Effects of a self-management arthritis programme with an added exercise component for osteoarthritic knee: randomized controlled trial

AIM: This paper is a report of a study to assess the effect of an adapted arthritis self-management programme with an added focus on exercise practice among osteoarthritic knee sufferers. BACKGROUND: Osteoarthritis of the knee is a major source of loss of function in older people. Previous studies have found self-management programmes to be effective in increasing arthritis self-efficacy and in mastery of self-management practice. METHOD: A randomized control trial was carried out from December 2002 to May 2003 and 120 participants (65.9%, including 67 in intervention group and 53 in control group) completed the 16-week postintervention assessments. Outcome measures included arthritis self-efficacy, use of self-management techniques, pain intensity and daily activity. FINDINGS: At 16 weeks, there was a 'statistically' significant improvement in the arthritis self-efficacy level (P 相似文献   

Integrated health programme: a workplace randomized controlled trial

Title.  Integrated health programme: a workplace randomized controlled trial.
Aim.  This paper is the report of a pilot study to assess if an Integrated Health Programme would reduce sick leave and subjective health complaints, and increase coping in a population of nursing personnel.
Background.  The work group in Norway with most sick leave is healthcare workers. More than 50% of the sick leave is because of subjective health complaints. Work place physical exercise interventions have a documented positive effect on sick leave.
Method.  After baseline screening, employees who had agreed to participate ( n  = 40) were randomized to an intervention or control group. The intervention group participated in an Integrated Health Programme twice weekly during working hours. The programme consisted of physical exercise, stress management training, health information and an examination of the participants' workplace. The control group was offered the same intervention after the project was finished. This study was carried out from 2001 to 2002.
Findings.  There were no statistically significant effects on sick leave or health-related quality of life. The intervention group reported fewer neck complaints compared to the control group, but otherwise there were no effects on subjective health complaints. However, the subjective effects were large and highly statistically significant, the intervention group reporting improvement in health, physical fitness, muscle pain, stress management, maintenance of health and work situation.
Conclusion.  The Integrated Health Programme was not effective in reducing sick leave and subjective health complaints, but may be of use to employers wanting to increase employee job satisfaction and well-being.     

A community-based exercise programme to improve functional ability in people with Alzheimer's disease: a randomized controlled trial

Scand J Caring Sci; 2012; 26; 12–19
A community‐based exercise programme to improve functional ability in people with Alzheimer’s disease: a randomized controlled trial Rationale: Dementia is a common neurodegenerative condition in older age associated with functional decline across multiple domains. This decline impacts not only on the person with dementia, but also on their informal carers and health and aged care systems. With the number of people with dementia rapidly increasing and few effective treatments, there is now a critical need for interventions to improve functional ability in those with the condition. Aims and objective: This study assesses the effectiveness of a community‐based home exercise programme in improving cognitive and physical function and independence in activities of daily living (ADL) in people with Alzheimer’s disease, the most common form of dementia. Methods: In a 4‐month randomized controlled trial, 40 community‐dwelling patients diagnosed with Alzheimer’s disease and their informal carers were randomly allocated to either the treatment (exercise plus usual treatment) or control (usual treatment) group. The exercise programme consisted of daily exercises and walking under the supervision of their carer. Patients were assessed at baseline and 4‐months follow‐up by a blinded assessor on primary outcome measures of cognitive and physical function and ADL using standardized assessment scales. Results: Sixteen men and 24 women diagnosed with Alzheimer’s disease participated in the study. They had a mean age of 74.1 years (range 51–89) and a mean Mini Mental State Examination score of 22.0 (range 10–28), indicating mild to moderate dementia. At 4‐months follow‐up, patients who exercised, compared with controls, had improved cognition (increased Mini Mental State Examination scores by 2.6 points, p < 0.001), better mobility (2.9 seconds faster on Timed Up and Go, p = 0.004) and increased Instrumental Activities of Daily Living scores by 1.6 (p = 0.007). Conclusion: This study suggests that participation in a community‐based exercise programme can improve cognitive and physical function and independence in ADL in people with Alzheimer’s disease.     

A randomized controlled trial of a video module to increase U.S. poison center use by low-income parents

Context. U.S. poison centers decrease medical visits by providing telephone advice for home management of potential poisonings, but are underutilized by low-income African-American and Latino parents, and those with limited English proficiency, due to lack of knowledge and misconceptions about poison centers. Objectives. To assess the effectiveness of a poison prevention video module in improving knowledge, behavior, and behavioral intention concerning use of poison centers in a population of low-income, language-diverse adults attending parenting courses offered by a community organization. Methods. A randomized, blinded, controlled trial was conducted at 16 parenting course sites of a community organization and included 297 participants. The organization's instructors presented the video module (intervention) or the usual class curriculum (control). Participants completed questionnaires at baseline and a telephone interview 2–4 weeks later. Changes from baseline to follow-up were compared between the intervention and control groups using analysis of variance and Chi-square tests. Intervention group participants were stratified by English proficiency and compared to assess baseline and follow-up responses by language. Results. After the intervention, participants in the intervention group had a significantly greater increase in knowledge about the poison center, were more likely to have the correct poison center phone number at home, and had greater behavioral intention to use the poison center compared to control group participants. At baseline, Spanish-primary-language participants with limited English proficiency had less knowledge about the poison center, were less likely to have the poison center number at home, and had lower behavioral intention to use the poison center than English proficient participants, but significantly improved after the intervention. Conclusions. This video module, when presented by a community organization's instructors, was highly effective in improving knowledge, behavior, and behavioral intention concerning use of poison centers within a low-income, language-diverse population.     

Motor relearning programme for stroke patients: a randomized controlled trial

OBJECTIVE: To study the efficacy of the motor relearning approach in promoting physical function and task performance for patients after a stroke. DESIGN: Matched-pair randomized controlled trial. SETTING: An outpatient rehabilitation centre in Hong Kong. PARTICIPANTS: Fifty-two outpatients with either a thrombotic or haemorrhagic stroke who completed either the study or control group. INTERVENTIONS: The patients received 18 2-h sessions in six weeks of either the motor relearning programme or a conventional therapy programme. MAIN OUTCOME MEASURES: The Berg Balance Scale, the Timed Up and Go Test, the Functional Independence Measure (FIM), the modified Lawton Instrumental Activities of Daily Living (IADL) test, and the Community Integration Questionnaire. RESULTS: Patients in the motor relearning group showed significantly better performance on all but the Timed Up and Go Test when compared with the control group (F(1,150) = 6.34-41.86, P < or = 0.015). The interactions between group and occasion were significant on all five outcome measures, indicating that the rates of change across time between the motor relearning and control groups differed (F(3,150) = 3.60-33.58, P < 0.015). CONCLUSION: The motor relearning programme was found to be effective for enhancing functional recovery of patients who had a stroke. Both 'sequential' and 'function-based' concepts are important in applying the motor relearning approach to the rehabilitation of stroke patients.     

Efficacy of a nurse-led email reminder program for cardiovascular prevention risk reduction in hypertensive patients: A randomized controlled trial

Background

Many strategies have been evaluated to improve the prevention and control of cardiovascular (CVD) risk factors. Nursing telephonic and tele-counseling individualized lifestyle educational programs have been found to improve blood pressure control and adherence to lifestyle recommendation. This study tested the efficacy of a nurse-led reminder program through email (NRP-e) to improve CVD risk factors among hypertensive adults.

Methods

All participants received usual CVD prevention and a guideline-based educational program. Subjects in the NRP-e group also received weekly email alerts and phone calls from a nurse care manager for 6 months. Emails contained a reminder program on the need for adherence with a healthy lifestyle based upon current guidelines. Follow-up visits were scheduled at 1, 3 and 6 months after enrollment; randomization was made centrally and blood samples were evaluated into a single laboratory.

Results

The final sample consisted of 98 (control) and 100 (NRP-e) subjects (mean age 59.0 ± 14.5 years; 51.0% males). After 6 months, the following CVD risk factors significantly improved in both groups: body mass index, alcohol and fruit consumption, cigarette smoking, adherence to therapy hours, systolic and diastolic blood pressure, fasting blood glucose, low-density lipoproteins (LDL) and total cholesterol, triglycerides, and physical activity. In the NRP-e group, however, the prevalence of several behaviors or conditions at risk decreased significantly more than in the control group: obesity (−16%), low fruit consumption (−24%), uncontrolled hypertension (−61%), LDL (−56%), and total cholesterol (−40%).

Conclusions

The NRP-e improved a range of CVD risk factors. The program had low costs, required only an average of <20 min per day in addition to normal practice, and may deserve further evaluation for the inclusion among existing care management approaches.     

Effect of active resistive exercise on breast cancer-related lymphedema: a randomized controlled trial

Kim DS, Sim Y-J, Jeong HJ, Kim GC. Effect of active resistive exercise on breast cancer–related lymphedema: a randomized controlled trial.

Objective

To investigate the differences between the effects of complex decongestive physiotherapy with and without active resistive exercise for the treatment of patients with breast cancer–related lymphedema (BCRL).

Design

Randomized control-group study.

Setting

An outpatient rehabilitation clinic.

Participants

Patients (N=40) with diagnosed BCRL.

Interventions

Patients were randomly assigned to either the active resistive exercise group or the nonactive resistive exercise group. In the active resistive exercise group, after complex decongestive physiotherapy, active resistive exercise was performed for 15min/d, 5 days a week for 8 weeks. The nonactive resistive exercise group performed only complex decongestive physiotherapy.

Main Outcome Measures

The circumferences of the upper limbs (proximal, distal, and total) for the volume changes, and the Short Form-36 version 2 questionnaire for the quality of life (QOL) at pretreatment and 8 weeks posttreatment for each patient.

Results

The volume of the proximal part of the arm was significantly more reduced in the active resistive exercise group than that of the nonactive resistive exercise group (P<.05). In the active resistive exercise group, there was significantly more improvement in physical health and general health, as compared with that of the nonactive resistive exercise group (P<.05).

Conclusions

For the treatment of patients with BCRL, active resistive exercise with complex decongestive physiotherapy did not cause additional swelling, and it significantly reduced proximal arm volume and helped improve QOL.     

The effects of exercise and social support on mothers reporting depressive symptoms: a pilot randomized controlled trial

A 12-week randomized controlled trial was conducted (n = 20) investigating the effects of a multi-intervention programme of exercise and social support compared to a control group. Both groups had given birth in the past 12 months and were experiencing depressive symptomatology. Pretest data of physical fitness and structured questionnaires were compared to post-test data. The results from the study showed that mothers who were in the multi-intervention group improved their fitness levels and depressive symptomatology significantly more than the control group. However, there were no significant changes to either group's social support levels. These results are encouraging and suggest that a pram push walking intervention might be an effective treatment for mothers suffering postnatal distress.     

The effect of a simple traditional exercise programme (Baduanjin exercise) on sleep quality of older adults: a randomized controlled trial

BackgroundSleep disturbance is a major problem for older adults, calling for the development of alternative medicine techniques to help improve sleep quality in this population.ObjectivesThe purpose of this study was to explore the effectiveness of a Baduanjin exercise program on sleep quality in Taiwanese elderly.DesignA randomized controlled trial, longitudinal research design was employed.Setting and participantsThis study was conducted in an urban area of northern Taiwan. The inclusion criteria for participants were as follows: (1) community-dwelling older adults age 60 years or older; (2) no regular exercise within 6 months; (3) able to communicate; and (4) independent in self-care. Subjects were excluded if they had (1) depression tendency as demonstrated by the Chinese version of the Geriatric Depression Score of eight or higher; (2) impaired mobility; or (3) unstable health status. A total of 202 older people were screened for this study, 87 of whom were eligible according to the inclusion criteria. Of these, 55 completed the 12-week study.MethodsFifty-five participants were randomly assigned to the exercise group (27) or the control group (28). Those in the exercise group received 12 weeks of Baduanjin exercise training, while those in the control group had no intervention. The Pittsburg Sleep Quality Index was administered to subjects at four time points: before the intervention, and at the 4th, 8th, and 12th week after intervention.ResultsSubjects in the Baduanjin exercise group had significantly improved overall sleep quality, subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction after 12 weeks of intervention (p < 0.001), while those in control group showed no significant difference in sleep quality. Compared with the control group, the Baduanjin exercise group reported significantly better sleep quality after four weeks of intervention which was maintained throughout the 12-week exercise period.ConclusionsThis study confirmed that the Baduanjin exercise program can improve sleep quality for Taiwanese community-dwelling older adults. We recommend application of this simple, gentle exercise program in older persons to improve their sleep quality.     

The effectiveness of an osteoporosis prevention education programme for women in Hong Kong: a randomized controlled trial

Aims. The purpose of this study was to evaluate whether a nurse‐initiated education programme on four specific osteoporosis‐prevention related behaviours leads to their adoption or positive attitude changes compared with women who did not participate in this programme. Research method. The design was a randomized controlled design and the setting was a local private beauty clinic. Outcome measures. Pre‐, post‐ and follow‐up education data compared attitudes and consumption frequency before and after the education programme. Results. The results showed significant increases in the reported follow‐up for each behaviour: consumption of soya foods (mean = 4·3, SD = 0·5), milk (mean = 4·2, SD = 0·8), more exercise (mean = 4·3, SD = 0·5) and vitamin D/exposure to sunlight (mean = 4·2, SD = 0·9) for subjects in the case group compared with control group subjects (soya foods: mean = 3·3, SD = 0·9, P < 0·001; milk: mean = 3·0, SD = 0·9, P < 0·001; more exercise: mean = 3·4, SD = 1·0, P = 0·003; vitamin D/sunlight: mean = 2·7, SD = 0·9, P < 0·00). Most of the participants either disagreed (n = 11, 55·0%) or strongly disagreed (n = 9, 45·0%) that there was not enough information provided in the education programme to motivate them to change. On the satisfaction score, they rated the nurse's performance as either satisfactory (n = 11, 55·0%) or very satisfactory (n = 9, 45·0%) on presentation and ability to answer their questions and either satisfactory (n = 12, 60·0%) or very satisfactory (n = 8, 40·0%) on ability to describe each behaviour clearly. Conclusion. A targeted education programme conducted with Hong Kong women resulted in significantly increased consumption of calcium including soya‐based foods, milk and vitamin D. According to the reported attitudinal and behavioural intentions, participants’ positive feedback suggests that women who participated in this educational programme were motivated to make changes and benefited from the support of this nurse‐initiated education programme. Relevance to clinical practice. Osteoporosis was a serious health concern that most commonly affected women. As indicated by the results of this study, this educational programme can act as simple but effective nursing intervention to promote women's attitudinal and behavioural intentions towards osteoporosis‐prevention.