The Effect of Exercise on Sleep and Fatigue in Rheumatoid Arthritis: A Randomized Controlled Study

2014 ◽  
Vol 41 (10) ◽  
pp. 1966-1973 ◽  
Author(s):  
Laura Durcan ◽  
Fiona Wilson ◽  
Gaye Cunnane
Keyword(s):  
Rheumatoid Arthritis ◽  
Sleep Quality ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Exercise Program ◽  
Chronic Fatigue ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled

Objective.Sleep disturbance and chronic fatigue are common in rheumatoid arthritis (RA) and contribute to disability, symptomatology, and healthcare use. It has long been recognized in other populations that exercise can improve sleep and diminish fatigue. The effect of exercise on sleep quality and fatigue in RA has not been evaluated.Methods.Ours is a randomized controlled study in RA to determine the effect of an exercise program on sleep quality and fatigue. These were measured using the Pittsburgh Sleep Quality Index and the Fatigue Severity Scale. Patients were randomized to either a 12-week, home-based exercise intervention or usual care. The exercise program consisted of specific exercises to target individual deficiencies identified using the Health Assessment Questionnaire (HAQ) with cardiovascular work as per the guidelines. The intervention group was evaluated on a 3-week basis. Full evaluation was carried out at baseline and at 12 weeks.Results.Forty patients were randomized to the intervention with 38 controls. In the exercise intervention group, there was a statistically significant improvement in HAQ (p = 0.00), pain (p = 0.05), stiffness (p = 0.05), sleep quality (p = 0.04), and fatigue (p = 0.04). In our control group, there was a statistically significant improvement demonstrated in their overall perceptions of the benefits of exercise, but none of the other variables.Conclusion.Our study demonstrates that an exercise program resulted in significant improvement in sleep quality and fatigue. This is particularly interesting given the importance of fatigue as an outcome measure in RA and gives us yet another reason to prescribe exercise in this population.

scholarly journals The Use of a Game-Based Decision Aid to Educate Pregnant Women about Prenatal Screening: A Randomized Controlled Study

2018 ◽  
Vol 36 (03) ◽  
pp. 322-328 ◽  
Author(s):  
Erin Johnson ◽  
Bob Wong ◽  
Nancy Rose ◽  
Gwen Latendresse ◽  
Roger Altizer ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Clinical Care ◽  
Intervention Group ◽  
Randomized Controlled Study ◽  
Constructive Method ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled

Purpose This project developed and evaluated the efficacy of a game decision aid among pregnant women about prenatal screening in a randomized controlled study. Study Design Participants were recruited from an obstetric clinic of an academic urban medical center and randomized (n = 73) to one of two study groups: the control group (n = 39) that used a brochure or the intervention group (n = 34) that also used a game decision aid. Result Participants who played the game had higher knowledge scores (m = 21.41, standard deviation [SD] = 1.74) than participants in the control group (m = 19.59; SD = 3.31), p = 0.004. The median time of game playing was 6:43 minutes (range: 2:17–16:44). The groups were similar in frequency of completing screening after the study, control = 6 (15%) versus intervention = 11 (32%), p = 0.087. However, the more interaction with the game resulted in more positive attitudes toward screening. Conclusion The addition of a game decision aid was effective in educating pregnant women about prenatal screening. As other genetic testing decisions continue to increase within clinical care, game-based decision tools may be a constructive method of informed decision-making.

Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study

2007 ◽  
Vol 56 (5) ◽  
pp. 659-663 ◽  
Author(s):  
David B. Huang ◽  
Jing Zhou
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Shigella Flexneri ◽  
Intervention Group ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Therapy Regimen ◽  
Randomized Controlled ◽  
Highly Active ◽  
Before And After

Patients with AIDS frequently develop diarrhoeal illness. In this randomized, controlled study, 260 patients were screened for those who had not had diarrhoea in the preceding 3 months and who had received a stable highly active antiretroviral therapy regimen for at least 6 weeks prior to the study enrolment. A total of 148 patients met the inclusion criteria and were enrolled: 75 patients were randomly assigned to an intensive handwashing intervention (i.e. handwashing after defecation, after cleaning infants who had defecated, before preparing food, before eating, and before and after sex) and 73 patients were randomly assigned to the control group. Patients in both groups were called weekly by telephone to determine compliance with handwashing and to determine the number of diarrhoeal episodes for the preceding week. Patients were observed for 1 year. Patients assigned to the intensive handwashing intervention group washed their hands more frequently compared with the control group (seven vs four times a day, respectively; P <0.05) and developed fewer episodes of diarrhoeal illness (1.24±0.9 vs 2.92±0.6 new episodes of diarrhoea, respectively; P <0.001) during the 1 year observation. The most common pathogens identified in both groups in patients who developed diarrhoeal illness were Giardia lamblia, Cryptosporidium, Entamoeba histolytica and Shigella flexneri. These data suggest that intensive handwashing reduces diarrhoeal illness in patients with AIDS.

The Effect of 20-Minute Mindful Breathing on the Perception of Suffering and Changes in Bispectral Index Score (BIS) in Palliative Care Informal Caregivers: A Randomized Controlled Study

2019 ◽  
Vol 37 (8) ◽  
pp. 606-612 ◽  
Author(s):  
Seng Beng Tan ◽  
Hui Chi Ching ◽  
Yuik Ling Chia ◽  
Anne Yee ◽  
Chong Guan Ng ◽  
...  
Keyword(s):  
Palliative Care ◽  
Bispectral Index ◽  
Informal Caregivers ◽  
Intervention Group ◽  
Index Score ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
The University

Informal caregivers are at risk of being overwhelmed by various sources of suffering while caring for their significant others. It is, therefore, important for caregivers to take care of themselves. In the self-care context, mindfulness has the potential to reduce caregiver suffering. We studied the effect of a single session of 20-minute mindful breathing on the perceived level of suffering, together with the changes in bispectral index score (BIS) among palliative care informal caregivers. This was a randomized controlled study conducted at the University of Malaya Medical Centre, Malaysia. Forty adult palliative care informal caregivers were recruited and randomly assigned to either 20-minute mindful breathing or 20-minute supportive listening. The changes in perceived suffering and BIS were measured preintervention and postintervention. The reduction in suffering score in the intervention group was significantly more than the control group at minute 20 ( U = 124.0, n1 = n2 = 20, mean rank1 = 24.30, mean rank2 = 16.70, z = −2.095, P = .036). The reduction in BIS in the intervention group was also significantly greater than the control group at minute 20 ( U = 19.5, n1 = n2 = 20, mean rank1 = 29.52, mean rank2 = 11.48, z = −4.900, P < .0001). Twenty minutes of mindful breathing was more efficacious than 20 minutes of supportive listening in the reduction in suffering among palliative care informal caregivers.

scholarly journals Evaluation of the Quilting Technique for Reduction of Postmastectomy Seroma: A Randomized Controlled Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ashraf Khater ◽  
Waleed Elnahas ◽  
Sameh Roshdy ◽  
Omar Farouk ◽  
Ahmed Senbel ◽  
...  
Keyword(s):  
Intervention Group ◽  
Pathological Finding ◽  
Late Complications ◽  
Demographic Characteristics ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Wound Drainage ◽  
Axillary Clearance ◽  
Randomized Controlled

Background. Postmastectomy seroma causes patients’ discomfort, delays starting the adjuvant therapy, and may increase the possibility of surgical site infection.Objective. To evaluate quilting of the mastectomy flaps with obliteration of the axillary space in reducing postmastectomy seroma.Methods. A randomized controlled study was carried out among 120 females who were candidates for mastectomy and axillary clearance. The intervention group (N=60) with quilting and the control group without quilting. All patients were followed up routinely for immediate and late complications.Results. There were no significant differences between the two groups as regards the demographic characteristics, postoperative pathological finding, and the immediate postoperative complications. The incidence of seroma was significantly lower in the intervention group compared with the control group (20% versus 78.3%,P<0.001). Additionally, the intervention group had a shorter duration till seroma resolution (9 days versus 11 days,P<0.001) and a smaller volume of drainage (710 mL versus 1160 mL,P<0.001) compared with the control group.Conclusion. The use of mastectomy with quilting of flaps and obliteration of the axillary space is an efficient method to significantly reduce the postoperative seroma in addition to significantly reducing the duration and volume of wound drainage. Therefore we recommend quilting of flaps as a routine step at the end of any mastectomy.

scholarly journals Effectiveness of a Targeted Exercise Intervention in Reversing Older People's Mild Balance Dysfunction: A Randomized Controlled Trial

2012 ◽  
Vol 92 (1) ◽  
pp. 24-37 ◽  
Author(s):  
Xiao Jing Yang ◽  
Keith Hill ◽  
Kirsten Moore ◽  
Susan Williams ◽  
Leslie Dowson ◽  
...  
Keyword(s):  
Older People ◽  
Exercise Intervention ◽  
Physical Therapist ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Home Exercise ◽  
Control Group ◽  
Home Exercise Program ◽  
Randomized Controlled

Background Previous research has mainly targeted older people with high risk of falling. The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored. Objective This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematically screened as having mild balance dysfunction. Design This was a community-based, randomized controlled trial with assessors blinded to group allocation. Participants Study participants were older people who reported concerns about their balance but remained community ambulant (n=225). After a comprehensive balance assessment, those classified as having mild balance dysfunction (n=165) were randomized into the trial. Intervention Participants in the intervention group (n=83) received a 6-month physical therapist–prescribed balance and strength home exercise program, based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit. Participants in the control group (n=82) continued with their usual activities. Outcome Measures Laboratory and clinical measures of balance, mobility, and strength were assessed at baseline and at a 6-month reassessment. Results After 6 months, the intervention group (n=59) significantly improved relative to the control group (n=62) for: the Functional Reach Test (mean difference=2.95 cm, 95% confidence interval [CI]=1.75 to 4.15), the Step Test (2.10 steps/15 seconds, 95% CI=1.17 to 3.02), hip abductor strength (0.02, 95% CI=0.01 to 0.03), and gait step width (2.17 cm, 95% CI=1.23 to 3.11). There were nonsignificant trends for improvement on most other measures. Fourteen participants in the intervention group (23.7%) achieved balance performance within the normative range following the exercise program, compared with 3 participants (4.8%) in the control group. Limitations Loss to follow-up (26.6%) was slightly higher than in some similar studies but was unlikely to have biased the results. Conclusions A physical therapist–prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment.

scholarly journals AB1309-HPR EFFICACY OF ADDING CAFFEINE TO THE TREATMENT REGIMEN IN REDUCING METHOTREXATE INTOLERANCE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A RANDOMIZED CONTROLLED STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1945.1-1945
Author(s):  
A. Fehr ◽  
F. El Noby ◽  
N. Fathi ◽  
R. Lotfy
Keyword(s):  
Rheumatoid Arthritis ◽  
Severity Score ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Base Line ◽  
Clinical Rheumatology ◽  
Randomized Controlled ◽  
Significant Difference

Background:Rheumatoid arthritis is one of common form of chronic inflammatory arthritis. Methotrexate has remained anchor treatment because of its potent efficacy1. Intolerance to Methotrexate is a common cause of non-compliance2&3.Objectives:To investigate the effect of adding caffeine orally as Methylxanthines (Caffeine), act as adenosine receptor antagonists4to reduce symptoms of moderate to severe methotrexate intolerance in patients with Rheumatoid Arthritis5.Methods:A prospective, randomized controlled study conducted at Aswan University Hospital, Egypt from Jan 2018 till may 2019. Sixty patients with Rheumatoid arthritis who have had experienced moderate to severe methotrexate intolerance was enrolled in the study. The methotrexate intolerance severity score (MISS)6was evaluated at base line before initiation of study then at the next three months consecutively. Patients were randomly assigned by closed envelope method into 2 groups each containing 30 patients:Group (A); 30 patients was prescribed caffeine (coffee or dark chocolate) as an antidote to methotrexate intolerance7.Group (B); 30 matched patients acted as control group that included who will continue methotrexate regimen without addition of any extra caffeine.Results:Twenty four patients (80%) at time three follow up visit showed full improvement of symptoms of methotrexate-intolerance compared to ten patients (33.3%) at 2nd month follow up visit and seven patients (23%) at 1st month follow up visit with statistically significant difference all over the study period (P=0.005). half of study group patients discontinued anti-emetic and other drugs while none in control group did.Conclusion:Adding caffeine to management regimen can reduce the symptoms of severe methotrexate-intolerance in Rheumatoid Arthritis patients.References:[1]Friedman, B., & Cronstein, B. (2019). Methotrexate Mechanism in Treatment of Rheumatoid Arthritis. Joint Bone Spine, 86(3):301-307[2]Wang, W., Zhou, H., & Liu, L. (2018). Side effects of methotrexate therapy for rheumatoid arthritis: a systematic review. European journal of medicinal chemistry. Volume 158, 502-516[3]Bulatović, M., Heijstek, M. W., Verkaaik, M., van Dijkhuizen, E. P., Armbrust, W., Hoppenreijs, E. P., ... & Rademaker, C. M. (2011). High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: development and validation of a methotrexate intolerance severity score. Arthritis & Rheumatism, 63(7), 2007-2013.[4]Malaviya, A., Baghel, S., Verma, S., Thakran, R., & Messi, C. (2019). Use of coffee for alleviating methotrexate intolerance in rheumatic diseases. Indian Journal of Rheumatology, 14(1), 79-79.[5]Ribeiro, J. A., & Sebastiao, A. M. (2010). Caffeine and adenosine. Journal of Alzheimer’s Disease, 20(s1), S3-S15.[6]Fatimah, N., Salim, B., Nasim, A., Hussain, K., Gul, H., & Niazi, S. (2016). Frequency of methotrexate intolerance in rheumatoid arthritis patients using methotrexate intolerance severity score (MISS questionnaire). Clinical rheumatology, 35(5), 1341-1345.[7]Malaviya, A. N. (2017). Methotrexate intolerance in the treatment of rheumatoid arthritis (RA): effect of adding caffeine to the management regimen. Clinical rheumatology, 36(2), 279-285.Disclosure of Interests:None declared

scholarly journals Effects of a Differential Diagnosis List of Artificial Intelligence on Differential Diagnoses by Physicians: An Exploratory Analysis of Data from a Randomized Controlled Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5562
Author(s):  
Yukinori Harada ◽  
Shinichi Katsukura ◽  
Ren Kawamura ◽  
Taro Shimizu
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Primary Outcome ◽  
Intervention Group ◽  
Exploratory Analysis ◽  
Differential Diagnoses ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled

A diagnostic decision support system (DDSS) is expected to reduce diagnostic errors. However, its effect on physicians’ diagnostic decisions remains unclear. Our study aimed to assess the prevalence of diagnoses from artificial intelligence (AI) in physicians’ differential diagnoses when using AI-driven DDSS that generates a differential diagnosis from the information entered by the patient before the clinical encounter on physicians’ differential diagnoses. In this randomized controlled study, an exploratory analysis was performed. Twenty-two physicians were required to generate up to three differential diagnoses per case by reading 16 clinical vignettes. The participants were divided into two groups, an intervention group, and a control group, with and without a differential diagnosis list of AI, respectively. The prevalence of physician diagnosis identical with the differential diagnosis of AI (primary outcome) was significantly higher in the intervention group than in the control group (70.2% vs. 55.1%, p < 0.001). The primary outcome was significantly >10% higher in the intervention group than in the control group, except for attending physicians, and physicians who did not trust AI. This study suggests that at least 15% of physicians’ differential diagnoses were affected by the differential diagnosis list in the AI-driven DDSS.

scholarly journals OP0159 EFFICACY OF COMPREHENSIVE TECHNOLOGY-ASSISTED HOME-BASED EXERCISE IN ANKYLOSING SPONDYLITIS: A RANDOMIZED, CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 100.3-100
Author(s):  
Y. Wang ◽  
X. Liu ◽  
Y. Shi ◽  
X. Ji ◽  
W. Wang ◽  
...  
Keyword(s):  
Exercise Intervention ◽  
Medical Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Group Differences ◽  
Control Group ◽  
Home Based ◽  
The Mean

Background:Clinical practice guidelines recommend that exercise is an essential component in the self-management of Ankylosing Spondylitis (AS). Attending supervised interventions requiring periodic medical center visits can be burdensome and patients may decline participation, whereas, effective home-based exercise interventions that do not need regular medical center visits are likely to be more accessible and acceptable for patients with AS. Recently, increasing evidences have been accumulated that the wearable devices could facilitate patients with inflammatory arthritis by giving exercise instructions and improving self-efficacy. Therefore, patients with AS may benefit from an effective technology-assisted home-based exercise intervention.Objectives:To investigate the efficacy of a comprehensive technology-assisted home-based exercise intervention on disease activity in patients with AS.Methods:This study was a 16-week assessor-blinded, randomized, waiting-list controlled trial (ChiCTR1900024244). Patients with AS were randomly allocated to the home-based exercise intervention group and the waiting-list control group. A 16-week comprehensive exercise program consisting of a moderate intensity (64%-76% HRmax) aerobic training for 30min on 5 days/week and a functional training for 60min on 3 days/week was given to patients in the intervention group immediately after randomization, with 1.5h training sessions for two consecutive days by a study physical therapist at baseline and Week 8. The aerobic exercise intensity was controlled by a Mio FUSE Wristband with a smartphone application. The functional training consisted of the posture training, range of motion exercises, strength training, stability training and stretching exercises. Patients in control group received standard care during the 16-week follow-up and started to receive the exercise program at Week 16. The primary outcome was ASDAS at Week 16. The secondary outcomes were BASDAI, BASFI, BASMI, ASAS HI, peak oxygen uptake, body composition and muscle endurance tests. The mean difference between groups in change from baseline was analyzed with the analysis of covariance.Results:A total of 54 patients with AS were enrolled (26 in intervention group and 28 in control group) and 46 (85.2%) patients completed the 16-week follow-up. The mean difference of ASDAS between groups in change from baseline to 16-week follow-up was −0.2 (95% CI, −0.4 to 0.003, P = 0.032), and the mean change from baseline was -0.4 (95% CI, -0.5 to -0.2) in the intervention group vs -0.1 (95% CI, -0.3 to 0.01) in the control group, respectively. Significant between-group differences were found between groups for BASDAI (−0.5 [95% CI, −0.9 to −0.2], P = 0.004), BASMI (−0.7 [95% CI, −1.1 to −0.4], P <0.001), BASFI (−0.3 [95% CI, −0.6 to 0.01], P=0.035), peak oxygen uptake (2.7 [95% CI, 0.02 to 5.3] ml/kg/min, P=0.048) and extensor endurance test (17.8 [95% CI, 0.5 to 35.2]s, P=0.044) at Week 16. Between-group differences were detected in ASAS HI (−0.9 [95% CI, −1.7 to −0.1], P=0.030), body fat percentage (−1.0 [95% CI, −2.0 to −0.01] %, P=0.048) and visceral adipose tissue (−4.9 [95% CI, −8.5 to −1.4] cm2, P=0.008) at Week 8, but not at Week 16. No significant between-group differences were detected in the total lean mass, time up and go test and the flexor endurance test during the follow-up.Conclusion:Comprehensive technology-assisted home-based exercise has been shown to have beneficial effects on disease activity, physical function, spinal mobility, aerobic capacity, and body composition as well as in improving fatigue and morning stiffness of patients with AS.References:[1]van der Heijde D, Ramiro S, Landewé R, et al. Ann Rheum Dis 2017;76:978–991.Disclosure of Interests:None declared

Self-Managed Music-Guided Exercise Intervention Improved Upper and Lower Extremity Muscle Strength for ICU Survivors—A Pilot Randomized Controlled Study

2021 ◽  
pp. 109980042110502
Author(s):  
Zhan Liang ◽  
Hilary Yip ◽  
Kimberly Sena Moore ◽  
Tanira Ferreira ◽  
Ming Ji ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Active Control ◽  
Exercise Intervention ◽  
Controlled Study ◽  
Control Group ◽  
Active Control Group ◽  
Randomized Controlled ◽  
Left And Right ◽  
The Mean

Objective The objective of this study was to evaluate effects of a self-managed music-guided exercise intervention on muscle strength among intensive care unit (ICU) survivors. Methods We used a two-arm randomized-controlled trial. Following ICU discharge, eligible participants were assigned to one of two groups: music group ( n = 13) or active control group ( n = 13). The music group was taught to self-manage upper and lower extremity exercise movements by listening to an individualized music-guided playlist twice daily for 5 days. The active control group was provided an exercise brochure and advised to perform the same exercises at the same intervals. Dynamometers were used to measure muscle strength. T-tests and Weighted GEE models were used for testing the intervention effect between groups. Results Twenty-six subjects were enrolled. The mean age was 62.8 ( SD = 13.8), 53.8% were male, 65.4% were Caucasian, and the mean APACHE severity of illness score was 59 ( SD = 23.4). Reasons for ICU admission were mainly cardiac and medical. The music group showed significant improvements in handgrip, plantar flexion, leg extension, elbow flexion, and shoulder adduction strengths on left and right sides. Additionally, left and right leg extensor and left plantar flexor strengths showed significant post-differences, and small to moderately large effect sizes, between the music group and control group. Conclusion These findings suggest that a music-guided exercise intervention has the potential to improve muscle strength in ICU survivors and prevent further post-ICU deterioration in ICU survivors. Future trials should build upon these preliminary findings.

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