed studies showed promising effects of multimodal interventions on physical functioning, no significant differences in postoperative complications and hospital stay were observed. Limited available evidence showed conflicting results regarding the effectiveness of these interventions on preserving muscle mass and improving health-related quality of life. Further studies examining the impact of nutrition and exercise interventions on upper GI patient outcomes are required and would benefit from reporting a core outcome set.

scholarly journals The Effect of an App for Day-to-Day Postoperative Care Education on Patients With Total Knee Replacement: Randomized Controlled Trial

10.2196/15323 ◽  
2019 ◽  
Vol 7 (10) ◽  
pp. e15323 ◽  
Author(s):  
Thomas Timmers ◽  
Loes Janssen ◽  
Walter van der Weegen ◽  
Dirk Das ◽  
Willem-Jan Marijnissen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Physical Functioning ◽  
Postoperative Care ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Health Care Consumption ◽  
Perceived Involvement

Background Patients who undergo primary Total Knee Replacement surgery (TKR) are often discharged within 1-3 days after surgery. With this relatively short length of hospital stay, a patient’s self-management is a crucial factor in optimizing the outcome of their treatment. In the case of TKR, self-management primarily involves adequate pain management, followed by physiotherapy exercises and daily self-care activities. Patients are educated on all these topics by hospital staff upon discharge from the hospital but often struggle to comprehend this information due to its quantity, complexity, and the passive mode of communication used to convey it. Objective This study primarily aims to determine whether actively educating TKR patients with timely, day-to-day postoperative care information through an app could lead to a decrease in their level of pain compared to those who only receive standard information about their recovery through the app. In addition, physical functioning, quality of life, ability to perform physiotherapy exercises and daily self-care activities, satisfaction with information, perceived involvement by the hospital, and health care consumption were also assessed. Methods A multicenter randomized controlled trial was performed in five Dutch hospitals. In total, 213 patients who had undergone elective, primary, unilateral TKR participated. All patients had access to an app for their smartphone and tablet to guide them after discharge. The intervention group could unlock day-to-day information by entering a personal code. The control group only received weekly, basic information. Primary (level of pain) and secondary outcomes (physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption) were measured using self-reported online questionnaires. All outcomes were measured weekly in the four weeks after discharge, except for physical functioning and quality of life, which were measured at baseline and at four weeks after discharge. Data was analyzed using Student t tests, chi-square tests, and linear mixed models for repeated measures. Results In total, 114 patients were enrolled in the intervention group (IG) and 99 in the control group (CG). Four weeks after discharge, patients in the IG performed significantly better than patients in the CG on all dimensions of pain: pain at rest (mean 3.45 vs mean 4.59; P=.001), pain during activity (mean 3.99 vs mean 5.08; P&lt;.001) and pain at night (mean 4.18 vs mean 5.21; P=.003). Additionally, significant differences were demonstrated in favor of the intervention group for all secondary outcomes. Conclusions In the four weeks following TKR, the active and day-to-day education of patients via the app significantly decreased their level of pain and improved their physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption compared to standard patient education. Given the rising number of TKR patients and the increased emphasis on self-management, we suggest using an app with timely postoperative care education as a standard part of care. Trial Registration Netherlands Trial Register NTR7182; https://www.trialregister.nl/trial/6992

Bed rest attenuates sympathetic and pressor responses to isometric exercise in antigravity leg muscles in humans

2004 ◽  
Vol 286 (5) ◽  
pp. R844-R850 ◽  
Author(s):  
Atsunori Kamiya ◽  
Daisaku Michikami ◽  
Tomoki Shiozawa ◽  
Satoshi Iwase ◽  
Junichiro Hayano ◽  
...  
Keyword(s):  
Muscular Atrophy ◽  
Muscle Sympathetic Nerve Activity ◽  
Plantar Flexion ◽  
Isometric Exercise ◽  
Cardiovascular Responses ◽  
Bed Rest ◽  
Exercise Tests ◽  
Leg Muscles ◽  
Maximal Voluntary Force ◽  
Before And After

Although spaceflight and bed rest are known to cause muscular atrophy in the antigravity muscles of the legs, the changes in sympathetic and cardiovascular responses to exercises using the atrophied muscles remain unknown. We hypothesized that bed rest would augment sympathetic responses to isometric exercise using antigravity leg muscles in humans. Ten healthy male volunteers were subjected to 14-day 6° head-down bed rest. Before and after bed rest, they performed isometric exercises using leg (plantar flexion) and forearm (handgrip) muscles, followed by 2-min postexercise muscle ischemia (PEMI) that continues to stimulate the muscle metaboreflex. These exercises were sustained to fatigue. We measured muscle sympathetic nerve activity (MSNA) in the contralateral resting leg by microneurography. In both pre- and post-bed-rest exercise tests, exercise intensities were set at 30 and 70% of the maximum voluntary force measured before bed rest. Bed rest attenuated the increase in MSNA in response to fatiguing plantar flexion by ∼70% at both exercise intensities (both P < 0.05 vs. before bed rest) and reduced the maximal voluntary force of plantar flexion by 15%. In contrast, bed rest did not alter the increase in MSNA response to fatiguing handgrip and had no effects on the maximal voluntary force of handgrip. Although PEMI sustained MSNA activation before bed rest in all trials, bed rest entirely eliminated the PEMI-induced increase in MSNA in leg exercises but partially attenuated it in forearm exercises. These results do not support our hypothesis but indicate that bed rest causes a reduction in isometric exercise-induced sympathetic activation in (probably atrophied) antigravity leg muscles.

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