The effectiveness of home-based physical therapy on glycemic control and quality of life in adults with prediabetes

Background: Prediabetes is the preceding stage of diabetes which puts an individual to induce complications same as that of diabetes; hence, it should be treated to prevent its progression to diabetes and other consequences. However, there is very less literature about impact of home-based physical therapy on glycemic control and quality of life in Indian prediabetic population. Aims and Objectives: The aims of this study were to evaluate whether the home-based physical therapy shows effect on glycemic control and individual’s quality of life after a 3-month intervention. Materials and Methods: The study was conducted on 55 individuals who were diagnosed with prediabetes (36 males and 19 females) on basis of HbA1c level ranging from 5.7% to 6.4%. A 12-week exercise protocol was made which includes warm up exercises, main exercise program (aerobic and strengthening training), and cool down exercises along with dietary changes. SF-36 and HbA1c level is taken at baseline and at the end of 12 weeks for quality of life and glycemic control measures in participants, respectively. Results: The difference in HbA1c levels before and after treatment was found to be statistically significant. The HbA1c levels after the 3-month intervention showed significant reduction (P < 0.008) along with significant difference in all domain of SF-36 except in domain 3 (role limitation due to emotional problem) and domain 6 (social functioning). Conclusion: The home-based physical therapy program is effective in glycemic control and quality of life in adults with prediabetes.

Comparison of the application of WOMAC, SF-36 scales and the "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) standard in the evaluation of efficacy in patients with Kashin-Beck disease / 中华地方病学杂志

Objective:To compare the application effect among Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scale, Medical Outcomes Study 36-item Short Form (SF-36) scale and "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) standard in the evaluation of therapeutic effect of patients with Kashin-Beck disease, which could provide basis for the treatment evaluation of patients with Kashin-Beck disease.Methods:A total of 213 patients with Kashin-Beck disease in Gansu Province were investigated. WOMAC scale, SF-36 scale and standard of WS/T 79-2011 were used to analyze the quality of life of patients before and after treatment. The reliability, construct validity, content validity, discriminant validity of WOMAC and SF-36 scales were compared. Correlation between WOMAC, SF-36 scales and standard of WS/T 79-2011 were evaluated.Results:Both WOMAC and SF-36 scales had good construct validity and content validity (construct validity showed WOMAC and SF-36 scales contained 1 and 2 common factors, respectively; content validity showed WOMAC and SF-36 scales contained 3 and 8 common factors, respectively). The reliability and discriminant validity of WOMAC scale were better than those of SF-36 seale (reliability showed WOMAC reliability coefficient ≥0.934, the reliability coefficient of SF-36 scale was ranged from 0.386 to 0.999. Discriminant validity showed there were differences in 3 dimensions of the WOMAC scale before and after treatment, while there were differences in 6 out of 8 dimensions of the SF-36 scale). The correlation coefficients between WOMAC scale and standard of WS/T 79-2011 ranged from 0.175 to 0.437, the correlation coefficients between SF-36 scale and standard of WS/T 79-2011 ranged from - 0.434 to - 0.099 ( P < 0.05). Conclusion:The reliability, discriminant validity and correlation with the standard of WS/T 79-2011 of WOMAC scale are better than those of SF-36 scale in efficacy evaluation of patients with Kashin-Beck disease.

Quality of life in patients after minimally invasive coronary artery bypass grafting surgery versus off-pump coronary artery bypass grafting surgery: A propensity score matching study / 中国胸心血管外科临床杂志

@#Objective    To compare and analyze the postoperative quality of life in patients after minimally invasive coronary artery bypass grafting (MICABG) and conventional median thoracotomy off-pump coronary artery bypass grafting surgery (OPCABG). Methods    From November 2015 to January 2018, 94 patients who underwent MICABG in the Peking University Third Hospital were included in the MICABG group. During the same period 441 patients who received OPCABG were included in the OPCABG group. The patients were matched by using propensity score matching method with a ratio of 1∶1. The quality of life was compared between two groups at 1 month, 6 months and 12 months after the surgery using SF-36 scale. Results    A total of 82 patients were matched for each group. In the MICABG group, there were 66 males and 16 females with a mean age of 62.6±8.2 years. In the OPCABG group, there were 67 males and 15 females with a mean age of 63.2±13.2 years. One month after the operation, the physical health assessment (PCS) and mental health assessment (MCS) of the MICABG group were higher than those of the OPCABG group (50.3±10.6 points vs. 46.1±10.3 points, P=0.011; 59.5±9.3 points vs. 54.2±11.0 points, P=0.002). Scores of these following five dimensions: general health, physical functioning (PF), role-physical, social functioning (SF), role-emotion in the MICABG group were higher than those in the OPCABG group, while the score of body pain was inferior to that in the OPCABG group, and the differences were statistically significant (P<0.05). Six months after the surgery, the PCS and MCS of the two groups were not statistically different (80.0±13.1 points vs. 77.8±12.4 points, P=0.271; 81.6±13.5 points vs. 80.4±11.2 points, P=0.537). However, the scores of PF and SF in the MICABG group were still higher than those in the OPCABG group (P<0.05). Twelve months after the surgery, there was no statistical difference in the score of each dimension between the two groups (P>0.05). Conclusion    The improvement of quality of life within 6 months after MICABG is better than that of OPCABG, and it is similar between the two groups at 12 months after the surgery, indicating that MICABG has a certain effect of improving the short-term quality of life after the surgery, and the long-term quality of life is comparable to conventional surgery.

Vitamin D is associated with a low quality of life: a primary care study

Introduction: Some studies have described impairment in quality of life of vitamin-deficient subjects. However, little is known about this association in primary care. This study aimed to evaluate the association between vitamin D deficiency and quality of life in postmenopausal women attending primary care in the municipality of Santa Maria ­ Brazil. Methods: A cross-sectional study was carried out with postmenopausal women over 55 years of age, accompanied in primary care, from March to August 2014. These women were randomly selected among the participants of a cohort study in the municipality of Santa Maria ­ Brazil. Data were collected through a standardized questionnaire, quality of life was assessed using the Short Form-36 Health Survey (SF-36), and 25-hydroxyvitamin D were measured using the ALPCO® ELISA method. Results: Of the total of 78 studied women, 11.54% had vitamin D deficiency. Women with vitamin D deficiency had a poorer quality of life assessed by SF-36. In the regression analysis, both vitamin D deficiency and falls were independently associated with a lower physical component of the SF-36. Conclusion: Vitamin D deficiency is associated with poorer quality of life in the studied postmenopausal women.

Mejoría del dolor, la función y la calidad de vida en dolor lumbar subagudo: ensayo clínico controlado con ejercicio vs. AINES / Improvement of pain, function and quality of life in subacute low back pain: controlled clinical trial with exercise vs. NSAIDs

Introducción. El dolor lumbar es una de las causas más frecuentes de consulta y discapacidad en pacientes, y según su evolución temporal se puede clasificar como agudo, subagudo y crónico. Objetivo. Estimar en pacientes con Dolor Lumbar Subagudo (DLS), la eficacia de un programa de ejercicio comparado con antiinflamatorios no esteroideos (AINES). Métodos. Se realizó un ensayo clínico controlado aleatorio, con enmascaramiento simple en 90 pacientes y DLS con o sin radiculopatía, 46 pacientes fueron asignados a un programa de ejercicio físico y 44 a tratamiento con AINES. El desenlace primario fue la mejoría del dolor y los secundarios mejoría en la función, calidad de vida, ausentismo laboral y depresión con seguimiento a 1, 3 y 6 meses. Resultados. Al mes, no se registró diferencias en el dolor entre los grupos de 8,16 (IC 95 % -2,19 a 18,51), sin embargo, en el grupo de ejercicios hubo una mejoría de 47,3 (SD: 19,8) a 28,8 (SD: 20,5), p <0,001, y en el grupo de AINES de 45,2 (SD: 22,6) a 34,9 (SD: 25,0), p = 0,018. Otras muestras de mejoría se observaron en la función medida por el Índice de Discapacidad de Oswestry (ODI), la cual mejoró al mes en el grupo de ejercicio (p<0,001), mientras,la función física también mejoró al mes en el grupo de ejercicio (p= 0,038). Otra mejoría se observó en el dolor, función y calidad de vida que se mantuvo a los 3 y 6 meses en ambos grupos. Finalmente, La recurrencia fue mayor en el grupo de AINES: 25,5 % vs. 7,1 % (p= 0,04) al mes; 25,5 % vs. 7,1 % (p= 0,04) y 20,5 % vs. 5 % (p= 0,04), a los 3 y 6 meses. Conclusión. El ejercicio supervisado fue más efectivo que los AINES para disminuir la discapacidad y las recurrencias y mejorar la función física en pacientes con DLS.

Introduction. Low back pain is one of the most frequent causes of consultation and disability in patients, and according to its temporal evolution it can be classified as acute, subacute and chronic. Objective. To estimate the efficacy of an exercise program compared to non-steroidal anti-inflammatory drugs (NSAIDs) in patients with subacute low back pain (LBP). Methods. A randomized, single-masked, controlled clinical trial was conducted in 90 patients and DLS with or without radiculopathy, 46 patients were assigned to a physical exercise program and 44 to NSAID treatment. The primary outcome was improvement in pain and the secondary outcomes were improvement in function, quality of life, work absenteeism and depression with follow-up at 1, 3 and 6 months. Results. At 1 month, there was no difference in pain between groups of 8.16 (95 % CI -2.19 to 18.51), however, in the exercise group there was an improvement from 47.3 (SD: 19.8) to 28.8 (SD: 20.5), p <0.001, and in the NSAID group from 45.2 (SD: 22.6) to 34.9 (SD: 25.0), p = 0.018. Other signs of improvement were seen in function as measured by the Oswestry Disability Index (ODI), which improved at 1 month in the exercise group (p<0.001), while physical function also improved at 1 month in the exercise group (p= 0.038). Another improvement was observed in pain, function and quality of life which was maintained at 3 and 6 months in both groups. Finally, recurrence was higher in the NSAID group: 25.5 % vs. 7.1 % (p= 0.04) at 1 month; 25.5 % (p= 0.04) at 1 month; 25.5 % (p= 0.038) in the exercise group (p= 0.038) at 1 month.

Impacto de un programa de ejercicio físico domiciliario de intensidad leve-moderada sobre calidad de vida, fuerza, resistencia aeróbica, equilibrio y flexibilidad en pacientes adultos mexicanos trasplantados de riñón

Contexto en México, la enfermedad renal crónica presenta un aumento exponencial y el trasplante renal se ha colocado como la mejor opción de tratamiento. A pesar de ello, los receptores de trasplante presentan una menor capacidad funcional y calidad de vida comparándolos con individuos sanos, lo cual se asocia a un estilo de vida sedentario, sumado con los efectos musculoesqueléticos de los inmunosupresores, sin embargo, la investigación es limitada. Objetivo evaluar el impacto en calidad de vida, fuerza, resistencia aeróbica, equilibrio y flexibilidad de un programa domiciliario de ejercicio físico de intensidad leve-moderada, en pacientes adultos mexicanos trasplantados de riñón. Metodología participaron nueve pacientes (29 ± 5,2 años), a los cuales se les evaluó la fuerza de agarre manual mediante un dinamómetro; la flexibilidad mediante la prueba de "distancia dedos planta" (sit-and-reach test por su nombre en inglés); su agilidad-equilibrio y fuerza en miembro inferior mediante la prueba de "pararse-sentarse", y "levántate y anda" (sit-to-stand y get-up-and-go por sus nombres en inglés) respectivamente; su actitud cardiorrespiratoria mediante el test de marcha por seis minutos, y su calidad de vida mediante el cuestionario de salud SF36. Resultados se mostraron mejoras estadísticamente significativas en dinamometría manual (P 0,005), "distancia dedos planta" (P 0,016), sentarse y pararse (P 0,0011) y test de marcha por seis minutos (P 0,012). En el cuestionario SF36, hubo mejoría en la función física (P 0,03) y salud general (P 0,01), pero no hubo cambios en los análisis de laboratorio y la tasa de filtración glomerular. Conclusiones un programa domiciliario de ejercicio combinado de intensidad leve-moderada parece tener un efecto positivo sobre la capacidad funcional y la calidad de vida de los receptores de trasplante renal, sin embargo, es necesaria una mayor investigación para evaluar la adherencia al programa.

Background in Mexico, chronic kidney disease presents an exponential increase, kidney transplantation has become the best treatment option. Despite this, transplant recipients have lower functional capacity and quality of life compared to healthy individuals, which is associated with a sedentary lifestyle, added to the musculoskeletal effects of immunosuppressants. However, the research is limited. Purpose to evaluate the impact of a home program of strength exercises, aerobic endurance, balance and flexibility of mild-moderate intensity in transplant patients. Methodology 9 patients (29.5, 2 years) participated, manual grip strength was evaluated by means of a dynamometer, flexibility through the sit and reach test, agility-balance and strength in the lower limb by means of the "sit to stand" and the "get up and go" respectively, functional capacity through the 6-minute walk test, and quality of life through the SF36 health questionnaire. Results Statistically significant improvements were shown in manual dynamometry (P 0.005), sit and reach test (P 0.016), Sit to stand test (P0.0011), 6-minute walk test (P 0.012). In the SF36 questionnaire, there was improvement in physical function (P0.03) and general health (P0.01), there were no changes in laboratory tests and glomerular filtration rate. Conclusion a home program of combined mild-moderate intensity exercise seems to have a positive effect on the functional capacity and quality of life of kidney transplant recipients, however, more research is needed to evaluate adherence to the program.

Trastornos mentales y calidad de vida relacionada con la salud en profesionales de Unidades de Cuidados Intensivos / Mental disorders and health-related quality of life in Intensive Care Units professionals

Resumen Los profesionales de la salud de las Unidades de Cuidados Intensivos (UCI) enfrentan situaciones de sufrimiento humano, competitividad y demanda, que podrían perjudicar su calidad de vida y su salud mental. El objetivo del estudio fue describir los trastornos mentales comunes y la calidad de vida relacionada con la salud en profesionales de la salud de la UCI en Salvador, Brasil. Este estudio transversal con 195 profesionales utilizó un cuestionario sociodemográfico y laboral, el Self-Reporting Questionnaire (SRQ-20) de trastornos mentales comunes y el 36-Item Short Form Health Survey (SF-36v2) de calidad de vida relacionada con la salud. El 29.7 % de los profesionales presentaron trastornos mentales comunes, especialmente entre profesionales de enfermería (RP = 2.28; IC 1.19-4.39; p = .007). La calidad de vida relacionada con la salud para todos los profesionales estuvo disminuida, principalmente en función social (44.25 ± 10.15) y rol emocional (45.86 ± 10.58). El SRQ-20 correlacionó fuertemente con los dominios dolor corporal (r = -.502), salud general (r = -.526), vitalidad (r = -.656), función social (r = -.608), salud mental (r = -.631) y el componente de salud mental (r = -.638) del SF-36v2 (p < .01). Los profesionales con trastornos mentales comunes mostraron una calidad de vida relacionada con la salud más deteriorada, esencialmente en dominios del componente de salud mental, y refirieron también dolor corporal. Es necesario discutir e implementar estrategias de evaluación, prevención y promoción de la salud mental entre los profesionales de las UCI para que sean consideradas dentro de las políticas de salud laboral.

Comprometimento da qualidade de vida em pacientes com acalásia chagásica e fatores clínicos associados / Impaired quality of life in chagas acalasia patients and associated clinical factors

ABSTRACT Background: No study has focused on Health-Related Quality of Life (HRQoL) for Chagas Achalasia patients. Objective: To compare HRQoL between Chagas Achalasia patients and the general population; and to correlate HRQoL with clinical factors that can affect it. Methods: Sixty Chagas Achalasia patients and 50 controls were evaluated. All patients underwent esophageal manometry for the diagnosis of achalasia and esophagogram to determine the grade of megaesophagus. Three questionnaires were used: 1) clinical: the following data were collected: demographic, medical history, body mass index, occurrence of six esophageal symptoms (Esophageal Symptom Score: number of symptoms reported by patients), duration of dysphagia; 2) socio-economic-cultural status evaluation: patients and controls answered seven questions about their socio-economic-cultural conditions; 3) HRQoL: the validated Brazilian-Portuguese version of the Short-form Health Survey (SF-36) questionnaire (license QM020039) was used. It measures health in eight domains: 3a) four physical: physical functioning, role limitations relating to physical health, bodily pain, and general health perception; 3b) four mental: vitality, social functioning, role limitations relating to emotional health, and mental health. These domains can be summarized into Physical and Mental Summary scores. We analyzed correlations between SF-36 Physical/Mental Summary Component scores and the following clinical factors: Esophageal Symptom Score, duration of dysphagia, body mass index, grades of megaesophagus (defined by the esophagogram) and presence/absence of megacolon (defined by opaque enema). Results: Patients and controls had similar age, gender, medical history, and socio-economic-cultural lifestyles (P>0.05). All patients had dysphagia and megaesophagus. SF-36 scores were significantly lower in Chagas Achalasia patients than controls for all eight domains (physicals: P<0.002; mentals: P<0.0027). The Physical and Mental Summary Component scores were also lower in Chagas Achalasia patients than controls (P<0.0062). For patients, the Physical Summary score was negatively correlated to Esophageal Symptom Score (P=0.0011) and positively correlated to body mass index (P=0.02). No other correlations were found. Conclusion: Chagas Achalasia patients have an impaired HRQoL in all physical and mental domains. Patients reporting more symptoms had worse physical domains. Patients with higher body mass index had better physical domains.

RESUMO Contexto: Não encontramos na literatura estudos sobre a qualidade de vida em pacientes com acalásia chagásica especificamente. Objetivo: Comparar a qualidade de vida de pacientes com acalásia chagásica e a da população em geral. Também, correlacionar a qualidade de vida nestes pacientes com fatores clínicos que possam afetá-la. Métodos: Estudamos 60 pacientes com acalásia chagásica e 50 controles. Todos os pacientes foram submetidos à manometria esofágica para diagnóstico de acalásia e esofagograma técnica padrão para determinar o grau do megaesôfago. Usamos 3 questionários: 1) clínico: foram coletados os seguintes dados: demográficos, história clínica, índice de massa corporal, presença de seis sintomas esofágicos (definimos Escore de Sintomas Esofágicos como o número de sintomas relatados pelos pacientes), duração da disfagia; 2) avaliação sócio-econômico-cultural: sete questões sobre as condições sócio-econômico-culturais foram perguntadas para pacientes e controles; 3) qualidade de vida: foi avaliada pelo questionário SF-36, versão validada para o português-Brasil (licença QM020039). Este é um questionário genérico que mede a qualidade de vida em oito domínios: 3a) quatro físicos: capacidade funcional, aspectos físicos, dor corporal, estado geral de saúde; 3b) quatro mentais: vitalidade, aspectos sociais, aspectos emocionais, saúde mental. Estes oito domínios podem ser compilados em dois escores: Sumário dos Escores Físicos e Sumário dos Escores Mentais. Na análise de fatores clínicos que pudessem afetar a qualidade de vida dos pacientes, avaliamos: escores de sintomas esofágicos, duração da disfagia, índice de massa corporal, graus de megaesôfago e presença/ausência de megacólon. Resultados: Os dois grupos (pacientes e controles) apresentaram semelhantes idade, gênero, história médica e condições socioeconômico-culturais (P>0,05). Todos os pacientes tinham disfagia e megaesôfago. Com relação à qualidade de vida, pacientes com acalásia chagásica apresentaram valores significativamente menores do que os controles em todos os domínios do questionário SF-36 (domínios físicos: P<0,002; domínios mentais: P<0,0027). Os Sumários dos Escores Físicos e Mentais também foram significativamente menores em pacientes do que nos controles (P<0.0062). A análise dos fatores clínicos que poderiam afetar a qualidade de vida nos pacientes mostrou que o Sumário dos Escores Físicos se correlaciona negativamente com o Escores Dos Sintomas Esofágicos (P=0,0011) e positivamente com o índice de massa corporal (P=0,02). Não observamos qualquer outra correlação. Conclusão: Pacientes com Acalásia Chagásica têm pior qualidade de vida que a população em geral, em todos os domínios físicos e mentais. Pacientes que relataram mais sintomas apresentaram pior qualidade de vida nos domínios físicos. Pacientes com valores maiores de índice de massa corporal apresentaram melhor qualidade de vida nos domínios físicos.

Application of Chinese version of SF-36 scale and its reliability and validity in patients with chronic Keshan disease / 中华地方病学杂志

Objective:To evaluate the reliability and validity of the Chinese version of concise health status questionnaire (SF-36 scale) in evaluating the quality of life of patients with chronic Keshan disease, and to provide a scientific basis for studying the quality of life and the evaluation of treatment and rehabilitation of this population.Methods:In the August 2017, using cluster random sampling method, 175 patients with chronic Keshan disease treated by self-management of family beds in Pingliang City, Gansu Province in 2017 were selected as survey subjects, and demographic and disease data were collected. The Chinese version of SF-36 scale was used to investigate the quality of life. Split-half reliability and Cronbach's α coefficient were used to evaluate the reliability of the SF-36 scale; the factor analysis, correlation and differences between groups were used to evaluate the validity of the SF-36 scale.Results:The split-half reliability value of SF-36 scale was 0.916, and the Cronbach's α coefficient was 0.869. Factor analysis extracted 3 common factors from 8 dimensions of SF-36 scale, and the cumulative contribution rate of the 3 common factors to the total variance was 72.08%. In addition to the correlation coefficient ( r) between Role-Emotional and Bodily Pain dimension, the r value between total score and the scores of each dimension, and the scores of each dimension of SF-36 scale were 0.140 - 0.769. Except for the Bodily Pain dimension, there were statistically significant differences in the scores of Physiological Functioning, Role-Physical, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health dimension of the quality of life of patients with different grades of cardiac function ( F = 4.66, 10.73, 6.77, 14.61, 5.58, 9.57, 7.10, P < 0.05). Conclusion:The Chinese version of SF-36 scale has good reliability and validity in evaluating the quality of life of patients with chronic Keshan disease, and can be used to evaluate the quality of life of the patients.

Quality of Life of Elderly People Living in Different Types of Long-term Care Facilities

Abstract Population aging is a worldwide occurrence that has become urgent in developing countries. Quality of life can be measured to identify functional capacity and determine the degree of impact on quality of life exerted on an individual. This study aimed to measure the quality of life of elderly people who have been living in different long-term care facilities for the elderly. Therefore, this research was developed with a qualitative and descriptive approach. Data were obtained from medical records and interviews, and were analyzed in R language interpreter software on the Ubuntu Linux operating system. Seventy-nine elderly people participated in the study. Eleven lived in Home Marista, and 68 lived in Home Jesus Maria José. A socioeconomic questionnaire was used to collect data on the socioeconomic characteristics of the participants. The Mini-Mental State Exam was used to measure degree of cognition. The Short Form-36 Questionnaire was used to measure quality of life. The present study suggests that the results found can clarify the individual vulnerability of the elderly in the age group studied regardless of the type of residence. Despite the discrepancy found regarding the care provided at the long-term care facilities, the scores, obtained with the quality of life assessment, did not show significant differences.

Ações interdisciplinares da fisioterapia integrativa nos processos terapêuticos de dor / Interdisciplinary actions of integrative physiotherapy in pain therapeutic processes / Acciones interdisciplinarias de fisioterapia integrativa en procesos terapéuticos del dolor

Objetivo: demonstrar e discutir através de uma visão Integrativa o impacto do atendimento fisioterápico em pacientes portadores de dores neuromioarticulares agudas e crônicas por meio da aplicação do Questionário SF-36. Método: estudo observacional, transversal realizado com 299 pacientes que participaram do núcleo integrativo de dor no período de março a outubro de 2016, em um programa de atendimento padronizado de três blocos de fisioterapia, aplicado o questionário SF ­ 36 (medical outcomes study 36 ­ item short ­ form health survey) como indicador de resposta clinica. Foram incluídos pacientes advindos dos ambulatórios e encaminhados pelos médicos e como critérios de exclusão utilizamos: Pacientes com perda de mobilidade e dor exacerbada ao movimento; não adaptação ao programa; contra indicação médica e abandono do programa com 3 faltas consecutivas. Resultados: Ficou evidenciado, que a fisioterapia com o modelo integrativo interdisciplinar , através dos resultados do programa no núcleo da dor efetivamente promoveu a melhora nos quesitos de capacidade funcional, limitação por aspectos físicos e dor com redução de passagem em pronto socorro, consultas em ambulatórios médicos de ortopedia, cirurgia e grupo de avaliação em coluna e especialidades gerais. Conclusão: Demonstra-se que o paciente monitorado por uma equipe integrativa melhora a saúde funcional e gera impacto nos gastos administrativos de um convênio privado através de uma visão integral de saúde.

Objective: to demonstrate and discuss through an Integrative view the impact of physiotherapeutic care in patients with acute and chronic neuromyoarticular pain through the application of the SF-36 Questionnaire. Method: observational, cross-sectional study conducted with 299 patients who participated in the integrative pain nucleus from March to October 2016, in a standardized care program of three physiotherapy blocks, applied the Questionnaire SF - 36 (medical outcomes study 36 - item short - form health survey) as an indicator of clinical response. Patients from outpatient clinics and referred by physicians were included and exclusion criteria were used: Patients with loss of mobility and pain exacerbated by movement; non-adaptation to the programme; against medical indication and abandonment of the program with 3 consecutive absences. Results: It was evidenced that physiotherapy with the interdisciplinary integrative model, through the results of the program in the pain nucleus effectively promoted improvement in the terms of functional capacity, limitation by physical aspects and pain with reduced passage in the emergency room, consultations in orthopedic medical outpatient clinics, surgery and evaluation group in spine and general specialties. Conclusion: It is demonstrated that the patient monitored by an integrative team improves functional health and generates an impact on the administrative expenses of a private agreement through an integral view of health.

Objetivo: demostrar y discutir a través de una visión integradora el impacto de la atención fisioterapéutica en pacientes con dolor neuromioarticular agudo y crónico a través de la aplicación del Cuestionario SF-36. Método: estudio observacional, transversal, realizado con 299 pacientes que participaron en el núcleo integrativo del dolor de marzo a octubre de 2016, en un programa de atención estandarizado de tres bloques de fisioterapia, se aplicó el Cuestionario SF - 36 (estudio de resultados médicos 36 - ítem corto - encuesta de salud forma) como indicador de respuesta clínica. Se incluyeron pacientes de ambulatorios y referidos por médicos y se utilizaron criterios de exclusión: pacientes con pérdida de movilidad y dolor exacerbado por el movimiento; la no adaptación al programa; contra indicación médica y abandono del programa con 3 ausencias consecutivas. Resultados: Se evidenció que la fisioterapia con el modelo integrador interdisciplinario, a través de los resultados del programa en el núcleo del dolor promovió efectivamente la mejoría en términos de capacidad funcional, limitación por aspectos físicos y dolor con paso reducido en la sala de emergencias, consultas en ambulatorios médicos ortopédicos, cirugía y grupo de evaluación en columna vertebral y especialidades generales. Conclusión: Se demuestra que el paciente monitoreado por un equipo integrador mejora la salud funcional y genera un impacto en los gastos administrativos de un contrato privado a través de una visión integral de la salud. Descriptores: Fisioterapia; Interdisciplinario; Dolor; Integrante; SF-36

Assessment of the health status and its influencing factors in target recipients of the precision poverty alleviation program in Zigui County in 2018 / 公共卫生与预防医学

Objective To investigate the current health status of the targeted recipients of the precision poverty alleviation program in Taiziwan Village, Shazhenxi Town, Zigui County and explore its influencing factors, and to provide reference for the formulation of local health poverty alleviation policies. Methods A cluster sampling method was used to investigate 115 poverty alleviation recipients aged 18 and above in Taiziwan Village. The status of “physiological health” and “mental health” was investigated using the international general SF-36 (Chinese version) health scale. Results The survey subjects were mainly the people with advanced age, low education background and suffering from chronic diseases. Except for the physiological function score being more than 70 points, the scores of other dimensions were all 60 points around. The scores were 61.74±19.86 points for physical health and 59.05±16.91 points for mental health, respectively. People aged 60 and above scored lower in all dimensions than those aged under 60. Factors that affected both physical and mental health of the whole population were advanced age and chronic diseases. While the factors that affected physical health of people aged 60 and above were chronic diseases, the factors that affected mental health were chronic diseases and a long interval between children's home visits. Conclusion The health status of people aged 60 and above is worse than that of people aged below 60. Their physical health is affected by chronic diseases, and their mental health is affected by chronic diseases and children's visit cycles. While formulating poverty alleviation policies for physical health, an attention should also be paid to mental health.

Long-term intensive family rehabilitation training for postoperative functional recovery in elderly hip fracture patients / 中国组织工程研究

BACKGROUND: Hip fracture can result in a high functional disability rate in elderly patients. Traditional rehabilitation pays more attentions to rehabilitation training during hospitalization, instead of family rehabilitation training out of hospital. Intensive family rehabilitation training for 6 months has been proven to be an effective method, but its longer-term effect still needs further study. OBJECTIVE: To explore the effect of long-term intensive family rehabilitation training on postoperative functional recovery in elderly hip fracture patients. METHODS: Eighty-nine elderly hip fracture patients who were treated with surgery were prospectively enrolled, and randomized into an experimental group (n=42) and a control group (n=47). The control group patients were treated with traditional rehabilitation training, and the patients in the experimental group were treated with long-term intensive family rehabilitation training. Functional exercises in the experimental group were guided, and the rehabilitation scheme was adjusted in time using network tools. All the patients were followed up for 12 months, and their functional recovery was assessed at 3, 6, and 12 months postoperatively by the activity of daily living score, 6-minute walking test, the hip Harris score, the functional independent measure score and the MOS 36-Item Short-Form Health Survey (SF-36) score. The study protocol was implemented in line with the ethic requirements of the Sixth People’s Hospital of Chengdu, and each patient was fully informed of the study procedures. RESULTS AND CONCLUSION: Patients’ function gradually recovered in both group postoperatively. The activity of daily living score, functional independent measure score, 6-minute walking test, Hip Harris score, and SF-36 score of the experimental group were significantly better than those in the control group at 3, 6, and 12 months postoperatively (P<0.05). To conclude, long-term intensive family rehabilitation training for elderly hip fractures can improve patients’ daily life ability and quality of life; however, the rehabilitation program and its efficacy still require further research.

Reliability and validity of self-rated Family Burden Scale in families of the patients with anorexia nervosa / 上海交通大学学报（医学版）

Objective • To explore the reliability and validity of self-rated Family Burden Scale (FBS) evaluating caregiver burden in families of the patients with anorexia nervosa (AN). Methods • The study included female AN patients (n=103) treated in the Eating Disorder Center of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from Jul. 2017 to Jul. 2019 and their caregivers (parents, n=148). General demographic information of the patients and their caregivers, the course of illness and body mass index (BMI) of patients, and the time each caregiver spent in caring for the patient per day were recorded. FBS, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the MOS item short form health survey (SF-36) were self-rated by the caregivers. One-third of the caregivers were selected by random number method for FBS rating by specialists. The reliability of the scale was evaluated by calculating Cronbach's α coefficient, self-rating and other-rating consistency and the consistency between husband and wife (41 couples). The validity of the scale was evaluated by calculating the correlation of FBS score with the course of disease, patients' BMI, the time spent in caring per day, scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36. Results • The Cronbach's α coefficient of FBS was 0.921, the correlation coefficient between self-rating and other-rating by specialists was 0.705 (P=0.000), and the correlation coefficient of consistency score between couples was 0.547 (P=0.000). FBS score showed no correlation with the course of disease, %BMI and the time spent in caring per day. Scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36 showed low correlation with FBS score (all P<0.05). Conclusion • Self-rated FBS shows good reliability when used in families of AN patients. The validity is not as ideal, which suggests further revision of the scale.

Effect of ginger-separated moxibustion on fatigue, sleep quality and depression in patients with chronic fatigue syndrome: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of ginger-separated moxibustion on fatigue, sleep quality and depression in the patients with chronic fatigue syndrome.@*METHODS@#A total of 62 patients with chronic fatigue syndrome were randomized into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 2 cases dropped off). In the control group, the patients had normal diet and proper physical exercise. In the observation group, on the basis of the control group, the ginger-separated moxibustion was added at Zhongwan (CV 12), Shenque (CV 8) and Guanyuan (CV 4), 30 min each time, once every two days, 3 times weekly. Separately, before treatment and after 4 weeks of treatment, the MOS item short form health survey (SF-36), the Pittsburgh sleep quality index (PSQI) scale and the self-rating depression scale (SDS) were adopted to evaluate the degrees of fatigue, sleep quality and depression in the patients of the two groups.@*RESULTS@#In the observation group, the score of each item of SF-36, the score of each item of PSQI and SDS score after treatment were all improved significantly as compared with those before treatment respectively (<0.05, <0.01). In the control group, the scores of overall health, vitality and mental health in SF-36 and the score of sleep time of PSQI after treatment were improved as compared with those before treatment respectively (<0.05). After treatment, the score of each item of SF-36, the scores of sleep quality, sleep time, sleep efficiency and sleep disorders of PSQI, as well as SDS score in the observation group were all better than those in the control group respectively (<0.01, <0.05). The score of SF-36 was relevant to the scores of PSQI and SDS in the patients of chronic fatigue syndrome ( =0.331, <0.05; =-0.706, <0.01). The improvement value of SF-36 score was closely related to the improvement value of SDS score in the observation group ( =-0.657, <0.01).@*CONCLUSION@#The ginger-separated moxibustion effectively relieves fatigue and depression condition and improves sleep quality in the patients with chronic fatigue syndrome. The fatigue condition is relevant with sleep quality and depression condition to a certain extent in the patients.

A three-year single center quality of life study among adult patients with tuberculosis arthritis who underwent surgery

Background@#Tuberculosis arthritis is a type of extrapulmonary manifestation of tuberculosis (TB) and can be seen in many clinical forms, especially in developing countries.@*Aims@#This study will look into the quality of life (QoL) of patients who were diagnosed with tuberculous arthropathy of the extremity and underwent surgery at the University of Santo Tomas Hospital (USTH) from January 2014 to December 2016 using the Tagalog SF – 36 questionnaire.@*Methods@#All patients who underwent surgery for TB arthropathy at USTH for three years were included. The Tagalog SF – 36 questionnaire was administered to the patients during follow-up to assess the QoL scores. A detailed evaluation of the questions was performed to depict any pattern on specii c areas that affect the QoL of patients.@*Results@#Patients who underwent surgery scored high for role emotional (mean 93.33) and lowest on the bodily pain scale (mean 69.2). Higher physical component scores (PCS) were noted in patients who underwent surgery in 2014 compared to 2015 and 2016. Higher mental component scores (MCS) scores were also noted in patients operated in 2014 compared to 2015 and 2016. All patients have good QoL scores after surgery and complete medical treatment as demonstrated by the SF-36 scores. Tuberculous arthropathy can affect the physical and mental aspects of patients. No signii cant difference in mean scores by year were seen in all the scales of the SF-36 (p = >0.05).@*Conclusion@#All patients have good QoL scores after surgery and complete medical treatment as demonstrated by the SF-36 scores. QoL scores showed more improvement as the duration post-treatment is longer.

Determinant of Quality of Life in Patients with Chronic Cerebral Infarct

This study investigated how physical and cognitive function and psychological factors affected the health-related quality of life (HRQoL, hereafter HQ) of stroke patients in South Korea. The study enrolled 32 right-handed subjects with chronic cerebral infarction with disability and preserved cognitive function (Mini-Mental State Examination ≥ 20). Physical disability was assessed using the modified Rankin Scale (mRS) and Korean modified Barthel Index (KMBI). Quality of life was measured using the World Health Organization Quality of Life-Abbreviated form (WHOQOL-BREF, hereafter WB) and the 36-Item Short-form Health Survey (SF-36) in face-to-face interviews. Psychological distress was investigated using the Beck Depression Inventory Scale-II. The associations of each domain of WB and SF-36 were investigated using Pearson correlation analyses. Physical disability was negatively correlated with HQ in the SF-36. The physical function and bodily pain scales of the SF-36 were negatively correlated with physical disability. The general health domain of the SF-36 was negatively correlated with psychological scores. Emotional status was associated with physical health, social relationships, and general health in HQ. In summary, the severity of physical disability was associated with the patient's general and physical health and body pain. These findings suggest the importance of psychological, cognitive, and physiological interventions for improving the quality of life of patients after cerebral infarction.

Prospective cohort study comparison of bipolar and monopolar transurethral resection of prostate for benign prostatic hyperplasia: haemoglobin, sodium levels, and urethral catheter traction application

Background: Bipolar Transurethral Resection of Prostate (TURP) and monopolar TURP has been widely used for surgical management of bladder outlet obstruction due to benign prostatic hyperplasia. The aim of this study is to prove the difference of haemoglobin (Hb), sodium levels (Na⁺), application of urethral catheter traction between two groups.Methods: Prospective cohort study was conducted for 82 patients as eligible sample which divided into two groups, bipolar TURP and Monopolar TURP from September 2018 to August 2019. The patient’s demographics, preoperative, postoperative data, and application of urethral catheter traction were recorded.Results: The result shows basic characteristic data seem comparable. The decline levels of Hb before surgery 14.2(2.6) and after surgery 13.6(2.6) in monopolar group was significant (p=0.01), and also in bipolar group 13.7(2.1) vs 13.4(2.1) was significant (p=0.033), despite decreasing Hb levels between two groups were insignificant (p=0.639) but decline levels of Na between two groups were significant (p=0.013) Na⁺ level in bipolar 0(3) and monopolar 1(4). The application of urethral catheter traction in bipolar (19.5%) lower than monopolar (80.5%) were statistically significant (p<0.001).Conclusions: Based on the results of this study, bipolar TURP surgery can be an optional recommendation in treating Benign Prostate Hyperplasia (BPH) in terms of better preserving blood sodium during surgery and low use of traction without significant bleeding complications.

Effect Of Sudarshan Kriya On Functional Capacity, Quality Of Life And Stress Levels In Patients With Type 2 Diabetes: A Prospective Experimental Study

Background: Type 2 diabetes mellitus describes a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia resulting from defects in insulin secretion or insulin action or both. Diabetic management consists of a combination of diet, exercise, and weight loss. Sudarshan Kriya yoga use specific rhythms of the breath to eliminate stress, support the various organs and systems and restore peace of mind but no scientific study has been done to assess the efficacy. Hence the study was done to establish a scientific basis of sudarshan kriya yoga as an adjunct to conventional medical management on functional capacity, Quality of life and stress levels in type 2 diabetic subjects. Materials and Methods: 60 subjects were enrolled and according to their latest glycemic index (HbA1c), stratified into 2 groups (30 in each group) – with fair to good control (<8) and with poor control (>8). Block randomization method using a block of four was used for random allocation of subjects to experimental (sudarshankriya yoga) and control groups (breathing exercises). Baseline assessment of Functional Capacity, Quality of life and stress levels was done using 6 Minute Walk Test, SF-36 and Hamilton depression rating Scale respectively. The pre post measurements of outcome measures were analysed. Results: Following 4 weeks of Sudarshan kriya Yoga and Breathing exercises, there was a statistically significant increase in 6 MWD, SF 36 scores in all domains and reduction in % Heart Rate rise and Hamilton Depression Rating scores and no statistically significant reduction in Basal Heart Rate. However the increase was statistically more significant in the experimental group as compared to the control group. Conclusion: Sudarshan Kriya yoga has an effect on functional capacity, quality of life and stress levels in subjects with Type 2 Diabetes Mellitus. As Sudarshan Kriya Yoga shows improvement not only in the autonomic function but also shows a reduction in stress levels, it should be incorporated as an adjunct in the management of these subjects. KEY WORDS: Diabetes Mellitus, Sudarshan Kriya Yoga, SF 36.

Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study

ABSTRACT BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.