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1.
Ly Thuy Nguyen Kimberly Alexander Patsy Yates 《Journal of pain and symptom management》2018,55(6):1459-1472
Objectives
To assess the feasibility of conducting a trial of a psychoeducational intervention involving the provision of tailored information and coaching to improve management of a cancer-related symptom cluster (fatigue, pain, and sleep disturbance) and reduce symptom cluster impacts on patient health outcomes in the Vietnamese context and to undertake a preliminary evaluation of the intervention.Methods
A parallel-group single-blind pilot quasi-experimental trial was conducted with 102 cancer patients in one Vietnamese hospital. The intervention group received one face-to-face session and two phone sessions delivered by a nurse one week apart, and the comparison group received usual care. Patient outcomes were measured at baseline before the chemotherapy cycle and immediately preceding the next chemotherapy cycle. Separate linear mixed models were used to evaluate the impact of the intervention on total symptom cluster severity, symptom scores, functional status, depressive symptoms, and health-related quality of life.Results
The study design was feasible with a recruitment rate of 22.6% and attrition rate of 9.8%. Compared to the control group, the intervention group showed a significant reduction in symptom cluster severity, fatigue severity, fatigue interference, sleep disturbance, depression, and anxiety. Significant differences were not observed for pain severity, pain interference, functional status, and health-related quality of life. The intervention was acceptable to the study population, with a high attendance rate of 78% and adherence rate of 95.7%.Conclusion
On the basis of the present study findings, future randomized controlled trials are needed to test the effectiveness of a symptom cluster psychoeducational intervention in Vietnam. 相似文献2.
Mia Forslin Katharina Fink Ulf Hammar Lena von Koch Sverker Johansson 《Archives of physical medicine and rehabilitation》2018,99(8):1483-1490
Objective
To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance.Design
A 10-year longitudinal observational cohort study.Setting
University hospital.Participants
A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased.Interventions
Not applicable.Main Outcome Measures
Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables.Results
Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years.Conclusions
This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. 相似文献3.
Kristine L. Kwekkeboom Lauren Tostrud Erin Costanzo Christopher L. Coe Ronald C. Serlin Sandra E. Ward Yingzi Zhang 《Journal of pain and symptom management》2018,55(5):1286-1295
Context
Symptom researchers have proposed a model of inflammatory cytokine activity and dysregulation in cancer to explain co-occurring symptoms including pain, fatigue, and sleep disturbance.Objectives
We tested the hypothesis that psychological stress accentuates inflammation and that stress and inflammation contribute to one's experience of the pain, fatigue, and sleep disturbance symptom cluster (symptom cluster severity, symptom cluster distress) and its impact (symptom cluster interference with daily life, quality of life).Methods
We used baseline data from a symptom cluster management trial. Adult participants (N = 158) receiving chemotherapy for advanced cancer reported pain, fatigue, and sleep disturbance on enrollment. Before intervention, participants completed measures of demographics, perceived stress, symptom cluster severity, symptom cluster distress, symptom cluster interference with daily life, and quality of life and provided a blood sample for four inflammatory biomarkers (interleukin-1β, interleukin-6, tumor necrosis factor-α, and C-reactive protein).Results
Stress was not directly related to any inflammatory biomarker. Stress and tumor necrosis factor-α were positively related to symptom cluster distress, although not symptom cluster severity. Tumor necrosis factor-α was indirectly related to symptom cluster interference with daily life, through its effect on symptom cluster distress. Stress was positively associated with symptom cluster interference with daily life and inversely with quality of life. Stress also had indirect effects on symptom cluster interference with daily life, through its effect on symptom cluster distress.Conclusion
The proposed inflammatory model of symptoms was partially supported. Investigators should test interventions that target stress as a contributing factor in co-occurring pain, fatigue, and sleep disturbance and explore other factors that may influence inflammatory biomarker levels within the context of an advanced cancer diagnosis and treatment. 相似文献4.
Sarah Prinsloo Diane Novy Larry Driver Randall Lyle Lois Ramondetta Cathy Eng Gabriel Lopez Yisheng Li Lorenzo Cohen 《Journal of pain and symptom management》2018,55(5):1276-1285
Context
Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment and may adversely affect quality of life (QOL) for years.Objectives
We explored the long-term effects of electroencephalographic neurofeedback (NFB) as a treatment for CIPN and other aspects of QOL.Methods
Seventy-one cancer survivors (mean age 62.5; 87% females) with CIPN were randomized to NFB or to a waitlist control (WLC) group. The NFB group underwent 20 sessions of NFB where rewards were given for voluntary changes in electroencephalography. Measurements of pain, cancer-related symptoms, QOL, sleep, and fatigue were obtained at baseline, end of treatment, and one and four months later.Results
Seventy one participants enrolled in the study. At the end of treatment, 30 in the NFB group and 32 in the WLC group completed assessments; at four months, 23 in the NFB group and 28 in the WLC completed assessments. Linear mixed model analysis revealed significant group × time interaction for pain severity. A general linear model determined that the NFB group had greater improvements in worst pain (primary outcome) and other symptoms such as numbness, cancer-related symptom severity, symptom interference, physical functioning, general health, and fatigue compared with the WLC group at the end of treatment and four months (all P < 0.05). Effect sizes were moderate or large for most measures.Conclusion
NFB appears to result in long-term reduction in multiple CIPN symptoms and improved postchemotherapy QOL and fatigue. 相似文献5.
Mehdi Kargarfard Ardalan Shariat Lee Ingle Joshua A. Cleland Mina Kargarfard 《Archives of physical medicine and rehabilitation》2018,99(2):234-241
Objective
To assess the effects of an 8-week aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS).Design
Randomized controlled design.Setting
Referral center of an MS society.Participants
Women (N=32; mean age ± SD, 36.4±8.2y) with diagnosed relapsing-remitting MS. After undergoing baseline testing by a neurologist, participants were allocated to either an intervention (aquatic training program, n=17) or a control group (n=15).Interventions
The intervention consisted of an 8-week aquatic training program (3 supervised training sessions per week; session duration, 45–60min; 50%–75% estimated maximum heart rate).Main Outcome Measures
Six-minute walk test (6-MWT), balance (Berg Balance Scale [BBS]), and perceptions of fatigue (Modified Fatigue Impact Scale; [MFIS]) at baseline and after the 8-week intervention. Differences over time between the experimental and control groups were assessed by a 2×2 (group by time) repeated-measures analysis of variance.Results
Thirty-two women completed the 8-week aquatic training intervention (experimental group, n=17; control group, n=15). All outcome measures improved in the experimental group: 6-MWT performance (pretest mean ± SD, 451±58m; posttest mean ± SD, 503±57m; P<.001); BBS (pretest mean ± SD, 53.59±1.70; posttest mean ± SD, 55.18±1.18; P<.001), and MFIS (pretest mean ± SD, 43.1±14.6; posttest mean ± SD, 32.8±5.9; P<.01). A significant group-by-time interaction was evident between the experimental and control groups for 6-MWT (P<.001, partial eta2 [ηp2]=.551), BBS (P<.001, ηp2=.423), and MFIS (P<.001, ηp2=.679).Conclusions
Aquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS. 相似文献6.
Jichuan Wang Shana Jacobs Darren A. Dewalt Emily Stern Heather Gross Pamela S. Hinds 《Journal of pain and symptom management》2018,55(2):359-367
Context
Children in treatment for cancer experience multiple, troubling, and interrelated symptoms. Analyzing the interrelatedness of symptoms and how that changes during treatment could yield clinically relevant patient profiles to guide patient care.Objectives
The aims were to identify pediatric profiles with respect to Patient-Reported Outcomes Measurement Information System® (PROMIS®; U.S. Department of Health and Human Services, National Institutes of Health) symptom measures, changes in profile status throughout a chemotherapy cycle, and if a baseline single-item fatigue measure could significantly predict symptom profile status and its changes.Methods
In a longitudinal, single-site, three data point (T1, T2, and T3) design, children between 8 and 18 years completed the PROMIS Pediatric short form measures for fatigue, depression, anxiety, and pain and one fatigue item from the Symptom Distress Scale. Latent profile analysis and latent transition analysis were conducted.Results
About 96 children participated; 58.3% were between 13 and 18 years, and 54.2% were males. Two latent profiles (less severe symptoms and severe symptoms) were identified. The prevalence of the severe symptom profile remained relatively unchanged from T1 to T2 but significantly declined at T3. The baseline single-item fatigue score significantly predicted the child's profile membership and its changes.Conclusion
Children experiencing troubling symptoms during cancer treatment are heterogeneous. With respect to the PROMIS symptom measures, two a priori unknown distinct latent profiles of patients were identified in a course of chemotherapy, and the transitions in the profile status were significantly predicted by a baseline single-item fatigue measure. 相似文献7.
Alexander T. Peebles Adam P. Bruetsch Sharon G. Lynch Jessie M. Huisinga 《Archives of physical medicine and rehabilitation》2018,99(10):2030-2037
Objectives
To compare physiological impairments between persons with multiple sclerosis (MS) with a history of falls and persons with MS without a history of falls, and to investigate the association between physiological impairments and dynamic balance.Design
Cross-sectional study.Setting
University motion analysis laboratory.Participants
Persons with MS (N=55; 27 recurrent fallers and 28 nonfallers). Participants were classified as fallers if they self-reported ≥2 falls in the previous 6 months.Interventions
None.Main Outcome Measures
Physiological impairment was assessed with sensorimotor delays, spasticity, plantar cutaneous sensation, and the sensory, cerebellar, and pyramidal subscales of the Expanded Disability Status Scale (EDSS). Dynamic balance was assessed using the average and variability of margin of stability and variability of trunk accelerations.Results
Compared with nonfallers, fallers had lower plantar sensation, longer sensorimotor delays, more spasticity, and more impairment in the pyramidal and cerebellar subscales of the EDSS. Additionally, these impairments were all moderately to strongly correlated with worse dynamic balance.Conclusions
This study highlights the multifactorial nature of instability in persons with MS. A better understanding of the physiological mechanisms of dynamic instability in persons with MS can be used to improve methods of monitoring disease progression, identifying which impairments to target through interventions, and appropriately evaluating intervention efficacy. 相似文献8.
Diana Dorstyn Rachel Roberts Gregory Murphy Ian Kneebone Ashley Craig Christine Migliorini 《Archives of physical medicine and rehabilitation》2018,99(2):272-280
Objective
To provide a preliminary evaluation of the effectiveness of an online resource for job seekers with multiple sclerosis (MS).Design
Randomized controlled design.Setting
Community-dwelling cohort.Participants
Adults (N = 95) with relapsing-remitting or progressive MS were randomly assigned to one of two groups. Forty-five accessed an email delivered, 7 module resource, Work and MS, over a 4 week period. Waitlist control participants (n=50) were offered the opportunity to access Work and MS 4 weeks postenrollment.Main Outcome Measures
Primary outcomes focused on vocational interests (My Vocational Situation Scale) and self-efficacy in job-seeking activities (Job-Procurement Self Efficacy Scale). Secondary outcomes focused on perceived workplace difficulties (Multiple Sclerosis Work Difficulties Questionnaire [MSWDQ]), optimism (Life Orientation Test – Revised), and mood (Patient Health Questionnaire-9).Results
Intention-to-treat analyses revealed pre-post gains: participants who accessed Work and MS reported improved confidence in their career goals (My Vocational Situation Scale g=.55; 95% confidence interval [CI], .14–.96; P=.008) and positively reappraised potential workplace difficulties (MSWDQ g range, .42–.47; P range, .023–.042). The effect on job self-efficacy was not significant, but changed in the expected direction (g=.17; 95% CI, –.23 to .57; P=.409). Completer data revealed larger, significant effect estimates (g range, .52–.64; P range, .009–.035).Conclusions
Findings provide preliminary support for the utility of a job information resource, Work and MS, to augment existing employment services. The results also suggest the need to test employment-ready interventions in a larger study population. This might include the addition of online peer support to increase intervention compliance. 相似文献9.
Objective
To evaluate the efficacy of neurodynamic techniques used as the sole therapeutic component compared with sham therapy in the treatment of mild and moderate carpal tunnel syndromes (CTS).Design
Single-blinded, randomized placebo-controlled trial.Setting
Several medical clinics.Participants
Volunteer sample of patients (N=250) diagnosed with CTS (n=150).Interventions
Neurodynamic techniques were used in the neurodynamic techniques group, and sham therapy was used in the sham therapy group. In the neurodynamic techniques group, neurodynamic sequences were used, and sliding and tension techniques were also used. In the sham therapy group, no neurodynamic sequences were used, and therapeutic procedures were performed in an intermediate position. Therapy was conducted twice weekly for a total of 20 therapy sessions.Main Outcome Measures
Symptom severity (symptom severity scale) and functional status (functional status scale) of the Boston Carpal Tunnel Questionnaire.Results
A baseline assessment revealed no intergroup differences in all examined parameters (P>.05). After therapy, there was statistically significant intragroup improvement in nerve conduction study (sensory and motor conduction velocity and motor latency) only for the neurodynamic techniques group (P<.01). After therapy, intragroup statistically significant changes also occurred for the neurodynamic techniques group in pain assessment, 2-point discrimination sense, symptom severity scale, and functional status scale (in all cases P<.01). There were no group differences in assessment of grip and pinch strength (P>.05).Conclusions
The use of neurodynamic techniques has a better therapeutic effect than sham therapy in the treatment of mild and moderate forms of CTS. 相似文献10.
Colin M. Bosma Nashwa Mansoor Chiara S. Haller 《Archives of physical medicine and rehabilitation》2018,99(8):1576-1583
Objective
To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI).Design
Longitudinal prospective multicenter, cohort study on severe TBI in Switzerland (2007–2011).Setting
Hospital, rehabilitation unit, and/or patient’s living facility.Participants
Patients with severe TBI (N=109) were included in the analyses. Injury severity was determined using the Abbreviated Injury Score of the head region after clinical assessment and initial computed tomography scan.Interventions
Not applicable.Main Outcome Measures
HRQoL (Medical Outcomes Study 12-Item Short-Form Health Survey Physical and Mental Component Summaries) and self-reported emotional, cognitive, and interpersonal functioning (Patient Competency Rating Scale for Neurorehabilitation).Results
Multilevel models for patients >50 and ≤50 years of age revealed significant negative associations between PTS symptom severity and interpersonal functioning (P<.001 and P=.002), respectively. Among patients ≤50 years of age, PTS symptom severity was significantly associated with total functioning (P=.001) and emotional functioning (P<.001). Among all patients, PTS symptom severity was significantly associated with cognitive functioning (P<.001) and mental HRQoL (P=.01).Conclusions
Findings indicate that PTS symptoms after severe TBI are negatively associated with HRQoL and emotional, cognitive, and interpersonal functioning. 相似文献11.
Krista Beth Highland Audrey Schoomaker Winifred Rojas Josh Suen Ambareen Ahmed Zhiwei Zhang Sarah Fink Carlin Christian E. Calilung Michael Kent Christin McDonough Chester C. Buckenmaier 《Archives of physical medicine and rehabilitation》2018,99(1):91-98
Objective
To examine the feasibility and preliminary effectiveness of an individualized yoga program.Design
Pilot randomized controlled trial.Setting
Military medical center.Participants
Patients (N=68) with chronic low back pain.Interventions
Restorative Exercise and Strength Training for Operational Resilience and Excellence (RESTORE) program (9–12 individual yoga sessions) or treatment as usual (control) for an 8-week period.Main Outcome Measures
The primary outcome was past 24-hour pain (Defense & Veterans Pain Rating Scale 2.0). Secondary outcomes included disability (Roland-Morris Disability Questionnaire) and physical functioning and symptom burden (Patient-Reported Outcomes Measurement Information System-29 subscales). Assessment occurred at baseline, week 4, week 8, 3-month follow-up, and 6-month follow-up. Exploratory outcomes included the proportion of participants in each group reporting clinically meaningful changes at 3- and 6-month follow-ups.Results
Generalized linear mixed models with sequential Bonferroni-adjusted pairwise significance tests and chi-square analyses examined longitudinal outcomes. Secondary outcome significance tests were Bonferroni adjusted for multiple outcomes. The RESTORE group reported improved pain compared with the control group. Secondary outcomes did not retain significance after Bonferroni adjustments for multiple outcomes, although a higher proportion of RESTORE participants reported clinically meaningfully changes in all outcomes at 3-month follow-up and in symptom burden at 6-month follow-up.Conclusions
RESTORE may be a viable nonpharmacological treatment for low back pain with minimal side effects, and research efforts are needed to compare the effectiveness of RESTORE delivery formats (eg, group vs individual) with that of other treatment modalities. 相似文献12.
Morgan K. Boes Rachel E. Bollaert Richard M. Kesler Yvonne C. Learmonth Mazharul Islam Matthew N. Petrucci Robert W. Motl Elizabeth T. Hsiao-Wecksler 《Archives of physical medicine and rehabilitation》2018,99(3):484-490
Objective
To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS).Design
Short-term intervention.Setting
University research laboratory.Participants
Participants (N=16) with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive AFO.Interventions
Three 6-minute walk tests (6MWTs), 1 per footwear condition: shoes (no AFO), prescribed passive AFO, and portable powered AFO (PPAFO). Assistive devices were worn on the impaired limb.Main Outcome Measures
Distance walked and metabolic cost of transport were recorded during each 6MWT and compared between footwear conditions.Results
Each participant completed all three 6MWTs within the experimental design. PPAFO use resulted in a shorter 6MWT distance than did a passive AFO or shoe use. No differences were observed in metabolic cost of transport between footwear conditions.Conclusions
The current embodiment of this PPAFO did not improve endurance walking performance during the 6MWT in a sample of participants with gait impairment due to MS. Further research is required to determine whether expanded training or modified design of this powered orthosis can be effective in improving endurance walking performance in persons with gait impairment due to MS. 相似文献13.
14.
Ilufredo Y. Tantoy Bruce A. Cooper Anand Dhruva Janine Cataldo Steven M. Paul Yvette P. Conley Marilyn Hammer Fay Wright Laura B. Dunn Jon D. Levine Christine Miaskowski 《Journal of pain and symptom management》2018,55(3):808-834
Context
Studies on multiple dimensions of the symptom experience of patients with gastrointestinal cancers are extremely limited.Objective
Purpose was to evaluate for changes over time in the occurrence, severity, and distress of seven common symptoms in these patients.Methods
Patients completed Memorial Symptom Assessment Scale, six times over two cycles of chemotherapy (CTX). Changes over time in occurrence, severity, and distress of pain, lack of energy, nausea, feeling drowsy, difficulty sleeping, and change in the way food tastes were evaluated using multilevel regression analyses. In the conditional models, effects of treatment group (i.e., with or without targeted therapy), age, number of metastatic sites, time from cancer diagnosis, number of prior cancer treatments, cancer diagnosis, and CTX regimen on enrollment levels, as well as the trajectories of symptom occurrence, severity, and distress were evaluated.Results
Although the occurrence rates for pain, lack of energy, feeling drowsy, difficulty sleeping, and change in the way food tastes declined over the two cycles of CTX, nausea and numbness/tingling in hands/feet had more complex patterns of occurrence. Severity and distress ratings for the seven symptoms varied across the two cycles of CTX.Conclusions
Demographic and clinical characteristics associated with differences in enrollment levels as well as changes over time in occurrence, severity, and distress of these seven common symptoms were highly variable. These findings can be used to identify patients who are at higher risk for more severe and distressing symptoms during CTX and to enable the initiation of preemptive symptom management interventions. 相似文献15.
Anneleen Malfliet Jeroen Kregel Mira Meeus Lieven Danneels Barbara Cagnie Nathalie Roussel Jo Nijs 《PM & R》2018,10(12):1330-1343.e1
Background
Pain neuroscience education is effective in chronic pain management. Central sensitization (ie, generalized hypersensitivity) is often explained as the underlying mechanism for chronic pain, because of its clinical relevance and influence on pain severity, prognosis, and treatment outcome.Objectives
To examine whether patients with more or fewer symptoms of central sensitization respond differently to pain neuroscience education.Design
A secondary analysis of a multicenter, triple-blind randomized controlled trial.Setting
University Hospital Ghent and University Hospital Brussels, Belgium.Patients
120 persons with chronic spinal pain with high or low self-reported symptoms of central sensitization.Interventions
Pain neuroscience education or neck/back school. Both interventions were delivered in 3 sessions: 1 group session, 1 online session, and 1 individual session.Main Outcome Measures
disability (primary), pain catastrophizing, kinesiophobia, illness perceptions, and hypervigilance.Results
Pain disability did not change in any group (P = .242). Regarding secondary outcomes: significant interaction effects were found for pain catastrophizing (P-values: P = .02 to P = .05), kinesiophobia (P = .02), and several aspects of illness perceptions (chronicity: P = .002; negative consequences: P = .02; personal control: P = .02; and cyclicity: P = .02). Bonferroni post hoc analysis showed that only the pain neuroscience education group (high and low self-reported symptoms of central sensitization) showed a significant improvement regarding kinesiophobia (P < .001, medium effect sizes), perceived negative consequence (P = .004 and P < .001, small to medium effect sizes), and perceived cyclicity of the illness (P = .01 and P = .01, small effect sizes). Pain catastrophizing only significantly reduced in people with high self-reported central sensitization symptoms (P < .05).Conclusion
Pain neuroscience education is useful in all patients with chronic spinal pain as it improves kinesiophobia and the perceived negative consequences and cyclicity of the illness regardless the self-reported signs of central sensitization. Regarding pain catastrophizing, pain neuroscience education is more effective in patients with high self-reported symptoms of central sensitization.Level of Evidence
I 相似文献16.
Daniel L. Riddle Gregory J. Golladay 《Archives of physical medicine and rehabilitation》2018,99(5):967-972
Objective
To identify preoperative risk factors associated with posthospitalization falls over an approximate 2-year postoperative period in patients undergoing both hip and knee arthroplasty.Design
A longitudinal cohort design.Setting
Communities surrounding 4 urban university–based medical centers.Participants
Adults (N = 596) with hip or knee arthroplasty over a 9-year period and followed yearly.Interventions
Not applicable.Main Outcome Measures
The primary outcome measure was a self-reported history of falls over the 2-year postoperative period. A fall was recorded when the participant reported landing on the floor or ground. Preoperative predictors of falls derived from previous evidence included preoperative fall history, depressive symptom severity, narcotic use, age, activity level, and comorbidity. Multinomial regression analysis was performed to determine factors that predicted either a single fall or multiple falls during a 2-year postoperative period.Results
Preoperative predictors of multiple postoperative falls were a preoperative history of falls, depressive symptoms, and hip vs knee arthroplasty. Patients with hip arthroplasty were more than twice as likely (odds ratio, 2.26; 95% confidence interval, 1.21–4.20) as patients with knee arthroplasty to have multiple self-reported falls in the first 2 postoperative years. No predictors were found for persons who reported falling only once postoperatively. Findings were generally supported in a sensitivity analysis.Conclusions
Clinicians involved in the pre- and postoperative care of persons undergoing hip or knee arthroplasty can use these findings to inform fall risk screening and intervention delivery to reduce fall risk in patients who are at risk for multiple falls after hip or knee arthroplasty. 相似文献17.
Alex W.K. Wong Stephen C.L. Lau Mandy W.M. Fong David Cella Jin-Shei Lai Allen W. Heinemann 《Archives of physical medicine and rehabilitation》2018,99(9):1763-1775
Objective
To determine the extent to which the content of the Quality of Life in Neurological Disorders (Neuro-QoL) covers the International Classification of Functioning, Disability and Health (ICF) Core Sets for multiple sclerosis (MS), stroke, spinal cord injury (SCI), and traumatic brain injury (TBI) using summary linkage indicators.Design
Content analysis by linking content of the Neuro-QoL to corresponding ICF codes of each Core Set for MS, stroke, SCI, and TBI.Setting
Three academic centers.Participants
None.Interventions
None.Main Outcome Measures
Four summary linkage indicators proposed by MacDermid et al were estimated to compare the content coverage between Neuro-QoL and the ICF codes of Core Sets for MS, stroke, MS, and TBI.Results
Neuro-QoL represented 20% to 30% Core Set codes for different conditions in which more codes in Core Sets for MS (29%), stroke (28%), and TBI (28%) were covered than those for SCI in the long-term (20%) and early postacute (19%) contexts. Neuro-QoL represented nearly half of the unique Activity and Participation codes (43%–49%) and less than one third of the unique Body Function codes (12%?32%). It represented fewer Environmental Factors codes (2%?6%) and no Body Structures codes. Absolute linkage indicators found that at least 60% of Neuro-QoL items were linked to Core Set codes (63%?95%), but many items covered the same codes as revealed by unique linkage indicators (7%?13%), suggesting high concept redundancy among items.Conclusions
The Neuro-QoL links more closely to ICF Core Sets for stroke, MS, and TBI than to those for SCI, and primarily covers activity and participation ICF domains. Other instruments are needed to address concepts not measured by the Neuro-QoL when a comprehensive health assessment is needed. 相似文献18.
James S. Krause Clara E. Dismuke-Greer Melinda Jarnecke Chao Li Karla S. Reed Phillip Rumrill 《Archives of physical medicine and rehabilitation》2019,100(5):931-937.e1
Objective
To identify demographic, educational, and disease-related characteristics associated with the odds of employment and earnings among participants with multiple sclerosis (MS).Design
Cross-sectional using self-report assessment obtained by mail or online.Setting
Medical university in the southeastern United States.Participants
Participants with MS (N=1059) were enrolled from a specialty hospital in the southeastern United States. All were adults younger than 65 years at the time of assessment.Interventions
Not applicable.Main Outcome Measures
Current employment status and earnings.Results
MS factors were highly related to employment, yet not as strongly to conditional earnings. Those with no symptoms reported 6.25 greater odds of employment than those with severe current symptoms. Compared with those with progressive MS, those with relapsing or remitting had greater odds of employment (odds ratio [OR]=2.24). Participants with no perceived cognitive impairment had 1.83 greater odds of employment than those with moderate to severe perceived cognitive impairment. Those with <10 years since MS diagnosis had 2.74 greater odds of employment compared with those with >20 years since diagnosis. An absence of problematic fatigue was highly related to the probability of employment (OR=5.01) and higher conditional earnings ($14,454), whereas the remaining MS variables were unrelated to conditional earnings. For non-MS variables, education was highly related to employment status and conditional earnings, because those with a postgraduate degree had 2.87 greater odds of employment and $44,346 greater conditional earnings than those with no more than a high school certificate. Non-Hispanic whites had 2.22 greater odds of employment and $16,118 greater conditional earnings than non-Hispanic blacks, and men reported $30,730 more in conditional earnings than women.Conclusions
MS indicators were significantly associated with employment status including time since diagnosis, fatigue, symptom severity, and presence of cognitive impairment. However, among those who were employed, conditional earnings were less highly related to these factors and more highly related to educational attainment. 相似文献19.
Luciana de Araujo Cazotti Anamaria Jones Diego Roger-Silva Luiza Helena Coutinho Ribeiro Jamil Natour 《Archives of physical medicine and rehabilitation》2018,99(9):1740-1746
Objective
To assess the effectiveness of the Pilates method on pain, function, quality of life, and consumption of pain medication in patients with mechanical neck pain.Design
The design was a randomized controlled trial, with a blinded assessor and intention-to-treat analysis.Setting
The study took place in the outpatient clinic of the rheumatology department, referral center.Participants
Patients (N=64) with chronic mechanical neck pain were randomly allocated to 2 groups: the Pilates group (PG) and a control group (CG).Interventions
The PG attended 2 sessions of Pilates per week, for 12 weeks. The protocol included Pilates exercises performed on a mat and on equipment and was adapted depending on the physical fitness of each participant; the repetitions varied from 6 to 12, respecting patient reports of fatigue and pain, using a single series for each exercise. The CG received only the standard pharmacological treatment. Both groups were instructed to use acetaminophen 750 mg if necessary. Patients were evaluated at baseline after 45, 90, and 180 days.Main Outcome Measures
We used the Numerical Pain Scale for pain, the Neck Disability Index for function, and the SF-36 questionnaire for quality of life.Results
The groups were homogeneous at baseline, the only exception being body mass index (BMI), with the PG showing higher BMI. Regarding the assessment between groups over time, statistical differences were identified for pain (P<.001), function (P<.001) and the SF-36 (functional capacity, P=.019; pain, P<.001; general health, P=.022; vitality, P<.001; mental health, P=.012) with the PG consistently achieving better results. Drug consumption was lower in PG patients (P=.037).Conclusions
This trial demonstrated the effectiveness of the Pilates method for the treatment of chronic mechanical neck pain, resulting in improvement of pain, function, quality of life, and reduction of the use of analgesics. 相似文献20.
Carl Todd DO 《Journal of bodywork and movement therapies》2018,22(2):281-286