scholarly journals Effect of Home-based Pulmonary Rehabilitation on Fatigue, Dyspnea, and Activities of Daily Living of COVID-19 Patients

2022 ◽  
Vol 10 (3) ◽  
Author(s):  
Romina Kalantari ◽  
Fatihe Kermansaravi ◽  
Fariba Yaghoubinia

Background: The acute nature and complications of COVID-19, including fatigue and dyspnea, reduce the ability of the affected individuals to play individual and social roles and perform activities of daily living, and have adverse effects on the life quality and economic status of patients. Conducting pre-discharge rehabilitation programs following a home-based approach can be effective in reducing fatigue and dyspnea and improving the activities of daily living of COVID-19 patients. Objectives: This study aimed to investigate the effect of home-based pulmonary rehabilitation on fatigue, dyspnea, and activities of daily living of COVID-19 patients in the teaching hospitals of Zahedan University of Medical Sciences in 2020. Methods: The quasi-experimental study enrolled 60 patients with COVID-19 respiratory symptoms admitted to the COVID-19 intensive care units of teaching hospitals affiliated with Zahedan University of Medical Sciences in 2020. The patients who met the inclusion criteria were selected using convenience sampling and randomly divided into intervention and control groups with color cards. The instruments used to collect the data were the Fatigue Severity Scale (FSS), the Borg Dyspnea Scale, and the Barthel Index completed by the participants before, two weeks, and two months after the intervention. The rehabilitation training was provided to the patient and the primary caregiver in the intervention group in three 45-min sessions individually and using training videos during the hospital stay. After discharge, the patients were followed up in person or by phone for eight weeks to ensure the effectiveness of the rehabilitation program. The collected data were analyzed using SPSS-22 software through repeated measures analysis of variance (ANOVA), independent samples t-test, and chi-square test at a significance level of 0.05 (P < 0.05). Results: The repeated measures ANOVA showed that changes in the fatigue and dyspnea scores were significant over time (P < 0.001). Furthermore, the intervention effect was significant (P = 0.04), and more remarkable changes were observed in the intervention group than in the control group. Given the significance of the group-time interactive effect on the two given variables, the comparisons were made point by point and with Bonferroni correction again by time and group. There were significant differences in the mean fatigue scores in the second (P = 0.03) and third (P < 0.001) stages and the mean dyspnea scores (P < 0.001) between the two groups. The mean scores of activities of daily living two weeks and two months after the intervention were significantly different between the two groups, with higher scores in the intervention group than in the control group (P = 0.01). The repeated measures ANOVA confirmed a statistically significant difference between the two groups in terms of the effect of time (P < 0.001) and group (P = 0.03) on the patients’ activities of daily living. Conclusions: The study showed that home-based pulmonary rehabilitation measures were effective on fatigue, dyspnea, and activities of daily living of COVID-19 patients. Thus, this intervention approach by nurses for family participation can be practical for treating acute and chronic respiratory diseases.

2013 ◽  
Vol 28 (3) ◽  
pp. 207-218 ◽  
Author(s):  
Lina Aimola ◽  
Alison R. Lane ◽  
Daniel T. Smith ◽  
Georg Kerkhoff ◽  
Gary A. Ford ◽  
...  

Background. Homonymous visual field defects (HVFDs) are one of the most common consequences of stroke. Compensatory training encourages affected individuals to develop more efficient eye movements to improve function. However, training is typically supervised, which can be time consuming and costly. Objective. To develop and evaluate the efficacy and feasibility of an unsupervised reading and exploration computer training for individuals with HVFDs. Methods. Seventy individuals with chronic HVFDs were randomly assigned to 1 of 2 groups: intervention or control. The former received 35 hours of reading and exploration training, and the latter received 35 hours of control training. Visual and attentional abilities were assessed before and after training using perimetry, visual search, reading, activities of daily living, the Test of Everyday Attention, and a Sustained Attention to Response task. Results. Eighteen individuals failed to complete the training; analyses were conducted on the remaining 28 intervention and 24 control group participants. Individuals in the intervention group demonstrated significant improvements in the primary outcomes of exploration (12.87%, 95% confidence interval [CI] = 8.44% to 17.30%) and reading (18.45%, 95% CI = 9.93% to 26.97%), which were significantly greater than those observed following the control intervention (exploration = 4.80%, 95% CI = 0.09% to 9.51%; reading = 1.95%, 95% CI = −4.78% to 8.68%). Participants in the intervention group also reported secondary subjective improvements, although these were not matched by objective gains in tasks simulating activities of daily living. Conclusions. Home-based compensatory training is an inexpensive accessible rehabilitation option for individuals with HVFDs, which can result in objective benefits in searching and reading, as well as improving quality of life.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 100.3-100
Author(s):  
Y. Wang ◽  
X. Liu ◽  
Y. Shi ◽  
X. Ji ◽  
W. Wang ◽  
...  

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


2018 ◽  
Vol 7 (2) ◽  
pp. 116
Author(s):  
Budi Darmawan ◽  
Diyah Fatmasari ◽  
Rr. Sri Endang Pujiast

Background: Wet cupping, furthermore mentioned cupping, decreases blood pressures through the level of negative air pressures added by hydrostatics filtration pressure to reinforce the power of fluids filtration in capillaries. However, an appropriate negative air pressure to decrease blood pressure remains an uncertainty.Purpose: This study aimed to analyze negative air pressure differences on cupping in decreasing blood pressures in hypertensive patients.Methods: This is a quasi-experimental design conducted in three Community Health Centers in Langsa City, Aceh, Indonesia. The samples were 36 hypertensive males with age from 45 to 55, who were randomly stratified into two groups with cupping pressures 400 mbar (n=18) as the control group; and 540 mbar (n=18) as the intervention group. The cupping session was performed to each group on T1 (alkahil) point and in the middle line of both shoulders blade points. The systolic blood pressure (SBP) and diastolic blood pressures (DBP) were measured by validated automatic sphygmomanometer. The follow-up periods were one week and two weeks. The data were then analyzed by repeated measures ANOVA.Results: Cupping pressure of 400 mbar decreased the mean of SBP and DPB with a p-value of 0.450 and 0.026, respectively after two weeks of intervention. Meanwhile, cupping pressure of 540 mbar decreased the mean of SBP and DBP with a p-value of 0.006 and 0.057, respectively. Tests of within-subjects resulted in the p-value of 0.250 (SBP) and 0.176 (DBP) after two weeks of intervention. There were no significant differences in SBP and DBP between the intervention group and the control group.Conclusion: The cupping pressure between 400 mbar and 540 mbar could reduce blood pressure; however, the cupping pressure of 540 mbar yielded greater effect in decreasing blood pressure than the 400 mbar. Negative air vacuum pressure loads on cupping to decrease blood pressure should be considered between 400 to 540 mbar, and further studies are needed.


2017 ◽  
Vol 7 (1) ◽  
pp. 56
Author(s):  
Khoirunnisa’ Munawaroh ◽  
Untung Sujianto ◽  
Mardiyono Mardiyono

Background: Barriers to performing activities of daily living are common complaints of patients with cancer. One of the factors causing these barriers is pain. A modified pro-self pain control is a method used to enhance the patients’ ability to cope with pain to increase their activity.Purpose: This study aimed to evaluate the modified pro-self pain control to increase activity in patients with colorectal cancer undergoing chemotherapy.Methods: The present study employed an experimental design. Patients with colorectal cancer undergoing chemotherapy were randomly assigned to the intervention group (n=24) and the control group (n=24). The patients in the control group were given a standard hospital intervention, while the patients in the intervention group were given the modified pro-self pain control for nine days. The data were collected using the instrument of KATZ index and analyzed using the independent t-test.Results: The result of this study showed that there was a higher increase of activity among the patients in the intervention group than in the control group. Independent t-test showed that there was a significant difference between the intervention group and the control group (p=0.00).Conclusion: The modified pro-self pain control was found more effective to increase the activity in patients with colorectal cancer undergoing chemotherapy than that of the standard hospital intervention. 


2019 ◽  
Vol 33 (5) ◽  
pp. 272-281 ◽  
Author(s):  
Mo Li ◽  
Ji-hui Lyu ◽  
Yi Zhang ◽  
Mao-long Gao ◽  
Rena Li ◽  
...  

The current study aimed to investigate the effects of group reminiscence therapy on cognitive function, depression, neuropsychiatric symptoms, and activities of daily living in patients with mild-to-moderate Alzheimer disease (AD). A single-blind randomized parallel-design controlled trial was conducted between May 1, 2017, and April 30, 2018. Ninety patients with mild-to-moderate AD recruited from Beijing Geriatric Hospital were randomly allocated into intervention (n = 45) and control groups (n = 45). In the intervention group, group-based reminiscence therapy was performed in two 30- to 45-minute sessions weekly for 12 weeks. Control participants received only conventional drug treatments and routine daily care. Alzheimer disease–related symptoms were evaluated using the Alzheimer’s Disease Assessment Scale-Cognitive section, the Cornell Scale for Depression in Dementia (CSDD), the Neuropsychiatric Inventory, and the Barthel Index. Four time points were set for data collection: baseline (before treatment), 4 weeks (during treatment), 12 weeks (end of treatment), and 24 weeks (12 weeks posttreatment). χ2 Tests, independent t tests, repeated-measures analysis of variance, and Bonferroni tests were used for data analysis. Significant improvements in depressive and neuropsychiatric symptoms were found in the intervention group compared to the control group ( P < .05). Mean CSDD scores in the intervention group were improved at all 3 time points compared to baseline and showed the greatest effect at 12 weeks ( t = 2.076, P = .041) and 24 weeks follow-up ( t = 3.834, P = .000) compared to controls. Group reminiscence therapy was effective for improving depressive symptoms and was beneficial for treating neuropsychiatric symptoms in patients with AD.


2020 ◽  
pp. bmjspcare-2020-002618
Author(s):  
Azam Dehghani ◽  
Ali Hajibagheri ◽  
Ismail Azizi-Fini ◽  
Fatemeh Atoof ◽  
Noushin Mousavi

BackgroundPain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.MethodsA randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient’s perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher’s exact tests and the repeated measures analysis.ResultsThe repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).ConclusionEarly mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Martin CS Wong ◽  
Harry HX Wang ◽  
Mandy WM Kwan ◽  
Shannon TS Li ◽  
Sian M Griffiths

Objective: A high prevalence of hypertension among the elderly has raised public concern in Asia particularly in Hong Kong. It is commonly observed among elderly being prescribed with more than one antihypertensive agent. However, poor adherence can serve as one of the major causes of suboptimal blood pressure (BP) control, and particular in elderly homes where the residents often lack family support. The study aimed to evaluate the effects of a new medication monitoring programme on BP control among elderly home residents with multiple medications. Methods: We recruited study subjects from three elderly homes enrolled in a pharmacist-led home-based medication monitoring programme launched by the Hong Kong Pharmaceutical Care Foundation. The programme aimed to optimise drug therapy and achieve better BP control. We used a cluster sampling to recruit elderly people (aged ≥65 years) prescribed with multiple medications, who were then followed up for six months. Subjects in the intervention group received medications under pharmacist-led medication monitoring programme, while the control group received usual care. Intention-to-treat analysis was adopted. Systolic BP and diastolic BP were measured at each 3-monthly follow-up as primary outcomes. Secondary outcomes included healthcare utilisation and staff satisfaction. Repeated measures analysis of variance (RMANOVA) was used to estimate the intervention effect after adjusting for other covariates. Results: A total of 290 residents were recruited. The study showed distinct patterns of changes in SBP and DBP between groups. After 6 months, participants in the intervention group (n=200) had an average of 5.16mmHg (p=0.134) and 2.66mmHg (p=0.198) decrease in SBP and DBP, respectively; while the control group (n=90) showed 12.40mmHg (p=0.027) and 6.60mmHg (p=0.061) increase in SBP and DBP, respectively, after adjusting for other covariates. Conclusions: Elderly home residents enrolled in this new pharmacist-led home-based medication monitoring programme had better BP parameters, suggesting that future programmes on other cardiovascular disease medications based on similar approach could potentially be effective in achieving favourable outcomes among the elderly population in primary care.


2018 ◽  
Vol 45 (5-6) ◽  
pp. 318-325 ◽  
Author(s):  
Hitoshi Okamura ◽  
Michiaki Otani ◽  
Naonori Shimoyama ◽  
Takayuki Fujii

Background/Aims: We investigated the efficacy of a combined exercise and cognitive training system that we devised for improvement of attention and concentration, cognition, and activities of daily living in older adults with dementia. Methods: A total of 100 dementia patients were randomly assigned to an intervention group or a control group. The intervention group was subjected to a combined exercise and cognitive training for 6 consecutive weeks. Evaluations were performed using the Trail Making Test-Part A, the Mini-Mental State Examination, and an N-type activities of daily living evaluation scale for the elderly. Results: A comparison of the changes in scores on the evaluation scales between the intervention group and the control group showed significant interactions for all scores. Conclusions: The combined system is effective in increasing attention and concentration and improving cognitive function and activities of daily living in dementia patients.


2021 ◽  
Vol 11 (3) ◽  
pp. 319
Author(s):  
María Jiménez Palomares ◽  
María Victoria González López-Arza ◽  
Elisa María Garrido Ardila ◽  
Trinidad Rodríguez Domínguez ◽  
Juan Rodríguez Mansilla

Background: In all types of dementia, cognitive abilities are affected, behaviour is altered and functional capacity is progressively lost. This cognitive deterioration manifests in the decrease of abilities required to perform the activities of daily living (ADL). The objective of this pilot study was to assess the effect of an Occupational Therapy programme based on the training of ADL through cognitive stimulation on the independence of ADL of persons with dementia. Methods: Institutionalized older adults with major neurocognitive disorder or dementia (N = 58) were randomly allocated to receive either the Occupational Therapy ADL cognitive stimulation programme or conventional Occupational Therapy. The cognitive level and the independence level performing ADL were measured at baseline (week 0), after 5 weeks of treatment (week 5) and after 6 weeks of follow up (week 12). A value of p < 0.05 and α = 0.0025 (Bonferroni correction) was considered as statistically significant. Results: The results obtained showed improvements in the level of independence performing ADLs in the intervention group compared to the control group (p = 0.006). The improvements were seen in relation to feeding (p = 0.001), dressing (p = 0.005) and bladder and bowel incontinence (p = 0.003), the changes observed in feeding are statistically significant. However, those improvements were not maintained after the follow up period. There were no significant changes in relation to the cognitive level (p = 0.741). Conclusions: Occupational Therapy based on ADL cognitive stimulation can have a positive effect, increasing the independence of subjects with major neurocognitive disorder or dementia who are institutionalised.


2019 ◽  
Vol 1 (1) ◽  
pp. 32-42
Author(s):  
Theresia Tutik Ismiati

Stroke is a disease caused by the interruption of blood supply to the brain. WHO (World Health Organization) stated 15 million people world wide suffer a stroke each year. As many as 5 million people are death sand 5 million people have permanent disability. Stroke Foundation of Indonesia (Yastroki) noted that Indonesia ranks  first in Asia with the majority of stroke patients and become leading causes of death in Indonesia. Stroke affects extremity dysfunction such decreased muscle strength which will contribute to the decline ability of Activities of daily living (ADL). There are several the rapies that have been done to over come muscle weakness and limitations of the ADL such as range of movement exercises, positioning, and acupressure is one form of therapy that can be done to restore extremity function. This study aims to determine the effect of acupressure intervention on limb muscle strength and Activities Of Daily Living (ADL) In Stroke Patients. Quantitative Study of quasi-experiment pre-post test design involved 113 respondents into two groups: the intervention group with 88 respondents and the control group with 25 respondents.The result showed male respondents (51.3%), aged 45-59 years (58.4%), and the first attack (85%). After the intervention of 7 day sine ach ofthe respondents, found significant differences increase muscle strength and ADL before the after intervention:  right limbmuscle strength(p =0.000); left limbstrength (p =0.000); and ADL (p =0.000). Respondent characteristics that influence muscle strength and ADL were age and frequency of stroke (P <0.05), where as no influence of gender (p> 0.05). The conclusions of this study that acupressureis an effective therapy on increase muscle strength and ADL of stroke patients. This research recommended acupressure as a complementary therapy to improve muscle strength andADLof stroke patients.


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