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1.
Cochrane Database Syst Rev ; 8: CD012924, 2021 08 03.
Article in English | MEDLINE | ID: covidwho-1813440

ABSTRACT

BACKGROUND: Children and adolescents diagnosed with cancer are at high risk of experiencing severe side effects from cancer treatment, many of which are amenable to physical therapy. These side effects can negatively impact a child's quality of life and ability to participate in daily activities (e.g. play and attendance at school). Researchers have evaluated physical therapy interventions in children with cancer and childhood cancer survivors. However, factors such as small sample sizes, varying intervention protocols and differences in cancer types among trials make it difficult to draw conclusions about efficacy. OBJECTIVES: The primary aim of this review was to evaluate the efficacy of physical therapy interventions - with a specific focus on symptom relief and compensation of therapy-related side effects - on the quality of life of children and adolescents diagnosed with cancer. Participants must be between the ages of 0 and 19 years at the time of the physical therapy intervention study. The intervention may occur prior to, during or following cancer treatment. The intervention must be compared to a control group of children receiving standard care, no physical therapy intervention or a comparison intervention. We have excluded general physical exercise studies where the primary aim was to improve physical fitness through aerobic, anaerobic, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens). We have also intended to record the occurrence of any adverse effects resulting from physical therapy interventions. The secondary aims were to evaluate the efficacy of physical therapy on impairments of pain, peripheral neuropathy, balance, gait, functional abilities and mobility, motor function and performance, range of motion, strength and fatigue. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, CINAHL, PEDro, ongoing trial registries, conference proceedings and the reference lists of relevant studies and reviews in March 2020. We also contacted oncology rehabilitation researchers working in paediatrics in March 2020 to identify additional studies. SELECTION CRITERIA: The review included randomised controlled trials (RCTs), cross-over trials, and controlled clinical trials (CCTs) that compared the effects of physical therapy interventions to a control group, and involved children and adolescents diagnosed with cancer between the ages of 0 and 19 years at the time of the intervention. We excluded studies examining general physical exercise interventions where the primary aim was to improve physical fitness through aerobic exercise, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens). DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We found no RCTs, cross-over trials or CCTs comparing the effects of physical therapy interventions with a focus on symptom relief and compensation of therapy-related side effects for children and adolescents between the ages of 0 and 19 years. AUTHORS' CONCLUSIONS: Results demonstrate that the evidence to date is inadequate to inform clinical practice. Recommendations for future research include the need for large-scale, high-quality designs that examine: (1) paediatric populations with same cancer types; (2) similar intervention protocols; (3) long-term outcomes; (4) physical therapy interventions (e.g. electrophysical modalities and sensory interventions); and (5) outcomes commonly impaired in children with cancer (e.g. peripheral neuropathy and gait deficits).


Subject(s)
Exercise , Neoplasms , Adolescent , Adult , Child , Child, Preschool , Exercise Therapy , Humans , Infant , Infant, Newborn , Neoplasms/therapy , Physical Fitness , Physical Therapy Modalities , Quality of Life , Young Adult
2.
Int J Environ Res Public Health ; 19(7)2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1776205

ABSTRACT

Exercise intervention researchers often struggle to transition participants from supervised/laboratory-based exercise to independent exercise. Research to inform this critical juncture remains underdeveloped. This qualitative case study investigated the transition from laboratory-based to home-based training in a subset of middle-aged and older African American couples whose exercise intervention experience was interrupted by the COVID-19 pandemic. All four couples (N = 8) whose study participation was interrupted participated in dyadic interviews by videoconference. Two investigators independently reviewed verbatim transcripts, and then used an iterative open coding approach to identify themes from the qualitative data. Three main themes were identified: (1) resistance training program modifications, (2) partner interactions, and (3) external pandemic-related factors. Each theme included both positive and negative feedback related to participants' experiences. Overall, virtual, home-based training appeared acceptable and feasible in this group. Further research is needed to investigate the utility of virtual training to effectively transition participants from laboratory-based to independent exercise.


Subject(s)
COVID-19 , Pandemics , African Americans , Aged , COVID-19/epidemiology , Exercise Therapy , Humans , Middle Aged , Pandemics/prevention & control , Qualitative Research
3.
BMJ Open ; 12(3): e055990, 2022 03 28.
Article in English | MEDLINE | ID: covidwho-1769916

ABSTRACT

INTRODUCTION: More than 50 million people worldwide are living with dementia in 2020, and this number is expected to double every 20 years. Physical exercise is a growing field in non-pharmacological interventions for dementia care. Due to public health measures during the COVID-19 pandemic, more people have considered adapting to technology-based exercise via digital devices. This scoping review will explore evidence relating to the use of technology-based group exercise by people with dementia or mild cognitive impairment. METHODS AND ANALYSIS: This review will follow the Joanna Briggs Institute scoping review methodology to review literature published between June and December 2021. This review is designed to identify existing types of technology-based group exercise interventions for people with dementia. The review will provide a synthesis of current evidence on the outcome and impacts of technology-based group exercise. The context of this review will include homes, assisted living facilities and memory care services but exclude hospitals. The review will include a three-step search strategy: (a) identify keywords from MEDLINE and Embase, (b) search using the identified keywords in databases (MEDLINE/PubMed, CINAHL, Web of Science, Embase, Cochrane Library, PsychInfo and Google) and (c) review references from included studies to identify additional studies. Only studies in English will be included. Four researchers will independently assess titles and abstracts and then review the full text of the selected articles, applying the inclusion criteria. The extracted data will be presented in tables and summarised narratively. ETHICS AND DISSEMINATION: Scoping review data will be collected from publicly available articles; research ethics approval is not required. The findings will be disseminated to healthcare practitioners and the public through a peer-reviewed publication and conference presentations.


Subject(s)
COVID-19 , Cognitive Dysfunction , Dementia , Cognitive Dysfunction/therapy , Dementia/therapy , Exercise Therapy , Humans , Pandemics , Research Design , Review Literature as Topic , Technology
4.
BMC Pregnancy Childbirth ; 22(1): 251, 2022 Mar 25.
Article in English | MEDLINE | ID: covidwho-1756376

ABSTRACT

BACKGROUND: Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic In addition, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity levels and improve mental health outcomes by providing an opportunity for social connectedness. The present study explores the experiences of pregnant women who participated in an online group exercise program during the pandemic and identifies relationships with maternal mental health and well-being. In addition, we present person-informed recommendations on how to improve the delivery of future online prenatal exercise programs. METHODS: Semi-structured interviews were conducted with pregnant women (8-39 weeks of pregnancy) who participated in an online group exercise program, from March to October 2020 in Spain. A phenomenological approach was taken, and open-ended questions were asked to understand women's experiences throughout the pandemic and the role the online exercise classes may have had on their physical activity levels, mental health, and other health behaviours such as diet. A thematic analysis was performed to evaluate data. In addition, women completed the State-Trait Anxiety Inventory and these data supplemented qualitative findings. RESULTS: Twenty-four women were interviewed, and the anxiety scores were on average 32.23 ± 9.31, ranging from low to moderate levels. Thematic analysis revealed that women felt safe exercising from home, an increased availability of time to schedule a structured exercise class, and consequently an improvement in their adherence to the program and other behaviours (i.e., healthier diet). Women emphasized feeling connected to other pregnant women when they exercised online together, and overall, this had a positive effect on their mental well-being. Women suggested that future online exercise programs should include flexible options, detailed instructions and facilitation by a qualified exercise professional. CONCLUSION: Pregnant women are receptive to online group exercise classes and expressed that they are an accessible option to accommodating physical activity during the pandemic. In addition, the online group environment provides an important sense of connectivity among pregnant women exercising together and this may mitigate the detrimental effect of COVID-19 on maternal mental health.


Subject(s)
COVID-19 , Mental Health , Exercise/psychology , Exercise Therapy , Female , Humans , Pandemics , Pregnancy , Pregnant Women/psychology
5.
J Back Musculoskelet Rehabil ; 35(2): 261-269, 2022.
Article in English | MEDLINE | ID: covidwho-1742177

ABSTRACT

BACKGROUND: COVID-19 has become a significant healthcare issue, particularly challenging for patients with ankylosing spondylitis (AS), because immune-related diseases and their treatments could adversely affect the susceptibility to or severity of a viral infection. OBJECTIVE: This study is conducted to present an exercise rehabilitation program that patients older than 60 years with AS can do at home during the COVID-19 pandemic. METHODS: Three Delphi surveys were conducted to reach a consensus on home-based rehabilitation programs. This study recruited ten experts and performed three Delphi rounds for a month. RESULTS: The expert panel suggested that home-based rehabilitation for the patients should be carried out with a clear rehabilitation goal. Their final recommendations are to institute a program aimed to ease symptoms, such as pain and stiffness; encourage patients to consult with experts regularly to ensure that they perform exercise rehabilitation properly at home; add fast walking and stretching to the rehabilitation program; and see if indoor cycling, Pilates, or yoga could be appropriate. CONCLUSIONS: This study suggests that patients with AS over 60 should repeat low-intensity exercises, such as stretching, for an hour a day, four to six times a week during the COVID-19 pandemic.


Subject(s)
COVID-19 , Spondylitis, Ankylosing , Exercise , Exercise Therapy , Humans , Pandemics , Spondylitis, Ankylosing/diagnosis , Treatment Outcome
6.
Lupus ; 31(4): 443-456, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1736231

ABSTRACT

OBJECTIVES: To investigate the perceptions and acceptability of a home-based exercise intervention in systemic lupus erythematosus (JSLE) and juvenile idiopathic arthritis (JIA) adolescent patients during the COVID-19 pandemic, and to explore the effects of the intervention on health-related quality of life (HRQoL), sleep quality, and mental health conditions parameters. METHODS: This was a randomized controlled trial of a 12-week, home-based exercise training program conducted between October and December 2020. During this period, social distancing measures were in place in Brazil to contain the spread of COVID-19. Adolescent patients diagnosed with JSLE and JIA participated in the study. Health-related qualitative and quantitative data were collected before and after the follow-up. RESULTS: 21 JSLE patients and 30 JIA patients were analyzed. Six themes emerged from patients' feedback: 1) Suitability of the home-based format; 2) Appropriate trainer supervision, 3) Motivators and facilitators for the program; 4) Barriers to the program; 5) Health benefits; 6) Patients' suggestions to improve the program. Overall, data indicated that the intervention showed good acceptability and elicited improvements in the perceived HRQoL and fatigue in JIA and JSLE patients during the pandemic. However, further quantitative analyses with validated HRQoL, sleep quality, and mental health conditions instruments did not capture these benefits (p>0.05). CONCLUSION: Our main findings based on in-depth qualitative assessments suggest that a home-based exercise training program was suitable and well-accepted by adolescents with JSLE and JIA during the COVID-19 pandemic. Nonetheless, adherence was not high, particularly among JIA patients, suggesting that facilitators and barriers identified in the current study should be explored to improve the quality of new home-based exercise programs implementation, particularly in a future emerging crisis.


Subject(s)
Arthritis, Juvenile/therapy , COVID-19 , Exercise Therapy/methods , Lupus Erythematosus, Systemic/therapy , Patient Acceptance of Health Care , Adolescent , Brazil , Exercise Therapy/psychology , Female , Humans , Male , Pandemics , Quality of Life
7.
Int J Environ Res Public Health ; 19(5)2022 Mar 07.
Article in English | MEDLINE | ID: covidwho-1732042

ABSTRACT

Computer workers' sedentary work, together with less active lifestyles, aggravated by the COVID-19 pandemic, represents a high risk for many chronic diseases, leading to a decrease in health-related quality of life (QoL). Workplace exercises consist of a set of physical exercises, implemented during work breaks, that have multiple benefits for workers' health. AIM: To assess the impact of online workplace exercises on computer workers' perception of quality of life. METHODS: Quasi-experimental study with two groups: a control group (n = 26) and an intervention group (n = 13). The inclusion criteria were that participants must be aged between 18 and 65 years old and the exclusion criteria included diagnosis of non-work-related medical conditions. The interventions consisted of workplace exercises, which were applied for 17 consecutive weeks, each session lasting 15 min, three times a week. The exercise programme, performed online and guided by a physiotherapist, consisted of mobility exercises, flexibility and strength exercises, with the help of a TheraBand® for elastic resistance. The control group were not subjected to any intervention. A socio-demographic questionnaire and the Health Survey Questionnaire (SF-36v2) were used in two assessment stages (M0-baseline and M1-final of intervention). A mixed ANOVA with interaction time*group was used to evaluate the effect of the exercise programme. RESULTS: A good perception of the QoL was obtained in both stages. The exercise programme had a positive effect in the domains of Pain (ptime*group = 0.012, η2p = 0.158), Physical Function (ptime*group = 0.078, η2p = 0.082), Physical Performance (ptime*group = 0.052, η2p = 0.098), and Emotional Performance (ptime*group = 0.128, η2p = 0.061). CONCLUSION: After 17 weeks of workplace exercises, it became clear that the intervention group positively increased their QoL perception, with this improvement being significant in the Pain domain, which resulted in an improvement in their health condition. Therefore, further studies are needed to determine the optimal exercise for CWs, with detailed exercise types, different intensities and focused on various health conditions.


Subject(s)
COVID-19 , Quality of Life , Adolescent , Adult , Aged , COVID-19/epidemiology , Computers , Exercise , Exercise Therapy/methods , Humans , Middle Aged , Pandemics/prevention & control , Perception , SARS-CoV-2 , Workplace , Young Adult
8.
Sports Med ; 52(3): 655-668, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1729435

ABSTRACT

BACKGROUND: Higher neck strength has been postulated to reduce head impact magnitude during purposeful heading in football. OBJECTIVES: This pilot trial explored the effect of a neck exercise programme on (1) neck strength and (2) head impact magnitude during heading in male and female adolescent football players. METHODS: Boys and girls (aged 12-17 years) were randomised by team to the intervention (5 weeks of supervised neuromuscular neck exercises integrated into part 2 of the FIFA 11 + , completed three times per week) or the control group (usual part 2 of the FIFA 11 + , no neck exercises). Outcomes included isometric neck strength and head impact magnitude (peak linear acceleration and peak angular velocity) during standardised heading from a throw-in (at baseline and 6 weeks) plus completion of an evaluation survey by intervention players and coaches. RESULTS: In total, 52 players (n = 31 intervention; n = 21 control) completed the study. Mixed-model analysis of variance (ANOVA) revealed significant differences in neck strength variables (p < 0.001), peak linear acceleration (p = 0.04) and peak angular velocity (p = 0.04) between the intervention and control groups over time. Intervention players demonstrated increases in mean composite neck strength (53.8% intervention vs 15.6% control) as well as decreases in mean peak linear head acceleration during heading (- 11.8% vs - 5.0%) from baseline to follow-up. Reduction in peak angular velocity was more pronounced in girls (- 27.7%) than boys (- 11.5%) in the intervention group. The addition of neck exercises into part 2 of the FIFA 11 + was feasible and accepted by players and coaches. CONCLUSION: On average, players who completed neck exercises demonstrated an increase in isometric neck strength and a decrease in head impact magnitude during heading. These exercises were easily incorporated into usual training. Australian New Zealand Clinical Trials Registry (no: ACTRN12619001375145).


Subject(s)
Exercise Therapy , Soccer , Adolescent , Australia , Child , Female , Humans , Male , Neck , Pilot Projects
9.
Sensors (Basel) ; 22(4)2022 Feb 19.
Article in English | MEDLINE | ID: covidwho-1715642

ABSTRACT

Concordant assessments of physical activity (PA) and related measures in cardiac rehabilitation (CR) is essential for exercise prescription. This study compared exercise measurement from an in-person walk test; wearable activity tracker; and self-report at CR entry, completion (8-weeks) and follow-up (16-weeks). Forty patients beginning CR completed the Six-Minute Walk Test (6MWT), Physical Activity Scale for the Elderly (PASE), and wore Fitbit-Flex for four consecutive days including two weekend days. The sample mean age was 66 years; 67% were male. Increased exercise capacity at CR completion and follow-up was detected by a 6MWT change in mean distance (39 m and 42 m; p = 0.01, respectively). Increased PA participation at CR completion was detected by Fitbit-Flex mean change in step counts (1794; p = 0.01). Relative changes for Fitbit-Flex step counts and a 6MWT were consistent with previous research, demonstrating Fitbit-Flex's potential as an outcome measure. With four days of data, Fitbit-Flex had acceptable ICC values in measuring step counts and MVPA minutes. Fitbit-Flex steps and 6MWT meters are more responsive to changes in PA patterns following exposure to a cardiac rehabilitation program than Fitbit-Flex or PASE-estimated moderate-vigorous PA (MVPA) minutes. Fitbit-Flex step counts provide a useful additional measure for assessing PA outside of the CR setting and accounts for day-to-day variations. Two weekend days and two weekdays are needed for Fitbit-Flex to estimate PA levels more precisely.


Subject(s)
Cardiac Rehabilitation , Aged , Exercise , Exercise Therapy , Fitness Trackers , Humans , Male , Prospective Studies
10.
J Gerontol Nurs ; 48(3): 30-36, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1705593

ABSTRACT

The current quality improvement project aimed at replicating the implementation of a sit-to-stand exercise program in a small 20-bed assisted living facility (ALF) in rural North Carolina. The primary outcome was for residents to maintain or improve function in performance of activities of daily living (ADLs). Even with the challenges of the coronavirus disease 2019 pandemic, ALF staff and residents found a way to continue the exercise program with a high level of participation and thus prevent avoidable decline in residents' independence with ADLs. [Journal of Gerontological Nursing, 48(3), 30-36.].


Subject(s)
Assisted Living Facilities , COVID-19 , Activities of Daily Living , Exercise Therapy , Humans , SARS-CoV-2
11.
Cyberpsychol Behav Soc Netw ; 25(2): 154-155, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1692291
12.
Prev Chronic Dis ; 19: E04, 2022 01 27.
Article in English | MEDLINE | ID: covidwho-1689851

ABSTRACT

The purpose of our study was to understand the capacity of Silver Sneakers, a federally funded and community-based exercise program, to serve older adults (aged ≥65 years) in our mixed rural/urban catchment area of central Pennsylvania. We identified 139 registered Silver Sneakers program locations; of these, 18 were closed because of the COVID-19 pandemic. We used questionnaires to interview Silver Sneakers program staff by telephone (n = 80 of 121, response rate of 66%). Most programs were offered by private gyms (52%). Fewer programs were in rural counties than in urban counties. Most facilities reported that membership was equally mixed by gender, and member retention strategies included program perks and promotion of Silver Sneakers as a Medicare benefit. Most (89%) programs were able to continue classes during the pandemic, in part by adapting to video platforms. Overall, Silver Sneakers programs offer a sustainable option to facilitate access to exercise programs and reduce barriers to physical activity among older adults in our catchment area.


Subject(s)
COVID-19 , Exercise , Aged , Exercise Therapy , Humans , Medicare , Pandemics , Pennsylvania , SARS-CoV-2 , United States
13.
Int J Environ Res Public Health ; 19(3)2022 02 07.
Article in English | MEDLINE | ID: covidwho-1686760

ABSTRACT

In this study, a design science research methodology was used aiming at designing, implementing and evaluating a digital health service to complement the provision of healthcare for elderly people with balance disorders and risk of falling. An explanatory sequential mixed methods study allowed to identify and explore the dissatisfaction with electronic medical records and the opportunity for using digital health solutions. The suggested recommendations helped to elaborate and develop "BALANCE", a digital service implemented on the METHIS platform, which was recently validated for remote monitoring of chronic patients in primary healthcare. "BALANCE" provides clinical and interactive data, questionnaire pre and post-balance rehabilitation, tutorial videos with balance exercises and patient-recorded videos of the exercises. This digital service was demonstrated, including five elderly patients with clinical recommendations for balance rehabilitation at home. Finally, the authors conducted two focus groups with the participants and their caregivers as well as with physicians. The focus groups aimed at exploring their satisfaction level, needs of adjustment in the "BALANCE" service and strategies for applicability. The digital healthcare service evaluation revealed a significant potential for clinical applicability of this digital solution for elderly people with balance disorders and risk of falling.


Subject(s)
Accidental Falls , Exercise , Accidental Falls/prevention & control , Aged , Delivery of Health Care , Exercise Therapy , Health Services , Humans
14.
NeuroRehabilitation ; 50(1): 57-63, 2022.
Article in English | MEDLINE | ID: covidwho-1674284

ABSTRACT

BACKGROUND: Parkinson's Disease (PD) is a neurodegenerative disorder affecting both motor and cognitive symptoms. While medications show some improvement in motor symptoms, cognitive symptoms can worsen. In-person exercise programs, such as PD SAFEx™, are an important adjunct therapy in improving symptoms. However, coronavirus disease 2019 (COVID-19) limited in-person exercise interventions. Therefore, there is a need to investigate the effectiveness of online exercise delivery. OBJECTIVE: To identify (1) whether an online exercise intervention can achieve similar results to an identical in-person intervention and (2) if online PD SAFEx™ can alter the cognitive decline of PD patients. METHODS: 20 participants with idiopathic PD participated in a 12-week online PD SAFEx™ program and were compared to 73 participants from in-person PD SAFEx™. The primary outcome measure was the Unified Parkinson's Disease Rating Scale-III measured before/after intervention. Three secondary cognitive measures were collected with the online group. RESULTS: Main effect of time on UPDRS-III scores of both groups were found (F(1,92) = 35.555, p < 0.001). No interaction was found between in-person and online groups (F(1,1) = 0.052, p = 0.820). TMT B in the online group showed significant improvements in executive function (F(1,17) = 7.095, p = 0.016). CONCLUSIONS: Online and in-person PD SAFEx™ both achieved clinically significant UPDRS-III improvement and are statistically equivalent. Online PD SAFEx™ reduced cognitive symptoms seen during COVID-19.


Subject(s)
COVID-19 , Parkinson Disease , Exercise Therapy , Feasibility Studies , Humans , Pilot Projects , SARS-CoV-2
16.
BMJ Open ; 12(2): e052631, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1673432

ABSTRACT

INTRODUCTION: Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults. METHODS: A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of life, SARC-F to determine sarcopenia status, and PRIMSA-7 to determine frailty status. Outcomes will be measured at baseline and at 6 months.Qualitative interviews will be conducted with volunteers(n=5), older adults (n=10) and family members (n=5) to explore their views on the intervention. ANALYSIS: Simple descriptive statistics will be used to describe participant characteristics, the feasibility of the study and the impact of the intervention on health outcomes. Parametric(t-test) or non-parametric(Mann-Whitney U test) statistics will be used to analyse continuous variables. χ2 test will be used for categorical variables. Qualitative data will be analysed using an inductive thematic analysis approach. ETHICS AND DISSEMINATION: This study received ethical approval from the University of Southampton Faculty of Medicine Ethics Committee and Research Integrity and Governance committee (ID: 52 967 .A1). Study findings will be made available to service users, voluntary organisations and other researchers who may be interested in implementing the intervention. TRIAL REGISTRATION NUMBER: NCT04672200.


Subject(s)
Frailty , Quality of Life , Aged , Exercise , Exercise Therapy/methods , Feasibility Studies , Humans
17.
Postgrad Med ; 134(2): 143-147, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1655783

ABSTRACT

In real practice, there is a paradox in the management of patients with 'long-term Covid-19.' Indeed, Family physicians (FPs) are on the front line in the management process of these patients. For 'long-term Covid-19' patients, and according to the World Health Organization guideline, the cardiopulmonary rehabilitation (CPR) should be provided not only at tertiary- or secondary care but mainly at primary care with a real implication of FPs. However, specific guidelines/recommendations were addressed for FPs. Therefore, an alternative including the CPR minimal advice that an FP should provide to 'long-term Covid-19' patients, seems to be necessary to respond to the needs of FPs to face their involvement with 'long-term Covid-19' patients. Thus, this paper aimed to report the CPR 'minimal advice' that should be provided by FPs managing 'long-term Covid-19' patients with incapacity (i.e.; alteration of the cardiorespiratory and muscular chain). According to the authors, FPs should be more cautious in the prescription of exercise and nutrition program and informed about the minimal advices related to nutritional and physical exercise rehabilitation guidelines when taking care of 'long-term Covid-19' patients, and how these guidelines can relieve the mental and physical problems, improve immunity, and accelerate the recovery process of the patients. With the occurrence of new variants of the severe acute respiratory syndrome coronavirus 2, the nutritional and exercise rehabilitation guidelines implemented by FPs become indispensable to promote the recovery of Covid-19 patients and support a return to normal life.


Subject(s)
COVID-19 , Exercise , Exercise Therapy , Humans , Physicians, Family , SARS-CoV-2
18.
BMJ Open Respir Res ; 9(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1627443

ABSTRACT

INTRODUCTION: Exercise is important in the postoperative management of lung cancer, yet no strong evidence exists for delivery of home-based programmes. Our feasibility (phase I) study established feasibility of a home-based exercise and self-management programme (the programme) delivered postoperatively. This efficacy (phase II) study aims to determine whether the programme, compared with usual care, is effective in improving physical function (primary outcome) in patients after lung cancer surgery. METHODS AND ANALYSIS: This will be a prospective, multisite, two-arm parallel 1:1, randomised controlled superiority trial with assessors blinded to group allocation. 112 participants scheduled for surgery for lung cancer will be recruited and randomised to usual care (no exercise programme) or, usual care plus the 12-week programme. The primary outcome is physical function measured with the EORTC QLQ c30 questionnaire. Secondary outcomes include health-related quality of life (HRQoL); exercise capacity; muscle strength; physical activity levels and patient reported outcomes. HRQoL and patient-reported outcomes will be measured to 12 months, and survival to 5 years. In a substudy, patient experience interviews will be conducted in a subgroup of intervention participants. ETHICS AND DISSEMINATION: Ethics approval was gained from all sites. Results will be submitted for publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12617001283369.


Subject(s)
Lung Neoplasms , Self-Management , Exercise , Exercise Therapy/methods , Humans , Lung Neoplasms/surgery , Prospective Studies , Quality of Life , Randomized Controlled Trials as Topic
19.
Exp Gerontol ; 159: 111701, 2022 03.
Article in English | MEDLINE | ID: covidwho-1626277

ABSTRACT

OBJECTIVE: The elderly population is increasing worldwide, and the decline in physical function resulting from this is a critical issue that, especially, leads to a disorder of balance. To investigate the effect of home-based specific and comprehensive balance training on balance and functional status in older adults. METHODS: Forty elderly men were randomized to conditions specific (n = 13) and comprehensive (n = 14) balance training or control (n = 13). The exercises were performed individually at each subject's home three times a week for ten weeks. The BESTest total and subsection scores, Activities-specific Balance Confidence (ABC) score, gait speed, timed-up-and-go (TUG), and functional gait assessment were evaluated at baseline, immediately after training and at 4-week follow-up. RESULTS: After the intervention, both intervention groups showed more significant improvements than the control group in all variables except section II of BESTest. At follow-up, significantly more gains than control were observed in all variables except section II of BESTest in the specific group and sections II and III in the comprehensive group. CONCLUSIONS: Our findings provide evidence that these home-based balance training regimens can enhance balance and functional status in aged individuals. Therefore, at present, because of the coronavirus disease 19 stay-at-home restrictions, it seems that these interventions are applicable strategies for the elderly when access to facilities or opportunities for physical activity outside the home is restricted for all ages, especially the elderly.


Subject(s)
COVID-19 , Functional Status , Aged , Exercise Therapy , Humans , Male , Postural Balance , SARS-CoV-2
20.
Am J Phys Med Rehabil ; 100(12): 1148-1151, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1604793

ABSTRACT

ABSTRACT: The purpose of this observational study was to report the experience of a 1-yr home training with functional electrical stimulation cycling of a person with T4 American Impairment Scale A paraplegia for 9 yrs, homebound due to the COVID-19 health crisis. The 40-yr-old participant had a three-phase training: V1, isometric stimulation; V2, functional electrical stimulation cycling for 3 sessions/wk; and V3, functional electrical stimulation cycling for 2-4 sessions/wk. Data on general and physical tolerance, health impact, and performance were collected. Borg Scale score relating to fatigue was 10.1 before training and 11.8 after training. The average score for satisfaction at the end of sessions was 8.7. Lean leg mass increased more than 29%, although total bone mineral density dropped by 1.6%. The ventilatory thresholds increased from 19.5 to 29% and the maximum ventilatory peak increased by 9.5%. Rosenberg's Self-esteem Scale score returned to its highest level by the end of training. For the only track event on a competition bike, the pilot covered a distance of 1607.8 m in 17 mins 49 secs. When functional electrical stimulation cycling training is based on a clear and structured protocol, it offers the person with paraplegia the opportunity to practice this activity recreationally and athletically. In times of crisis, this training has proven to be very relevant.


Subject(s)
Bicycling/physiology , Electric Stimulation Therapy/methods , Exercise Therapy/methods , Paraplegia/rehabilitation , Telerehabilitation/methods , Adult , COVID-19/prevention & control , Feasibility Studies , Humans , Male , Paraplegia/physiopathology , SARS-CoV-2 , Single-Case Studies as Topic , Treatment Outcome
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