scholarly journals Impact of Aquatic Exercise on Respiratory Outcomes and Functional Activities in Children with Neuromuscular Disorders: Findings from an Open-Label and Prospective Preliminary Pilot Study

2020 ◽  
Vol 10 (7) ◽  
pp. 458
Author(s):  
Marta Huguet-Rodríguez ◽  
José Luis Arias-Buría ◽  
Belén Huguet-Rodríguez ◽  
Rocío Blanco-Barrero ◽  
Daniel Braña-Sirgo ◽  
...  

Neuromuscular disorders (NMD) lead to the progressive loss of motor and respiratory functions and a decline in daily activities and participation. We aimed to evaluate respiratory changes and functional outcomes in children attending an aquatic therapy program. Eleven patients diagnosed with NMD (4–18 years, Vignos scale 1–9) were involved in a 10-week aquatic exercise program. The ventilation variables were: peak cough flow, volumes (forced expiratory volume in one second-FEV1 and inspiratory volume) and respiratory pressures to evaluate strength and oxygen saturation (O2 sat). Functional skills were measured in the aquatic environment (Water Orientation Test Alyn 1) and on dry land, (Pediatric Evaluation of Disability Inventory), together with quality of life (Pediatric Quality of Life Inventory). Our evaluation included several 2 × 6 mixed-model repeated measures analysis of covariance (ANCOVA) with time (baseline, post 1 session, pre-post at five weeks and pre-post at 10 weeks). Important improvements in functional skills were observed in and out of the water and children under the age of 11 displayed a significant difference for inspirational volume (p = 0.002) and O2 sat (p = 0.029). Clinical, statistically insignificant changes were found for peak cough flow and expiratory pressures values after aquatic exercise. These results may support a relationship between aquatic exercise in NMD, respiratory outcomes and functional activities in water and on land.

2021 ◽  
Vol 8 ◽  
pp. 205435812110577
Author(s):  
Isabelle Ethier ◽  
Immaculate Nevis ◽  
Rita S. Suri

Background: Recent randomized clinical trials have demonstrated beneficial effects of hemodiafiltration (HDF) compared with hemodialysis (HD) on mortality and hemodynamic stability. Data on quality of life in HDF compared with HD is limited. Objective: This study aimed to determine whether patients receiving HD experience improvements in quality of life, hemodynamic and laboratory parameters after switching to HDF. Design: Observational controlled cohort study. Setting & Patients: Adult patients receiving maintenance dialysis were followed for 3 months both before and after transfer to a new unit, where they received HDF. Prior to transfer, control patients were already treated by HDF. Methods: Quality of life at baseline and follow-up was measured using the validated minutes to recovery (MR) question. Dialysis data were collected for 3 consecutive sessions monthly; laboratory values were collected monthly. Wilcoxon signed rank test and repeated measures analysis of covariance were used to evaluate pre/post transfer changes and quantile regression to identify predictors of change in recovery time. Results: Of 227 patients, 82 died, were transplanted, were hospitalized or did not transfer, leaving 123 subjects and 22 controls for analysis. MR did not improve with switching to HDF, although patients with MR > 60 min before transfer experienced a significant decrease in their MR, compared with controls. There was no improvement in intradialytic hypotension with HDF. There were no differences in laboratory values before vs after switch. Limitations: Nonrandomized single-center study, including only small numbers of patients and covering a short follow-up period; hemodynamic values only evaluated over 1 week per month; residual kidney function not recorded. Conclusions: In this Canadian experience of HDF, patients remained stable with respect to several laboratory and dialysis related parameters. Switch to HDF was associated with substantially reduced recovery time in patients with MR > 60 minutes at baseline.


2013 ◽  
Vol 16 (4) ◽  
pp. 378-386 ◽  
Author(s):  
Mei-Chun Liu ◽  
Shih-Hsien Kuo ◽  
Chao-Po Lin ◽  
Yung-Mei Yang ◽  
Fan-Hao Chou ◽  
...  

The purpose of this study was to examine the effectiveness of a professional support (PS) intervention (including individualized health education and supportive phone calls) in reducing the severity of nausea and vomiting (NV) and improving the quality of life (QOL) of women in early pregnancy. An experimental pretest/posttest design with a control group was used. Participants were recruited from a regional teaching hospital in southern Taiwan. The women in the experimental group ( n = 40) received the PS intervention, while those in the control group ( n = 39) only received routine nursing care. Analysis of covariance and mixed models were used to compare the experimental and control groups while adjusting for covariates. The severity of NV and the perceived level of symptom distress were significantly lower in the experimental group than in the control group during weeks 2 and 4, and the women in the experimental group showed a significant improvement in their QOL in week 4 ( p < .05). However, there was no significant difference between the two groups in body weight at week 4 ( p = .501). These findings provide empirical evidence in support of the effectiveness of PS in reducing the severity of NV and improving QOL for women during early pregnancy. This intervention could be routinely applied in prenatal nursing health education. Future studies could apply the concept of PS to different populations and health issues.


2020 ◽  
Vol 32 (3) ◽  
pp. 148-155
Author(s):  
Lynn Shesser ◽  
Darcy Brodecki ◽  
Ruth Lebet

Home mechanical ventilation is an alternative to institutional management for some children with chronic or degenerative respiratory and neuromuscular disorders. Over the past 20 years, Children’s Hospital of Philadelphia has enhanced its Home Care Home Ventilator Program, designed to transition hospitalized children requiring long-term mechanical ventilation safely home. Program goals include supporting patient safety, medical stability, and caregiver competence while promoting quality of life. This longitudinal quality improvement project examined perceived quality of life for families with children discharged home for the first time on mechanical ventilation. We sought to identify unmet needs related to this transition. A self-report quality-of-life survey adapted from several validated tools was completed by the primary caregiver at 3 specific times over 6 months. Repeated-measures general linear modeling examined changes over time in caregivers’ perceptions of quality of life and confidence in meeting their child’s ongoing healthcare needs. After completing the inpatient portion of the program, followed by 6 months caring for their child at home with support from the hospital’s Home Care Department and Technology Dependence Center, caregivers reported more time to attend to their own needs and family activities, less financial burden, less anxiety, and perceived improvements in their child’s health and quality of life compared with hospitalization. Based on our findings, one program change was implemented: the Home Care social worker now meets with the family prior to discharge.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mahsa Asadollahi Hamedani ◽  
Alireza Salar ◽  
Fatihe Kermansaravi

Background: Nowadays, the high prevalence of hypertension and its serious complications for affected patients have made this disease a major health issue worldwide. Hypertension, like other chronic diseases, reduces the patients’ quality of life. Maintaining and improving their lifestyles requires the serious support of families. Objectives: This study aimed to explore the effect of the family-centered empowerment model on the quality of life of patients with hypertension. Methods: This clinical trial was performed on 70 hypertensive patients who were referred to two comprehensive health centers in Zahedan University of Medical Sciences in Zahedan, southeastern Iran, in 2020. The participants were selected and randomly allocated based on the inclusion criteria to the intervention (n = 35) and control (n = 35) groups using the consort. The participants in the intervention group received training in four 60-min sessions individually based on the family empowerment model. To collect data, a personal information form and the Quality of Life Questionnaire for hypertensive patients were used. The questionnaire was completed before the intervention and one and three months after the intervention by a self-report method. The collected data were analyzed by SPSS-22 using the independent samples t test, chi-square test, and repeated-measures analysis of variance. Results: The results of repeated-measures analysis of variance regarding the effect of time and group on the quality of life showed a statistically significant difference in the second and third phases between the two groups. In other words, the two variables of intervention and time affected the mean score of quality of life, and a statistically significant difference was observed in the measured time intervals (P < 0.001). Conclusions: This study showed that implementing the family-centered empowerment model improves the quality of life of patients with hypertension. Therefore, we recommend employing this method by nurses to engage the patients with chronic diseases and their families in the process of treatment.


2021 ◽  
Vol 26 (1) ◽  
pp. 163-168
Author(s):  
Maedeh Pourhossein Alamdari ◽  
Fazlollah Ahmadi ◽  
Mahmoud Abedini

Multiple sclerosis is a chronic and unpredictable disease and is a growing trend and, like other chronic diseases, affects one's quality of life and since sleep quality is one of the dimensions of quality of life, this study aimed to investigate the effect of applying continuous care model on sleep quality of patients with MS in 2013. This clinical trial study was performed on 80 patients with multiple sclerosis who were randomly assigned to experimental and control groups. Data collection tools included demographic information questionnaire, PSQI questionnaire and model implementation in four stages (familiarization, sensitization, control, evaluation). Model stages were performed individually and in groups for three weeks according to patients' educational needs (sleep, activity, medication and nutrition) and after two months follow up, control and evaluation were performed. Data were analyzed using Chi-square test, independent t-test and repeated measures ANOVA and spss16 software. Statistical analysis of variance (ANOVA) with repeated measures showed a significant difference between the mean of total score and the scores of sleep quality dimensions in three times between the two groups (p<0.05). It can be concluded that the implementation of continuous care model causes a significant difference in the sleep quality of patients with MS.


2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 62-62
Author(s):  
Amit Bahl ◽  
Amarnath Challapalli ◽  
Rosemary Greenwood ◽  
Katrina Hurley ◽  
Rajendra Persad

62 Background: Hormone therapy in combination with radiotherapy is a curative treatment option for prostate cancer (CaP). There is paucity of data regarding quality of life (QoL) evaluation of neoadjuvant Decapeptyl. We reported on the equivalence of cytoreductive efficacy of neoadjuvant Decapeptyl and Zoladex previously. Here we present the final QoL evaluation of the effect of Decapeptyl compared with Zoladex preradiotherapy. Methods: Seventy-one patients with localised CaP who have chosen radical radiotherapy had been randomised by stratified block design, toreceive either Decapeptyl (D: n = 37) or Zoladex (Z: n = 34) with bicalutamide cover. All the patients had subsequent radical radiotherapy and followed up as per departmental protocol. The effect of Decapeptyl and Zoladex on QoL was assessed using EQ5D, QLQ-PR25, QLQ-C30 questionnaires, which were completed at baseline, 6, 10 & 14 weeks after start of therapy. QoL scores were analysed as mean scores over the 4 treatment time points for all domains, controlling for baseline scores using Analysis of Covariance. Results: There was no clinically significant difference or trend towards worsening QoL with either Z or D in the global (EQ5D) and cancer-specific (QLQ-C30) domains. The cancer-specific (QLQ-C30) symptom score also showed no trend towards worsening QoL with either Z or D. Symptom scores in the QLQ-PR25 questionnaire did not show a significant difference between Z and D arms with the exception of hormone symptoms. The hormone symptoms showed an increasing trend over the 4 treatment time points, with those in the Z arm significantly (p = 0.02) more affected (3 points higher on average) than patients in the D arm, despite equivalence in cytoreductive effect and achieving castrate levels of testosterone. Conclusions: There were no clinically significant differences in QoL domains between Zoladex and Decapeptyl, apart from hormones symptoms which were worse with Zoladex. Further validation is required with affect on hormone symptoms as the primary outcome measure. To our knowledge this is the first reported prospective randomised data demonstrating the effect of Zoladex and Decapeptyl, on QoL in the neoadjuvant setting. Clinical trial information: EduraCT: 2008-007028-25.


Author(s):  
Mojtaba Dehestani Ardakani

Introduction: The purpose of this study was to determine the effect of aerobic exercise program on quality of life in multiple sclerosis men as a complementary therapeutic approach to multiple sclerosis. Methods: This was a semi-experimental study. The statistical sample consisted of 60 people was selected by the available sampling method from Kahrizak Nursing Home where was also a member of the Iranian MS society. They were randomly divided into control and test groups. After an introductory session of the patients with the aims and intervention method in the experimental group, 27 sessions of 60 minutes of aerobic exercise program were performed in 9 weeks. Data collection tools consisted of a demographic questionnaire, a short quality of life (SF-8) questionnaire, and self-report checklist with a significant level of p≤0.05. Descriptive statistical tests, independent t-test and repeated measures analysis of variance were used for analysis using SPSS version 16 statistical software with a significance level of p≤0.05. Results: The results showed that there was no significant different between the two groups in terms of the total score (df = 48 = T 21.1, p = 0.23) and dimensions of quality of life (Physical: df = 48, T = 1.31, p = 0.19; mental: df = 48, t = 0.96, p = 0.31) There was no significant difference between the control and experimental groups. The results of repeated measures analysis of variance showed that there was a significant difference between the experimental and control groups in terms of quality of life dimensions. Conclusion: In general, aerobic exercise, which was chosen as an exercise program in this study, improves the quality of life of multiple sclerosis patients. Therefore, this complementary therapeutic approach is recommended as an effective and cost-effective method in cost and time, as well as the ability to learn and easy to administer to multiple sclerosis patients.


2019 ◽  
Vol 5 (4) ◽  
pp. 151-160
Author(s):  
Alia Saberi ◽  
◽  
Hamidreza Hatamian ◽  
Amirreza Ghayeghran ◽  
Fatemeh Mola Hosseini ◽  
...  

Background: Multiple Sclerosis (MS) is a chronic demyelinating, inflammatory, and degenerative disease of the central nervous system. MS gradually limits and deteriorates the patients’ quality of life. Objectives: This study aimed to evaluate and compare the quality of life in patients with MS consuming Fingolimod and Cinnovex. Materials & Methods: In an analytical cross-sectional study, 106 patients with Relapsing-Remitting MS (RRMS) referred to specialized neurology clinics of Guilan University of Medical Sciences were selected for the study using a convenience sampling method (52 patients consuming Fingolimod and 54 patients consuming Cinnovex). Then, we collected their demographic information and medical profile. The patients were assessed by the Hamburg quality of life questionnaire in MS. The obtained data were analyzed in SPSS V. 22 using the Chi-square test, independent t-test, Mann-Whitney U, one-way and multivariate analysis of covariance. Results: There was a significant difference between the two groups in terms of age, number of attacks in the last 6 months, and educational level (P<0.05). After controlling confounding variables, it was found that consumers of Fingolimod had a better quality of life. At the subscales level, this difference was significant only in the mood dimension (F=6.931, P=0.011, η=0.12). Conclusion: Patients consuming Fingolimod reported a better quality of life compared to consumers of Cinnovex. This improvement was mainly found in mood scores.


2021 ◽  

Background: Menopause is a natural part of women's lives and is associated with a series of complications that can impair their quality of life. This study was conducted to determine the effect of educational interventions based on the Multi-Theory Model (MTM) on the quality of life among menopausal women. Methods: This randomized controlled trial was conducted on 80 menopausal women who met the inclusion criteria and were selected through the multi-stage stratified random sampling method. The participants were randomly allocated to either the control or intervention group (40 subjects per group). The intervention group participated in five 45-min educational sessions based on the MTM on the predetermined days of the week. The quality of life level scores were collected at baseline, immediately, and three months after the intervention using the Menopause-Specific Quality of Life questionnaire (MENQOL). On the other hand, the control group did not receive any intervention during the study period. Results: Analysis of variance of repeated measures showed a significant interaction between time and intervention. Therefore, the independent t-test was used to compare the mean score of quality of life, before, immediately, and three months after the intervention. The results showed a significant difference between the two groups regarding the scores immediately after and three months after the intervention. Conclusion: Structured educational program based on the MTM could be used as a simple and noninvasive intervention that helps menopausal women’s general health through menopausal symptoms relief, thereby improving their quality of life. Further interventions with larger sample sizes may be required to confirm these findings.


2005 ◽  
Vol 133 (4) ◽  
pp. 569-572 ◽  
Author(s):  
Ron B. Mitchell ◽  
James Kelly

OBJECTIVE: To evaluate the relationship between quality of life and the relative severity of sleep-disordered breathing (SDB) and to compare changes in quality of life after adenotonsillectomy in children with similar demographics but with either obstructive sleep apnea syndrome (OSAS) or with milder forms of SDB. STUDY DESIGN AND SETTING: All study participants underwent polysomnography to document the severity of SDB. The effectiveness of adenotonsillectomy for the relief of SDB was evaluated by using the OSA-18 quality of life survey (OSA-18). Preoperative and postoperative OSA-18 scores for each group of children (OSAS and mild SDB) were compared by using a repeated measures ANOVA. Changes between the 2 groups were compared by using an analysis of covariance with the preoperative score as a covariate. RESULTS: The study population included 61 children, 43 with OSAS and 18 with mild SDB. The demographics in the 2 groups were similar. The mean apnea-hypopnea index for children with OSAS was 21 (range, 5-46), and for children with mild SDB, it was 3 (range 0-4.9). The total OSA-18 score and the scores for all domains showed significant improvement after surgery for both groups of children ( P < .001). A comparison of mean difference in total and domain scores for the 2 groups of children was not significant. CONCLUSIONS AND SIGNIFICANCE: Preoperative values for the OSA-18 total and domain scores are high in children with either OSAS or mild SDB. Both groups of children show a dramatic improvement in quality of life after adenotonsillectomy and the degree of improvement is similar. Fortunately, surgical therapy with adenotonsillectomy is associated with marked improvement in quality of life for children with either OSAS or mild SDB.


Sign in / Sign up

Export Citation Format

Share Document