scholarly journals IMPACT OF PHYSIOTHERAPY PROGRAMME ON QUALITY OF LIFE AND FUNCTIONAL INDEPENDENCE POST ANTERIOR MEDIASTINAL TUMOUR WITH MYASTHENIA GRAVIS

2021 ◽  
Vol 10 (6) ◽  
pp. 3856-3859
Author(s):  
Chaitanya Ajay Kulkarni
Keyword(s):  
Quality Of Life ◽  
Myasthenia Gravis ◽  
Exercise Program ◽  
Neck Region ◽  
Active Role ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Early Recovery ◽  
Supervised Exercise

A thymoma occurs in approximately 15 per cent of adult diagnosed with Myasthenia gravis (MG). Recent studies have supported the active role of structured physiotherapy rehabilitation program post MG and its complicating symptoms. A male patient, 61 years old, was admitted to the physiotherapy out-patient department with present complains of lump in neck region with generalised weakness and early fatigability. From past two months, the patient faced difficulty in both basic and instrumental activities of daily living such as swallowing, transportation and regular hand movements. Investigation for the patient was carried out in which chest X-ray, CT chest and serum Ach R (positive) was done and was diagnosed with thymoma. Restricted muscle examination of the shoulder and scapular muscle was positive showing symptoms of chest pain and was rated 3/5 with associated discomfort giving away fatigue. The patient was operated for thymectomy which was an elective surgical procedure, operated under general an aesthesia for a duration of approximately 4 hrs. The patient was then referred for post-operative physiotherapy rehabilitation with incisional pain, cough with expectoration, early fatigue and reduced upper limb strength. The patient had a history of Type II Diabetes Mellitus. The focus of the physiotherapy rehabilitation program included airway clearance techniques, monitored graded bed mobilization, aerobic training and progressive resistance training. There was a significant improvement in the patient after 6 weeks of physiotherapy rehabilitation program. The early excision of thymoma with prompt tailor made supervised exercise program helps in early recovery and achievement of functional goal thus improving the quality of life and functional independence.

A Supervised Group Exercise Program for Patients with Multiple Myeloma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5171-5171
Author(s):  
Christine I. Chen ◽  
Danielle Rolfe ◽  
Faith Delosreyes ◽  
Devi Ahuja ◽  
Christina Lee
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Pain Treatment ◽  
Depression Scale ◽  
Exercise Program ◽  
Pilot Program ◽  
Group Setting ◽  
Supervised Exercise ◽  
Peak Vo2

Abstract Background: Cancer-related fatigue, anemia, bone pain, treatment toxicities, depression, and advanced age contribute to debilitation in myeloma. Myeloma pts are reluctant to exercise due to lack of disease-specific exercise guidelines and fear of injury. At our centre, a disease-modified, supervised exercise pilot program has been evaluated with 20 subjects. Methods: Subjects attending myeloma clinic were accrued over 6 wks in response to posted notices. Eligibility: no recent bone fracture/radiation, max. MET (metabolic equivalent) ≥6 (21mL O2 consumption/kg/min, VO2) sufficient to undergo regular exercise (DASI screen). The 12 wk program included weekly supervised group sessions (90 min) and individualized home-based exercises (twice weekly). Exercises were based on American College of Sports Medicine guidelines modified to cancer pts (Lucia et al 2003) and outlined in a manual. Exercises: 1) low-intensity aerobic (treadmills, track walking, recumbent cycle ergometers to 45–75% max. HR); 2) resistance training (therabands, balls, hand wts, or body wt); 3) flexibility training (stretch exercises). Subjects were assessed at baseline and 12 wks for: 1) body composition (wt, BMI, bioelectrical impedence); 2) fitness (HR, peak VO2, max. grip strength, endurance, flexibility measures); 3) quality of life (FACT-F questionnaire); 4) pain (Brief pain inventory); 5) mental health (Hospital Anxiety Depression Scale). Results: 20 subjects took part in the pilot program: 6M:14F; median age 60 yrs(42–74); median disease duration 29 mos(15mos–14yrs); median prior therapies 3(0–8); prior ASCT 16/20 - median time from ASCT 20 mos(3mos–12 yrs), 15/20 with bone disease/pain, 10/20 on active myeloma therapy. Comorbidities: 10/20 had lung, arthritis, or heart disease; 2/20 active smokers. Median Hb 116g/L (range 81–147) - 5/20 subjects had Hb≤100g/L. 18/20 subjects completed the 12 wk program (2 dropouts: 1 hospitalization, 1 unexpected travel). Attendance was variable - 24%(54/216) of total visits missed, most due to minor illness or disease/medication complications. Monthly program evaluations showed enthusiasm for the group format with individualized instruction helping to allay fears of injury. Despite weekly travel, subjects preferred the group setting vs home exercises alone, citing motivation from peers/instructors as vital. Conclusions: A formal exercise program for myeloma is feasible with potential benefits in fitness and mental health. Detailed exercise diagrams/video, expanded strength training, and increased individualized time to ensure proper technique were suggestions for incorporation into our current program. A planned RCT comparing our tailored exercise program to standard care will help develop a prescription for maintaining longterm quality of life for myeloma survivors. Mean baseline (SD) Mean Wk 12 (SD) Difference P-value (paired t-test) *Difference post-6 min walk to resting HR* 45 (18) 44 (19) −1.5 (21) 0.797 SBP* 21.4 (10.7) 18.5 (16.2) −2.9 (13.0) 0.427 6min walk 548 (102) 588 (114) 40 (48) 0.008 Peak VO2 12.6 (1.7) 13.3 (1.9) 0.7 (0.8) 0.007 Wt (kg) 72.6 (11.4) 71.8 (11.6) −0.8 (2.8) 0.320 BMI (Wt/Ht2) 27.5 (4.1) 27.2 (4.4) −0.3 (1.0) 0.328 Body fat (%) 34.7 (6.8) 34.8 (6.7) 0.0 (1.3) 0.328 Strength test 11.5 (3.2) 14.9 (5.6) 3.4 (3.4) 0.005 Flexibility test 20.4 (5.6) 22.9 (8.9) 2.5 (7.6) 0.288 FACT-F 113.7 (22.5) 117.6 (24.1) 3.9 (11.7) 0.214 HAD scale 6.5 (2.4) 5.2 (2.5) −1.2 (1.6) 0.012

Randomized clinical trial on the effect of a supervised exercise program on quality of life, fatigue, and fitness following esophageal cancer treatment (PERFECT study).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12055-12055
Author(s):  
Anne Maria May ◽  
Jonna van Vulpen ◽  
Anouk E Hiensch ◽  
Jelle P. Ruurda ◽  
Grard Nieuwenhuijzen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Esophageal Cancer ◽  
Cardiorespiratory Fitness ◽  
Exercise Intervention ◽  
Exercise Program ◽  
Post Intervention ◽  
Supervised Exercise ◽  
Supervised Exercise Program

12055 Background: Patients with potentially curable esophageal cancer are often treated with chemoradiotherapy followed by surgery. This treatment might have a negative impact on physical fitness, fatigue and quality of life (QoL). In patients with other types of cancer, evidence suggests that physical exercise reduces treatment related side effects. We investigated whether a supervised exercise program also beneficially affects QoL, fatigue and cardiorespiratory fitness (CRF) in patients after treatment for esophageal cancer. Methods: The multicenter PERFECT study randomly assigned patients in the first year after esophagectomy to an exercise intervention (EX) or usual care (UC) group. EX patients participated in a 12-week moderate to high intensity aerobic and resistance exercise program supervised by a physiotherapist. UC patients were advised to maintain their physical activity levels. Attendance and compliance with the exercise intervention protocol were retrieved from exercise logs. QoL (primary outcome, EORTC-QLQ-30, range 0-100), fatigue (MFI-20, range 4-20) and CRF (cardiopulmonary exercise testing) were assessed at baseline and after 12 weeks (post-intervention). The outcomes were analyzed as between-group differences using either linear mixed effects models or ANCOVA adjusted for baseline and stratification factors (i.e. sex, time since surgery, center), according to the intention-to-treat principle. Results: A total of 120 patients (age 64±8) were included and randomized to EX (n = 61) or UC (n = 59). Patients in the EX group participated in 96% (IQR:92-100%) of the supervised exercise sessions and compliance with all parts of the exercise program was high ( > 90%). Post-intervention, global QoL was not statistically different between groups, but significant (p < 0.05) beneficial EX effects were found for QoL-Summary scores (between-group difference 3.5, 95% CI 0.2;6.8) and QoL-role functioning (9.4, 1.3;17.5). Physical fatigue wat non-significantly lower in the EX group (-1.2; -2.6;0.1, p = 0.08). CRF was significantly higher (VO2peak (1.8 mL/min/kg, 0.6;3.0) following the EX intervention. Conclusions: Patients were well capable to complete an intensive supervised exercise program after esophageal cancer treatment, which led to small but significant improvements in several aspects of QoL and cardiorespiratory fitness. Our results suggest that supervised exercise is a beneficial addition to routine care of patients with esophageal cancer. Clinical trial information: NTR5045 .

scholarly journals Strategies to Support Physical Activity Participation in Older Adults With Heart Failure

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 454-454
Author(s):  
Katherine Hall ◽  
Amy Pastva ◽  
Heather King ◽  
Sean Lowers ◽  
Julie Miller ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Older Adults ◽  
Exercise Program ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Exercise Rehabilitation ◽  
Supervised Exercise ◽  
Home Based ◽  
Health Burdens

Abstract Physical activity (PA) is recommended for people living with heart failure (HF). Despite evidence of its benefits, participation in PA is low in this population, putting them at risk for loss of functional independence and additional health burdens. The aim of this pilot study was to ask older adults living with stable, chronic HF to identify strategies to support regular PA. Patients in an outpatient HF rehabilitation program were recruited to participate in focus groups about their PA knowledge, attitudes, and preferences as part of a stakeholder engagement project. At the beginning of the focus group, participants completed a questionnaire listing 8 potential strategies to optimize PA, and were asked to identify the top 4 strategies that they thought would be most beneficial to support regular PA participation. This was the focus of the current analysis. Thirteen adults with HF (M age=65; 46% female; 62% African American; M BMI=32.6 kg/m2) were enrolled. Top-rated strategies endorsed by participants to support long-term adherence to PA included provision of an exercise guide to support home-based exercise and supplement health provider-supervised exercise sessions (69%), group education classes (64%), completion of fitness assessments at regular intervals (62%), and provision of a transition pathway from an exercise rehabilitation program to a community-based exercise program (62%). The remaining strategies were endorsed by fewer than 50% of participants, and included remote delivery and support options. These results have important implications for future program development and implementation efforts to support PA among older adults with stable, chronic HF.

scholarly journals Multidisciplinary intensive outpatient rehabilitation program for patients with moderate-to-advanced Parkinson’s disease

2021 ◽  
pp. 1-9
Author(s):  
Noa Cohen ◽  
Yael Manor ◽  
Yitzhak Green ◽  
Gail Tahel ◽  
Inbal Badichi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Outpatient Rehabilitation ◽  
Advanced Parkinson’S Disease ◽  
Intensive Outpatient ◽  
Positive Results

BACKGROUND: Intensive, multi-disciplinary, rehabilitation programs for patients with Parkinson’s disease (PWPs) have shown to be effective. However, most programs are based on in-patient service, which is expensive. OBJECTIVE: To demonstrate the feasibility of a multidisciplinary, intensive, outpatient rehabilitation program (MIOR) for moderate to advanced Parkinson’s Disease (H&Y≥2). METHOD: The MIOR program takes place at a community rehabilitation center (‘Ezra Le’Marpe’), 3 times a week, 5 hours, 8 weeks, and includes 20 PWPs in each cycle. The multi-disciplinary team includes physical, occupational, speech and hydro therapists. Additional activities include, social work groups, boxing, dancing and bridge. RESULTS: Data was collected retroactively for the first two years. Data analysis includes 158 patient files who completed the program (mean disease duration 10.1±6 and mean H&Y stage 2.8±0.67). Assessments were performed at the beginning and end of the intervention. Positive results were collected: improvement in number of falls (p <  0.0001), Functional Independence Measure (p <  0.0001), quality of life (p <  0.01), balance (p <  0.0001), upper limb function (p <  0.0001) and paragraph reading vocal intensity (p <  0.01). CONCLUSIONS: MIOR is a feasible program, showing positive results in moderate to advanced PWP’s, improving quality of life, daily function, and motor performance. The current outcomes demonstrate feasibility of MIOR in addition to medical treatment.

scholarly journals Positive Impact of Organized Physical Exercise on Quality of Life and Fatigue in Children and Adolescents With Cancer

2021 ◽  
Vol 9 ◽  
Author(s):  
Filippo Spreafico ◽  
Francesco Barretta ◽  
Michele Murelli ◽  
Marco Chisari ◽  
Giovanna Gattuso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Children And Adolescents ◽  
Social Functioning ◽  
Positive Impact ◽  
Young Patients ◽  
Exercise Program ◽  
Well Being ◽  
Drop Out ◽  
Supervised Exercise

Background: Cancer and its treatment can cause serious health issues that impair physical and mental well-being in children and adolescents. Exercise may be a valid strategy for managing some symptoms, including fatigue. In the light of our experience, we provide further justification for including exercise as part of routine childhood cancer care.Methods: Forty-four children and adolescents who had solid cancers not contraindicating their movement were invited to join an in-hospital 6-week supervised exercise program, and asked afterwards to complete validated quality of life and fatigue scales. The program consisted of personalized workout sessions of aerobic, resistance and flexibility exercises. The results obtained on the scales were compared between 21 patients who engaged in the exercise program (GYM group) and 23 who refused (No-GYM group), examining the different dimensions of health-related quality of life (physical, emotional, cognitive, social) and fatigue (general, sleep/rest, cognitive) in the two groups.Results: Being diagnosed with cancer initially prompted all but one of the respondents to drop-out of previous routine exercise or sports although their continuation had not been contraindicated. After 6 weeks of exercise, the GYM group's scores for quality of life and fatigue showed a statistically significant better perceived emotional functioning, and a trend toward a better social functioning than in the No-GYM group.Conclusion: We suggest that exercise improves the satisfaction of children and adolescents with cancer with their physical, mental and social functioning. We would emphasize the potential benefits of general practitioners discussing and recommending exercise for their young patients with cancer.

scholarly journals Impact of a cardio-oncology rehabilitation program in patients with breast cancer undergoing cardiotoxic treatment

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C C Oliveira ◽  
M Matos ◽  
R Azevedo ◽  
R Flores ◽  
P Medeiros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Endothelial Function ◽  
Cancer Patients ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Exercise Group ◽  
Breast Cancer Patients ◽  
The Impact

Abstract Background Cancer treatment–related cardiotoxicity (CTrCD) is commonly associated with anthracyclines and anti-HER2 agents which are widely used for the treatment of breast cancer. In order to mitgate CTrCD, exercise-based cardio-oncology rehabilitation (COR) involving a structured exercise program has been proposed. Objectives To evaluate the impact of a cardiac-rehabilitation program in breast cancer patients submitted to chemotherapy with known cardiotoxicity. Methods A systematic review was performed. Two databases were searched, PubMed and SCOPUS. All randomized or controlled trials and other prospective studies published between 2000 and March 2020 which evaluate the impact of an aerobic exercise program on cardiorespiratory fitness (CRF), health-related quality of life (QOL), vascular/endothelial function as well as cardiac assessment namely through the evaluation of left ventricular function and cardiac biomarkers in patients undergoing anthracycline and/or anti-HER2 treatments were included. Main results Fourteen studies were included enrolling 578 breast cancer patients with a mean age of 48.80 years. Regarding the impact of exercise in CRF, 5 studies (n=176) reported a significant improvement of VO2 max. and 4 studies of VO2max./kg (n=137). The peak power output was also improved in 4 studies (n=95) in the exercise-group. Considering the assessment of QOL, 3 studies (n=180) revealed significant differences favoring the exercise-group. The results regarding the evaluation of the LVEF were not clear: 2 studies (n=48) reported a significant decrease on LVEF when compared to baseline at the end of the intervention in both groups, despite the exercise program. However, 2 studies (n=97) showed a significant increase on LVEF in the exercise-group. Three studies (n=82) did not found significant differences in global longitudinal strain between groups. Limited evidence was found in vascular and endothelial functon. In 2 studies (n=50), endothelial function measured by brachial artery flow-mediated dilatation significantly improved in the exercise-group. Two studies (n=98) reported no significant impact of exercise on atenuating the increase of cTnI and BNP levels in the course of chemotherapy. On the other hand, when considering NT-proBNP, an increase in its levels was attenuated in the exercise-group. Conclusions This study confirms that exercise-based COR seems to be an effective approach to improve several cardiovascular outcomes and quality of life in breast cancer patients. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Advanced Comprehensive Rehabilitation Approach for Post-operative patient with Anterior Mediastinal Tumor: Atypical Case Report

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1112-1117
Author(s):  
Angela Kapoor ◽  
Vaishnavi Yadav ◽  
Pratik Phansopkar
Keyword(s):  
Case Report ◽  
Myasthenia Gravis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Neck Region ◽  
Early Mobilization ◽  
Early Recovery ◽  
Post Surgery ◽  
Supervised Exercise ◽  
Surgery Patient

Myasthenia gravis (MG) is an autoimmune disease in which muscle weakness and fatigability of the skeletal muscle are as a result of an antibody at the neuromuscular junction against the acetylcholine receptor (AChR) affecting ladies and older men. A thymoma occurs in approximately 15 per cent of adult diagnosed with Myasthenia gravis (MG). Thymectomy is used as a surgical approach which helps to reduce the symptoms. Structured comprehensive physiotherapy rehabilitation post-surgery helps to achieve a successful functional recovery. A 61 year old male patient was admitted with complain of lump in neck region, generalised weakness and early fatigability while doing Activities of daily living since 2 months. Investigations were done for the same which revealed thymoma and surgical intervention i.e. thymectomy was performed. Patient was referred to post opt rehabilitation with complains of incisional pain, cough with expectoration, early fatigue performing basic Activities of daily living and reduced strength. Following the surgery patient underwent physiotherapy which comprised of exercises, breathing retraining and early mobilization. The case report concludes that early excision of thymoma with prompt tailor made supervised exercise program helps in early recovery and achievement of functional goal.

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