Design: Parallel-group controlled pragmatic pilot trial.
Subjects: There was a total of 83 patients with COPD (mean age 70?±?8 years with a forced expiratory volume in first second percent predicted of 60?±?17%). The intervention group (n?=?43) was introduced to and had access to the COPD Web in addition to usual care, while the control group (n?=?40) received usual care alone.
Main outcome measures: The feasibility of the COPD Web (i.e., if and how the COPD Web was used) was automatically collected through the website, while outcomes on health, conceptual knowledge, and physical activity (PA) were collected through questionnaires at baseline, 3 months and 12 months.
Results: At 3 months, 77% of the intervention group was considered users, and the majority of time spent on the site was related to PA and exercises and was spent during the first month (>80%). In addition, the intervention group reported increased PA (odds ratio [OR]?=?4.4, P?<?.001), increased conceptual knowledge in five domains (OR = 2.6–4.2, all P?<?.05), and altered disease management strategies (e.g., increased PA) (OR ≥ 2.7 P?<?.05) in comparison to the control group. The latter was also different between groups at 12 months (OR = 3.7, P?=?.044). Knowledge of PA was correlated with level of PA (ρ?=?.425–.512, P?<?.05) as well as to the use of PA as a strategy to manage their disease (χ2?=?11.2–32.9, P?<?.05).
Conclusion: Giving patients with COPD access to the COPD Web in addition to their ordinary primary care might be an effective shorter term (3 month) strategy to promote self-management. However, these results needs to be confirmed in a definitive large-scale trial.
- Key points
Even though self-management strategies are an important part of chronic obstructive pulmonary disease (COPD) management, access to support for such strategies are limited for a large part of the COPD-population.
Promoting self-management through the COPD Web might increase short-term levels of physical activity, promote conceptual knowledge and alter disease management strategies.
The primary care COPD population in this study experienced limited impact of the disease in daily life, limited exertional dyspnea, and high generic quality-of-life, but vastly reduced levels of physical activity.
A future large scale study should include strategies to encourage greater exposures to the COPD Web, including an extended analysis of factors associated with using or not using the tool over time and its impact on outcome measures, objective measures of conceptual knowledge, and physical activity, and it should include a large enough sample size to enable sub-group analyses and strategies to enhance recruitment.
Objective
The primary objective of this study was to quantify the lower extremity movements and capabilities of a population with lumbar spinal stenosis (LSS) compared with healthy age-matched controls under conditions of strain and no strain. The secondary objective was to identify challenging movement conditions for a population with LSS, on a lower limb aiming task with different levels of difficulty, compared with healthy age-matched controls under conditions of strain and no strain.Methods
Using a nonrandomized, controlled, before-and-after design, LSS patients (n = 16) and healthy controls (n = 16) performed 2 blocks of great toe–pointing movements to a series of projected squares. Following block 1, participants completed a 12-minute progressive exercise treadmill test. Pointing movements were analyzed using 3D motion analysis. Behavioral and kinematic measures evaluated performance.Results
Both groups' reaction times (RTs) lengthened as task difficulty increased. An interaction revealed that LSS patients were more adversely impacted by task difficulty, F (3,372) = 4.207; P = .006. The progressive exercise treadmill test facilitated RT for both groups, F (1,124) = 5.105; P = .026. Control participants showed less variability in time-to-peak velocity poststrain, a benefit not shared by LSS patients, t (31) = 2.149; P = .040.Conclusion
A lower extremity movement task captured differences under strain between healthy and LSS populations. The lower extremity Fitts' Law task accurately measured differences between healthy and LSS participants. For the subjects in this study, strain was sufficient to prevent LSS patients from demonstrating improvement in the variability of the ballistic phase of movement execution, whereas LSS patients' movement performance remained unchanged. This study also showed that regardless of strain, as task difficulty increased, LSS patients were more adversely impacted in the planning and execution of their lower limb movements than healthy control participants. The lower extremity motor control task (Fitts' task) can be used as a performance-based outcome measure to measure differences between healthy and LSS populations. 相似文献Materials and Methods: This pilot study is an experimental controlled study with repeat measurements. Thirty patients were randomly assigned to study and control groups. The study group, received six weekly sessions of ACT, in addition to the usual treatment, while the control group received only the usual treatment. Both groups were tested using the General Health Questionnaire (GHQ-28) and Buss Perry Aggression Questionnaire (BPAQ) at three cross sections of time.
Results: General health was improved significantly in study group comparing with control group (P < 0.0001). There were significant differences between the three time points of therapy (p = 0.0001; F(2,56) = 41/456). Additionally, there were significant differences between the means of the three time points of therapy in aggressiveness variable (p = 0.0001; F(2,56) = 190/845).
Findings: ACT improved general health and decreased aggressiveness in the study group compared to the control group and may be a good therapy for methamphetamine dependents who suffer from psychosis. 相似文献
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- Implications for Rehabilitation
Due to a change in body shape such as that caused by scoliosis, human posture changes and spinal deformities affect the position of the center of support, and thus balance ability may change.
AIS subjects have poor standing stability compared to a healthy matched control group.
Brace wearing had positive effect in improving quiet standing balance and standing on the dominant lower extremity in subjects with AIS undergoing brace treatment after 4 months of TLSO use.