scholarly journals Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7389
Author(s):  
Irene Cortés-Pérez ◽  
Marcelina Sánchez-Alcalá ◽  
Francisco Antonio Nieto-Escámez ◽  
Yolanda Castellote-Caballero ◽  
Esteban Obrero-Gaitán ◽  
...  

Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A200-A201
Author(s):  
Ragy Tadrous ◽  
Deirdre O’Rourke ◽  
Julie Broderick ◽  
David Mockler

Abstract Introduction Narcolepsy is a neurological condition that has been associated with considerable detriment to daily life including impaired quality of life, occupational and academic difficulties and adversely affected social and personal relationships. To date, there has been no systematic analysis of the literature regarding health-related quality of life (HRQoL) in Narcolepsy. This systematic review aimed to examine the impact of narcolepsy on HRQoL, measured through standardised HRQoL questionnaires such as the Short Form 36 (SF36). Methods Medline, Embase, Cinahl and Web of Science were searched for studies which investigated HRQoL in adults with narcolepsy. Studies were reviewed independently by two reviewers, and a random-effects meta-analysis was performed. The methodological quality of the included studies was assessed using a modified version of the Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies tool. The impact of study variables and characteristics on HRQoL was assessed using Spearman’s Correlation analyses with adjusted r2 values. Results A total of 30 studies were eligible for inclusion in the review. Additionally, meta-analyses were conducted for the SF36 and the EQ5D. The SF36 meta-analysis identified that the pooled mean scores for the Physical Component Summary (45.91) were less affected than the Mental Component Summary (42.98). The HRQoL of people with narcolepsy was compared to general population norms (US, UK, France and Norway) and to people with chronic diseases including multiple sclerosis, diabetes, and epilepsy. Conclusion People with narcolepsy report significant impairments in HRQoL when compared to the general population and other chronic health conditions including epilepsy, multiple sclerosis, diabetes and hypertension, especially concerning their mental wellbeing. Further research is warranted to identify the longitudinal effects of narcolepsy on HRQoL and to develop a narcolepsy-specific HRQoL tool. Support (if any) This review was completed as part of Mr Ragy Tadrous’ Master of Science (MSc) degree in Trinity College Dublin. This degree was co-sponsored by the Physiotherapy Department in St. James’s Hospital, Dublin.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominic O’Connor ◽  
Malcolm Brown ◽  
Martin Eatock ◽  
Richard C. Turkington ◽  
Gillian Prue

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.


Author(s):  
Juliana Vianna Pereira ◽  
Ana Gabriela Costa Normando ◽  
Carla Isabelly Rodrigues-Fernandes ◽  
César Rivera ◽  
Alan Roger Santos-Silva ◽  
...  

Author(s):  
Sherief R. Janmohamed ◽  
Eran C. Gwillim ◽  
Muhammad Yousaf ◽  
Kevin R. Patel ◽  
Jonathan I. Silverberg

2015 ◽  
Vol 16 (8) ◽  
pp. 639-651 ◽  
Author(s):  
N. Lindekilde ◽  
B. P. Gladstone ◽  
M. Lübeck ◽  
J. Nielsen ◽  
L. Clausen ◽  
...  

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697181
Author(s):  
Annabelle Machin ◽  
Randula Haththotuwa ◽  
Opeyemi Babatunde ◽  
Ian Scott ◽  
Nadia Corp ◽  
...  

BackgroundRheumatoid arthritis (RA) is the commonest inflammatory arthritis. Comorbid anxiety and depression are common, but under-recognised and under-treated. Depression in RA has been linked to reduced quality of life and treatment response and increased mortality. Past research into co-morbid mood problems in RA has mainly focused on the prevalence and impact of depression.AimTo complete a systematic review to explore the impact of anxiety on QOL and treatment outcomes in RA.MethodThe systematic review has been registered on PROSPERO. Databases (Web of Science, PsycINFO, CINAHL, Embase and Medline) have been systematically searched for relevant studies. Titles and abstracts have been independently screened by two reviewers. Data extraction and quality appraisal of studies will be carried out using a customized and piloted data extraction tool and the Newcastle-Ottawa Scale. Disagreements will be resolved through discussion or by a third reviewer. A narrative synthesis framework will be used to develop a theory of how anxiety impacts on QOL and treatment response and a meta-analysis performed.ResultsThe search has identified 6404 articles. After title screening, 284 abstracts have been reviewed and 48 full texts are being reviewed for inclusion. Full text review is ongoing, and results of the analysis will be presented.ConclusionHighlighting the impact of anxiety on outcomes in RA may suggest areas for future implementation studies to improve patient outcomes, potentially reducing associated morbidity and mortality.


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