Analysis of the determinants of sleep quality in a Spanish population: a study protocol for a cross-sectional study.

INTRODUCTION: Sleep problems are a growing public health concern being related, among others, to an increased risk of cardiovascular diseases or worse cognitive functioning. In addition, they can affect aspects related to personal motivation and quality of life. However, very few studies have analysed the possible determinants of sleep quality in the adult population as a whole, establishing patterns based on these determinants.The objectives are to evaluate the determinants of sleep quality in a representative sample of the general adult population between 25 and 65 years old, and to establish patterns of sleep quality based on lifestyles, psychological factors, morbidities, sociodemographic variables, biological markers and other possible determinants. METHODS AND ANALYSIS: Descriptive observational cross-sectional study. The study population will include a representative sample of 500 people between 25 and 65 years old from the cities of Salamanca and Ávila (Spain) selected by random sampling stratified by age groups and sex. A 90-minute visit will be performed, during which sleep quality will be assessed. The variables collected will be: morbidity, lifestyles (physical activity, diet, toxic habits), psychological factors (depression, stress, occupational stress and anxiety), socioeconomic and work-related variables, habitability conditions of the habitual residence and rest area, screen time, relaxation techniques and melatonin as a biological marker related to sleep quality. DISCUSSION: With the results of this work, improved interventions for behaviour modification could be designed, as well as intervention and education programmes or other research aimed at improving sleep quality. ETHICS AND DISSEMINATION: This study has a favourable opinion from the Ethics Committee for Drug Research of the Health Areas of Salamanca and Ávila (CEim Code: PI 2021 07 815). The results of this study will be published in international impact journals of different specialties. TRIAL REGISTRATION NUMBER: NCT05324267.

Effects of 12-week inspiratory muscle training with low resistance in patients with multiple sclerosis: A non-randomised, double-blind, controlled trial.

BACKGROUND: Patients with multiple sclerosis (MS) have respiratory limitations like fatigue or muscle weakness. The aim of the study was to evaluate the effectiveness of a low-intensity protocol with inspiratory muscle training (IMT) to improve respiratory strength, spirometric parameters and dyspnea in patients with MS. METHODS: This study was a controlled, non-randomised, double-blind trial on 67 patients with MS distributed in 2 groups, intervention group (IG) (n = 36) and respiratory exercise group (REG) (n = 31). Over 12 weeks, 5 days/week, 15 min/day all subjects followed a respiratory training program. IG trained with IMT with low resistance (20% maximum inspiratory pressure (MIP) during the first two weeks, 30% MIP after the second week). REG followed a program involving nasal breathing and maximum exhalation. Main outcome measured was inspiratory strength (MIP); secondary outcomes were maximum expiratory pressure (MEP), spirometry, dyspnea and health-related quality of life. RESULTS: After respiratory training, the intervention group improved MIP, MEP, MVV, peak expiratory flow (PEF), tidal volume (TV) and dyspnea, 51%, 36%, 21%,11%, 51% and 19% respectively (p < .001, p < .001, p < .001, p < .05, p < .05, p < .05). The control group improved MIP, MEP, MVV and PEF, 24%, 27%, 28% and 12% respectively (p < .001, p < .001, p < .001, p < .05). Improvements achieved on MIP and dyspnea were significantly higher in IG patients (p=.002, p=.046, respectively). CONCLUSION: 12-week inspiratory muscle training with low resistance was more effective than conventional respiratory exercises to improve respiratory strength, spirometric parameters and dyspnea in patients with multiple sclerosis.

Clinical benefits of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease.

PURPOSE: To evaluate the benefits of home-based pulmonary rehabilitation (PR) in patients with severe and very severe chronic obstructive pulmonary disease (COPD). METHODS: Randomized clinical trial involving 58 patients. Pulmonary function, quality of life evaluated by the Saint George Respiratory Questionnaire, breathlessness evaluated by the London Chest Activity of Daily Living Scale, and exercise tolerance evaluated by 6-minute walk distance were assessed at baseline and at 12 weeks. The program consisted of 2 weekly visits by a physiotherapist in the first 2 weeks, followed by visits twice a month, as well as weekly telephone calls. Training included breathing and stretching exercises and strength exercises (upper and lower limbs), along with endurance training, including walking, stair climbing, cycling, and treadmill walking, depending on available patient resources. RESULTS: The treatment group (TG; n = 23) and control group (CG; n = 18) completed the study. Following the intervention, no statistically significant differences were found in pulmonary function in the TG and CG. The TG exhibited statistically significant differences in the activity domain (P = .008), impact domain (P < .001), and total scores of the Saint George Respiratory Questionnaire (P < .001). In addition, the TG demonstrated statistically significant differences in all domains of the London Chest Activity of Daily Living Scale and no differences were observed in the CG after 12 weeks. There was a statistically significant difference in the 6-Minute Walk Distance in the TG after rehabilitation (P = .008). CONCLUSIONS: This study offers evidence that home-based PR promotes benefits in the quality of life, breathlessness in activities of daily living, and exercise capacity in patients with severe and very severe COPD. Home-based PR must be considered as part of the treatment for patients who live far from hospitals even in severe COPD.

Influencia de la fisioterapia sobre el estado de salud y la calidad de vida del paciente reumático / Influence of the physical therapy on the health and quality of life of the rheumatic patient

Objetivos. Evaluar la eficacia de un tratamiento de fisioterapia sobre rigidez, dolor y calidad de vida relacionada con la salud (CVRS) en pacientes reumáticos. Material y método. Estudio experimental, prospectivo, longitudinal y de intervención. Participan 29 sujetos con edad media (SD) de 54,16 (11,9) años, pertenecientes a la Asociación Salmantina de Pacientes con Artritis Reumatoide distribuidos aleatoriamente en 2 grupos: tratamiento (GT) y control (GC). Se valora la rigidez matinal en minutos, el dolor mediante la Escala de Downie y la CVRS a través del Perfil de Salud de Nottingham (NHP) y el Cuestionario de Salud short form-36 (SF-36). Se lleva a cabo un tratamiento individual de fisioterapia que incluye principalmente técnicas manuales en una o 2 sesiones semanales durante 6 meses. Resultados. La rigidez matinal presentó al inicio una media (SD) de 21,38 (29,99) min (GC=20,38, GT=22,19), aumentando en GC (26,82) y disminuyendo en GT (12,5). El dolor presentó al inicio media (SD) de 3,6 (2,03) puntos (GC=2,85, GT=4,22) disminuyendo en GT (3,68) y aumentando en GC (3,45). Se registró una mejora de CVRS en el GT con disminución de las puntuaciones en 4 dimensiones del NHP (dolor, sueño, movilidad física y reacciones emocionales) y aumento en el SF-36 (problemas físicos, función social, dolor, función física). En ningún caso los resultados fueron estadísticamente significativos. Conclusión. El estudio no puede concluir la eficacia de la fisioterapia en el tratamiento de la artritis reumatoide aunque los resultados apuntan a una disminución de la rigidez matinal y del dolor y un aumento de la CVRS, clínicamente interesantes (AU)

Objective. To evaluate the effectiveness of a specific physical therapy treatment on stiffness, pain and quality of life (HRQL) in rheumatic patients. Methods. Experimental, prospective, longitudinal and intervention study. It involved 29 individuals with a mean age (SD) of 54.16 (11,9) years, belonging to the Salmantina Association of Rheumatoid Arthritis Patients, randomized into 2 groups: treatment (GT) and control (GC). The study analyzed the time in minutes of morning stiffness, pain -using the Downie Scale- and CVRS through the Nottingham Health Profile (NHP) and the Health Questionnaire SF-36 (SF-36). It carries out an individual treatment that includes mainly physiotherapy manual techniques in one or two sessions per week for six months. Results. The time of early morning stiffness showed a mean (SD) 21.38 (29.99) minutes (GC=20,38, GT=22.19), increasing in GC (26.82) and decreasing in GT (12,5). Pain presented at the beginning a mean (SD) 3.6 (2.03) points (GC=2,85, GT=4.22) decreasing in GT (3.68) and increasing in GC (3.45). There was an improvement of CVRS in the GT with decreased scores on four dimensions of NHP (pain, sleep, physical mobility and emotional reactions) and increases in SF-36 (physical problems, social function, pain, function physics). In any case the results were statistically significant. Conclusion. The study cannot conclude the effectiveness of physiotherapy in the treatment of rheumatoid arthritis although the results show a decrease of morning stiffness and pain and increased CVRS, which is clinically interesting (AU)

[Influence of the physical therapy on the health and quality of life of the rheumatic patient]. / Influencia de la fisioterapia sobre el estado de salud y la calidad de vida del paciente reumático.

OBJECTIVE: To evaluate the effectiveness of a specific physical therapy treatment on stiffness, pain and quality of life (HRQL) in rheumatic patients. METHODS: Experimental, prospective, longitudinal and intervention study. It involved 29 individuals with a mean age (SD) of 54.16 (11,9) years, belonging to the Salmantina Association of Rheumatoid Arthritis Patients, randomized into 2 groups: treatment (GT) and control (GC). The study analyzed the time in minutes of morning stiffness, pain -using the Downie Scale- and CVRS through the Nottingham Health Profile (NHP) and the Health Questionnaire SF-36 (SF-36). It carries out an individual treatment that includes mainly physiotherapy manual techniques in one or two sessions per week for six months. RESULTS: The time of early morning stiffness showed a mean (SD) 21.38 (29.99) minutes (GC=20,38, GT=22.19), increasing in GC (26.82) and decreasing in GT (12,5). Pain presented at the beginning a mean (SD) 3.6 (2.03) points (GC=2,85, GT=4.22) decreasing in GT (3.68) and increasing in GC (3.45). There was an improvement of CVRS in the GT with decreased scores on four dimensions of NHP (pain, sleep, physical mobility and emotional reactions) and increases in SF-36 (physical problems, social function, pain, function physics). In any case the results were statistically significant. CONCLUSION: The study cannot conclude the effectiveness of physiotherapy in the treatment of rheumatoid arthritis although the results show a decrease of morning stiffness and pain and increased CVRS, which is clinically interesting.