Presence, communication and treatment of fatigue and pain complaints in incurable cancer patients

OBJECTIVE: This study describes the experiences of fatigue and pain in incurable cancer patients and the treatment they receive. METHODS: Patients were recruited via medical specialists from hospitals in the South and Southwest of the Netherlands. Hundred and twenty-five incurable cancer patients filled out a written questionnaire and were also interviewed at home. RESULTS: Ninety percent reported to suffer from fatigue and 48% had pain. Forty-five percent had discussed fatigue with a healthcare professional and 55% had discussed pain. Fifteen percent reported to receive medical treatment for their fatigue and 29% received pain treatment. Treatment for fatigue and pain treatment had been recently adjusted in 4% of the patients with fatigue complaints and 21% of the patients with pain complaints. CONCLUSION: Although fatigue is a more common problem than pain in patients with incurable cancer, less attention in the care is paid to fatigue and its treatment than to pain. PRACTICE IMPLICATIONS: Fatigue deserves more attention in the care policy for incurable cancer patients and more research should be focused on interventions to address fatigue in this group of cancer patients.     

Modulation in voluntary neural drive in relation to muscle soreness

The aim of this study was to investigate whether (1) spinal modulation would change after non-exhausting eccentric exercise of the plantar flexor muscles that produced muscle soreness and (2) central modulation of the motor command would be linked to the development of muscle soreness. Ten healthy subjects volunteered to perform a single bout of backward downhill walking exercise (duration 30 min, velocity 1 ms⁻¹, negative grade −25%, load 12% of body weight). Neuromuscular test sessions [H-reflex, M-wave, maximal voluntary torque (MVT)] were performed before, immediately after, as well as 1–3 days after the exercise bout. Immediately after exercise there was a −15% decrease in MVT of the plantar flexors partly attributable to an alteration in contractile properties (−23% in electrically evoked mechanical twitch). However, MVT failed to recover before the third day whereas the contractile properties had significantly recovered within the first day. This delayed recovery of MVT was likely related to a decrement in voluntary muscle drive. The decrease in voluntary activation occurred in the absence of any variation in spinal modulation estimated from the H-reflex. Our findings suggest the development of a supraspinal modulation perhaps linked to the presence of muscle soreness.     

The role of cocontraction in the impairment of movement accuracy with fatigue

The present experiment was designed to test the hypothesis that fatigue-induced impairment in movement accuracy is caused by a decrease in muscle cocontraction rather than a reduced ability to produce muscular force. Seven participants performed fast and accurate elbow extensions aimed at a target, before and after a fatigue protocol. The inertia of the manipulandum was decreased after the fatigue protocol so that the ratio of required to available force during movements was identical pre- and post-fatigue. After the fatigue protocol, movement endpoint accuracy decreased and movement endpoint variability increased. These alterations were associated with a decrease in cocontraction. We concluded that the impairment of movement accuracy during fatigue could not be explained by the lack of available force, but was likely to be due to a fatigue-induced decrease in muscular cocontraction. We then speculate that fatigue influences the relative weights of accuracy and energy economy in the optimisation of sensorimotor control.     

飞行疲劳相关症状的综合物理治疗

目的 为快速解除飞行疲劳相关症状提供综合物理治疗方案. 方法 空军航空兵部队飞行人员232例,根据其飞行疲劳相关症状的类型分为A、B、C 3组,采用中频电、超短波、半导体激光、耳穴压丸等综合物理因子组合配方治疗.治疗前后采用目测类比评分法(VAS)和口述分级评分法(VRS),记录分值进行评定. 结果 3组评分经统计学处理,采用治疗前后自身对照,治疗后评分明显优于治疗前,飞行人员疲劳相关症状有显著改善,差异有统计学意义(Z=5.958～9.250,P<0.01).结论通过相关指标的分析,证明所采用的治疗方案对于快速缓解飞行疲劳引起的肌肉酸痛、功能失调及炎症等相关症状有良好疗效.     

有氧运动对维持性血液透析患者下肢运动功能及疲乏状况的影响

目的：探讨有氧运动对维持性血液透析（ MHD）患者下肢运动功能及疲乏状况的影响。方法将120例病情稳定的MHD患者随机分为实验组和对照组。实验组在接受常规护理干预的基础上进行每周3次共12周的有氧运动;对照组接受常规护理。采用6 min步行测试（6MWT）评估干预前后两组患者的下肢运动功能,采用疲乏量表（FS-14）评估干预前后两组患者的疲乏状况。结果干预前两组6MWT距离和FS-14躯体疲劳评分、脑力疲劳评分、总分比较,差异无统计学意义（P＞0．05）;干预后实验组6MWT距离和FS-14躯体疲劳评分、脑力疲劳评分、总分明显低于干预前（P＜0．05）,也明显低于对照组（ P＜0．05）;干预后对照组6MWT距离和FS-14躯体疲劳评分、脑力疲劳评分、总分与干预前比较,差异无统计学意义（P＞0．05）。结论有氧运动能有效改善MHD患者的下肢运动功能,降低患者的疲乏程度。     

运动性疲劳对大鼠脑组织内HDAC2表达的影响

目的:建立SD大鼠的运动性疲劳模型,通过检测大鼠海马CA1区及大脑皮层内的HDAC2蛋白表达,探讨其在疲劳导致大鼠学习记忆障碍发病机理中的作用。方法:成年雄性SD大鼠随机分为对照组、运动后疲劳即刻组和运动后疲劳恢复90min组。疲劳即刻组和恢复90min组大鼠均进行10d游泳运动,每天运动至力竭,对照组大鼠不加任何干预。疲劳组采用避暗穿梭实验检测大鼠学习记忆功能受损情况,同时采用免疫组化法检测大鼠大脑皮层和海马CA1区的HDAC2蛋白表达,并测定HDAC2蛋白免疫阳性细胞的积分光密度值(IOD)。结果:疲劳即刻组和疲劳恢复90min组大鼠学习记忆功能有不同程度损伤,其大脑皮层和海马CA1区HDAC2的表达蛋白表达较对照组上调。结论:运动性疲劳致大鼠学习记忆功能损伤可能与大鼠大脑皮层和海马内HDAC2蛋白表达变化相关。     

电刺激及生物反馈康复治疗对产后盆底肌力和疲劳度的影响

目的 研究电刺激及生物反馈康复治疗对产后盆底肌力和疲劳度的影响.方法 将2012年3月-2013年5月在本院接受顺产分娩的180例产妇纳入研究对象,随机分为给予盆底功能训练联合电刺激生物反馈治疗的观察组和仅给予盆底功能训练的对照组各90例,观察盆底肌电活动、疲劳度及肌肉收缩力、尿失禁发生率、性生活满意率等情况.结果 观察组患者Ⅰ类肌纤维电位平均值（19.4±2.5）μV、Ⅱ类肌纤维电位平均值（23.3±3.1）μV,产后2、6个月阴道静息压（35.7±6.3）、（38.2±6.3）cmH2O,阴道收缩压（39.4±5.3）、（42.2±9.3）cmH2O,阴道收缩持续时间（5.7±0.8）、（4.8±0.7）s,性生活满意率（48.89％、75.56％）均高于对照组;Ⅰ类肌纤维疲劳度（3.8±0.5）％/s,Ⅱ类肌纤维疲劳度（3.4±0.6）％/s;产后2、6个月尿失禁率（21.11％、13.33％）均低于对照组.结论 电刺激及生物反馈康复治疗有助于增强盆底肌肉收缩力,缓解疲劳程度,提高生活质量,具有积极的临床应用价值.     

新闻媒体工作者的疲劳现状调查及健康教育对策

目的了解新闻媒体工作者的疲劳状况及存在的健康问题,为促进新闻工作者的健康提供依据。方法应用Trudie Chalder疲劳量表-14和自行设计的问卷对沈阳市291名新闻媒体工作者进行了调查,同时应用疲劳量表-14对143名地税局工作者进行调查,作为对照。结果新闻媒体工作者的疲劳总分为(6.8±3.0)分与对照组(6.0±2.8)分比较差异有统计学意义(P<0.01)。新闻媒体工作者中多有不吃早餐、晚餐吃得过晚、吃夜餐、睡眠不足、上网时间过长、活动不足等不良生活方式。结论不良的生活方式和疲劳严重影响了新闻媒体工作者的身体健康,亟须采取相应的健康教育措施进行改善。     

雷火灸配合推拿治疗慢性疲劳综合征疗效观察

目的观察雷火灸配合推拿治疗慢性疲劳综合征的疗效。方法将60例慢性疲劳综合征患者随机分为治疗组（雷火灸配合推拿）与对照组（普通针刺）各30例,依据临床症状进行疗效评定。结果治疗组治愈率为36.7%,总有效率为93.3%,对照组治愈率为16.7%,总有效率为76.7%,两组比较差异有统计学意义（P〈0.01）。结论雷火灸配合推拿治疗慢性疲劳综合征疗效优于普通针刺治疗。