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1.
Harm Reduct J ; 21(1): 129, 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961458

RESUMEN

OBJECTIVE: This multicenter, cross-sectional study was conducted to investigate the prevalence of treatment non-adherence and its associated factors among methadone maintenance patients in Vietnam. METHODS: This secondary data analysis was conducted using the data from a previous study. Six hundred patients were interviewed face-to-face to collect data on their demographic characteristics and social support. Information about the treatment characteristics and patients' non-adherence was gathered from medical records and books monitoring their treatment process. Treatment non-adherence was defined as missing at least one methadone dose in the last three months. RESULTS: The overall prevalence of non-adherence was 45.7%. The average social support score of patients who completely adhered to treatment was significantly higher than that of those who did not (p < 0.001). In the multivariate logistic regression model, for each one-unit increase in social support (one score), treatment time (a year), and patient's monthly income (one million Vietnam dongs), the odds of non-adherence decreased by 28% (aOR = 0.72, 95%CI 0.59-0.88, p = 0.002), 15% (aOR = 0.85, 95%CI 0.80-0.91, p < 0.001) and 9% (aOR = 0.91, 95%CI 0.85-0.97, p = 0.004), respectively. Patients living in Son La (a mountainous province) were 1.72 times (95%CI 1.09-2.71) more likely to be non-adherent as compared to those in other areas (p = 0.020). As per univariate analyses, other associated factors could be age, education level, family monthly income, occupation, and opioid relapse (p < 0.001). CONCLUSIONS: A high non-adherence rate was found among Vietnamese methadone maintenance patients. Interventions involving social support, occupation, income, and education are needed to improve their treatment adherence.


Asunto(s)
Cumplimiento de la Medicación , Metadona , Tratamiento de Sustitución de Opiáceos , Trastornos Relacionados con Opioides , Apoyo Social , Humanos , Metadona/uso terapéutico , Vietnam , Masculino , Estudios Transversales , Femenino , Adulto , Tratamiento de Sustitución de Opiáceos/estadística & datos numéricos , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Trastornos Relacionados con Opioides/tratamiento farmacológico , Trastornos Relacionados con Opioides/rehabilitación , Adulto Joven , Factores Socioeconómicos
2.
Salud Colect ; 20: e4826, 2024 Jun 07.
Artículo en Español | MEDLINE | ID: mdl-38967971

RESUMEN

The experience of homelessness is associated with strong stigmatization processes, which are often reflected in the treatment received from professionals and the healthcare system itself. This article aims to analyze the experiences of participants in a program for homeless individuals in Barcelona called Primer la Llar within the healthcare system, and how the stigma they suffer affects the care processes. This program follows the Housing First model, a social intervention that proposes providing housing without preconditions to individuals with long histories of street living, who suffer from severe mental disorders and/or addictions. Based on individual interviews with 20 participants conducted between 2016 and 2020, it is observed that in certain cases, entering the program, having housing availability, support from professionals, and the development of their own strategies had positive effects on improving their health, although they continue to perceive discriminatory attitudes in some medical settings. It is suggested that the transformation regarding stigmatization be understood broadly, affecting individuals, institutions, and society as a whole.


El tránsito por el sinhogarismo está asociado a procesos de fuerte estigmatización que, en muchas ocasiones, tienen su reflejo en el trato que reciben por parte de las y los profesionales y del propio sistema de atención en salud. Este artículo tiene como objetivo analizar las experiencias que tuvieron en el sistema sanitario las y los participantes de un programa para personas sin hogar en Barcelona llamado Primer la Llar, y cómo el estigma que sufren estas personas llega a condicionar los procesos de atención. Dicho programa sigue el modelo Housing First, una intervención social que propone la entrada a una vivienda sin condiciones previas a personas con largas trayectorias de vida en la calle, que sufren trastornos mentales graves y/o adicciones. A partir de entrevistas individuales con 20 participantes, realizadas entre 2016 y 2020, se observa que, en determinados casos, el ingreso en el programa, la disponibilidad de una vivienda, el soporte de profesionales y el desarrollo de estrategias propias tuvieron efectos positivos en la mejora de su salud, aunque continúan percibiendo actitudes discriminatorias en algunos espacios médicos. Se plantea la necesidad de que la transformación respecto a la estigmatización sea entendida en un sentido amplio, en las personas, en las instituciones y en la sociedad.


Asunto(s)
Vivienda , Personas con Mala Vivienda , Estigma Social , Humanos , Personas con Mala Vivienda/psicología , España , Masculino , Femenino , Adulto , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Trastornos Mentales/rehabilitación , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/rehabilitación , Trastornos Relacionados con Sustancias/terapia , Trastornos Relacionados con Sustancias/psicología , Atención a la Salud , Investigación Cualitativa
3.
JBJS Rev ; 12(7)2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38968369

RESUMEN

¼ The purpose of this article was to review the multidisciplinary, team-based approach necessary for the optimal management of patients with limb loss undergoing osseointegration surgery.¼ In this study, we describe the interdisciplinary process of screening, counseling, and surgical and rehabilitation considerations with an emphasis on principles rather than specific implants or techniques.¼ Integrated perioperative management and long-term surveillance are crucial to ensure the best possible outcomes.¼ We hope this model will service as an implant-agnostic guide to others seeking to development an osseointegration center of excellence.


Asunto(s)
Amputación Quirúrgica , Oseointegración , Humanos , Amputación Quirúrgica/rehabilitación , Grupo de Atención al Paciente , Miembros Artificiales
4.
J Coll Physicians Surg Pak ; 34(7): 848-850, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38978254

RESUMEN

This viewpoint emphasises the vital role that paediatric physiotherapy plays in satisfying children's rehabilitation requirements, especially those of children with chronic illnesses and impairments. It highlights issues including inadequate education and a lack of personnel, underscoring the need for individualised care in a variety of paediatric settings. The letter promotes more knowledge, financing, and research to improve the quality and accessibility of paediatric physical therapy services offered worldwide. It urges medical practitioners and legislators to address these significantly unmet needs in order to improve developmental outcomes and assure children's optimal physical well-being through the prioritisation of early intervention and tailored therapy. Key Words: Paediatric physiotherapy, Rehabilitation, Physical therapy.


Asunto(s)
Modalidades de Fisioterapia , Humanos , Niño , Necesidades y Demandas de Servicios de Salud , Niños con Discapacidad/rehabilitación , Pediatría , Accesibilidad a los Servicios de Salud
5.
J Appl Res Intellect Disabil ; 37(5): e13272, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38966968

RESUMEN

BACKGROUND: Tailored sexuality education for adolescents with intellectual and developmental disabilities is a crucial, yet unmet, need as this population is particularly at risk for sexual abuse and victimisation. However, there are no evidence-based interventions to specifically address this need. This paper presents the development of an intervention framework to address equity in sexuality education and support adolescents with intellectual and developmental disabilities to understand and provide sexual consent, a foundational aspect of sexuality education and sexual health. METHODS: The Sexual Health Equity Project team used a Community-Based Participatory Research approach to develop a four-module sexual consent intervention for adolescents with intellectual and developmental disabilities. We leveraged a diverse, interdisciplinary team in a suburban Midwestern school district, and used Backward Design to create objectives and assessments which were rooted in findings from qualitative data by special education teachers. RESULTS: The resulting sexual consent intervention, Ask Me First-Choices, is comprised of four modules covering topics including definition of sexual consent; decision-making strategies and practice; communicating consent and refusal, identifying situations of consent and non-consent; and legal issues surrounding consent. Each module is divided into five components for content delivery: (1) introduction, (2) lecture, (3) supplemental activity, (4) assessment, and (5) conclusion. We detail the intervention's unique aspects, emphasising areas where we used Universal Design for Learning principles to support teachers' instruction and students' learning. CONCLUSION: Our efforts to create a sexual consent intervention directly address sexuality education equity issues. We offer commentary on our design process and decisions, as well as recommendations for future groups who want to develop sexual health interventions in similar contexts for students with intellectual and developmental disabilities. Next steps include further testing and validation of the sexual consent intervention to build the evidence-base of sexuality education for adolescents with intellectual and developmental disabilities.


Asunto(s)
Investigación Participativa Basada en la Comunidad , Discapacidades del Desarrollo , Discapacidad Intelectual , Educación Sexual , Humanos , Adolescente , Discapacidad Intelectual/rehabilitación , Discapacidades del Desarrollo/rehabilitación , Femenino , Masculino , Conducta Sexual
6.
Child Care Health Dev ; 50(4): e13299, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38967420

RESUMEN

BACKGROUND: Autism is a complex neurodevelopmental disability with global prevalence of one in 100 individuals. Poor access to interventions in both under-resourced regions of high-income countries and low- and middle-income countries has deleterious effects on the health and wellbeing of individuals with autism and their families. Our objective was to utilize a reciprocal innovation framework and participatory methods to adapt and co-develop a culturally grounded group-based wellbeing and naturalistic developmental behavioural intervention (NDBI) training program for caregivers of young children with autism to be implemented in Kenya and rural Indiana. METHODS: This study was conducted within the Academic Model Providing Access to Healthcare (AMPATH) program. An evidence-informed Naturalistic Developmental Behavioral Intervention (NDBI) previously utilized in Indiana was adapted and iteratively refined using the Ecological Validity Framework (EVF) by a team of US and Kenyan disability experts. Key adaptations to the program were made across the EVF domains of language, persons, metaphors/content, concepts, goals, methods, and context. RESULTS: Substantial cultural adaptations were made to the NDBI following the EVF model, including the addition of traditional Kenyan cultural practices, use of narrative principles, and focus on daily routines over play. Pepea, the adapted program, involves 10 group sessions covering content in basic education on autism, positive caregiver coping strategies, and behavioural skills training to promote child communication and reduce challenging behaviour. Key adaptations for Pepea were integrated back into a US NDBI caregiver training program. CONCLUSIONS: This study fills a critical gap by detailing the adaptation process of a caregiver wellbeing and naturalistic developmental behavioural training program for caregivers of children with autism in low-resource settings. Our next steps are to report on mixed-methods outcomes from pilot implementation. Our long-term goal is to apply these insights to advance sustainable and scalable autism intervention services across the globe.


Asunto(s)
Cuidadores , Humanos , Kenia , Cuidadores/educación , Cuidadores/psicología , Preescolar , Estados Unidos , Masculino , Femenino , Trastorno Autístico/rehabilitación , Trastorno Autístico/terapia , Trastorno Autístico/psicología , Terapia Conductista/métodos , Países en Desarrollo , Indiana , Asistencia Sanitaria Culturalmente Competente , Desarrollo de Programa , Niño
7.
Clin Exp Rheumatol ; 42(6): 1248-1261, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38966940

RESUMEN

OBJECTIVES: To summarise the available evidence and assess the effectiveness of medium and long-term physiotherapy treatment in adults with fibromyalgia (FM). METHODS: This systematic review was registered in PROSPERO: CRD42023388356. The databases searched were MEDLINE, PEDro, Scopus, Cinhal, LatinIndex, and Cochrane, using the following keywords: "fibromyalgia", "physiotherapy", "treatment", "therapeutic exercise", "TENS", "laser therapy" and "manual therapy." The included articles analysed treatments with active or passive physiotherapy approaches in patients with FM. The variables included structural characteristics, such as: author, publication year, research question, and main outcome variables. The data on the findings of the articles comprised the following aspects: number of participants, intervention, follow-up, results, and principal conclusions. RESULTS: Thirty-three articles were analysed, with an overall PRISMA score of 18.63±3.36. The active treatment methods analysed were: movement and body awareness therapies (stretching, tai chi, yoga and Pilates); hydrotherapy; physical or aerobic exercise; and multidisciplinary therapy. The passive therapies analysed were: manual therapy; repetitive transcranial magnetic stimulation (rTMS); and other therapies (hyperbaric oxygen therapy, vibration therapy, virtual reality, transcutaneous electric nervous stimulation (TENS), pain neuroscience education, and acupuncture). Evidence was found on the positive effect of physiotherapy treatment on the signs and symptoms of fibromyalgia, such as pain, impairment of physical capacity and worse quality of life. CONCLUSIONS: The effectiveness of the active and passive therapies analysed in the management of the symptoms and signs of the disease was positive in most of the studies. However, more specific descriptions of the treatment protocol, frequency, intensity and treatment dose are required to reach a consensus, as well as primary studies for a more extended follow-up period to better evaluate long-term effects.


Asunto(s)
Fibromialgia , Modalidades de Fisioterapia , Humanos , Fibromialgia/terapia , Fibromialgia/fisiopatología , Fibromialgia/rehabilitación , Fibromialgia/diagnóstico , Resultado del Tratamiento , Factores de Tiempo , Adulto , Revisiones Sistemáticas como Asunto
8.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 49(3): 482-490, 2024 Mar 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-38970523

RESUMEN

Pelvic floor dysfunction (PFD) is a common clinical problem that can lead to bladder and bowel dysfunction such as urinary incontinence, urinary retention, fecal incontinence, pelvic organ prolapse, and sexual dysfunction. Pelvic floor rehabilitation aids are essential tools in the treatment of PFD. However, there is limited understanding of the efficacy and mechanisms of these aids, and there is a lack of standardized guidelines for selecting appropriate aids for different types of PFD. To assist patients in choosing suitable pelvic floor rehabilitation aids to their needs, it is necessary to summarize the existing types, mechanisms, and applications of these aids. Based on their mechanisms and target functions, pelvic floor rehabilitation aids can be mainly categorized into 3 main types. The first type includes aids that improve pelvic floor function, such as vaginal dumbbells, vaginal tampons, and vaginal dilators, which aim to strengthen pelvic floor muscles and enhance the contractility of the urethral, vaginal, and anal sphincters, thereby improving incontinence symptoms. The second type consists of aids that mechanically block the outlet, such as pessaries, urethral plugs, incontinence pads, incontinence pants, anal plugs, and vaginal bowel control systems, which directly or indirectly prevent incontinence leakage. The third type includes aids that assist in outlet drainage, such as catheters and anal excreta collection devices, which help patients effectively expel urine, feces, and other waste materials, preventing incontinence leakage. By summarizing the existing pelvic floor rehabilitation aids, personalized guidance can be provided to patients with PFD, helping them select the appropriate aids for their rehabilitation needs.


Asunto(s)
Trastornos del Suelo Pélvico , Diafragma Pélvico , Incontinencia Urinaria , Humanos , Femenino , Trastornos del Suelo Pélvico/rehabilitación , Incontinencia Urinaria/rehabilitación , Diafragma Pélvico/fisiopatología , Incontinencia Fecal/rehabilitación , Incontinencia Fecal/etiología , Pesarios
9.
Artículo en Chino | MEDLINE | ID: mdl-38973049

RESUMEN

Large vestibular aqueduct syndrome(LVAS) is a common recessive hereditary hearing loss disease, and some patients may also experience vestibular dysfunction. With the wide application of cochlear implant(CI) and the development of vestibular medicine, the pathophysiological mechanism of LVAS and the influence mechanism of CI on vestibular function are gradually elucidated. Consequently, the evaluation and rehabilitation of vestibular dysfunction function have also become research hotspots. This article reviews studies on vestibular function and related rehabilitation in patients with large vestibular aqueduct syndrome.


Asunto(s)
Acueducto Vestibular , Humanos , Acueducto Vestibular/anomalías , Implantes Cocleares , Enfermedades Vestibulares/rehabilitación , Enfermedades Vestibulares/fisiopatología , Implantación Coclear , Pérdida Auditiva Sensorineural/rehabilitación , Pérdida Auditiva Sensorineural/fisiopatología , Vestíbulo del Laberinto/fisiopatología
10.
J Foot Ankle Res ; 17(3): e12036, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38951733

RESUMEN

BACKGROUND: Motor coordination concerns are estimated to affect 5%-6% of school-aged children. Motor coordination concerns have variable impact on children's lives, with gait and balance often affected. Textured insoles have demonstrated positive impact on balance and gait in adults with motor coordination disorders related to disease or the ageing process. The efficacy of textured insoles in children is unknown. Our primary aim was to identify the feasibility of conducting a randomised controlled trial involving children with motor control issues. The secondary aim was to identify the limited efficacy of textured insoles on gross motor assessment balance domains and endurance in children with movement difficulties. METHODS: An assessor-blinded, randomised feasibility study. We advertised for children between the ages of 5-12 years, with an existing diagnosis or developmental coordination disorder or gross motor skill levels assessed as 15th percentile or below on a norm-referenced, reliable and validated scale across two cities within Australia. We randomly allocated children to shoes only or shoes and textured insoles. We collected data across six feasibility domains; demand (recruitment), acceptability (via interview) implementation (adherence), practicality (via interview and adverse events), adaptation (via interview) and limited efficacy testing (6-min walk test and balance domain of Movement ABC-2 at baseline and 4 weeks). RESULTS: There were 15 children randomised into two groups (eight received shoes alone, seven received shoes and textured insoles). We experienced moderate demand, with 46 potential participants. The insoles were acceptable, however, some parents reported footwear fixture issues requiring modification. The 6-min walk test was described as problematic for children, despite all but one child completing. Social factors impacted adherence and footwear wear time in both groups. Families reported appointment locations and parking impacting practicality. Underpowered, non-significant small to moderate effect sizes were observed for different outcome measures. Improvement in balance measures favoured the shoe and insole group, while gait velocity increase favoured the shoe only group. CONCLUSION: Our research indicates that this trial design is feasible with modifications such as recruiting with a larger multi-disciplinary organisation, providing velcro shoe fixtures and using a shorter timed walk test. Furthermore, progressing to a larger well-powered randomised control trial is justified considering our preliminary, albeit underpowered, efficacy findings. TRIAL REGISTRATION: This trial was retrospectively registered with the Australian and New Zealand Clinical Trial Registration: ACTRN12624000160538.


Asunto(s)
Estudios de Factibilidad , Ortesis del Pié , Trastornos de la Destreza Motora , Equilibrio Postural , Zapatos , Humanos , Equilibrio Postural/fisiología , Niño , Masculino , Femenino , Trastornos de la Destreza Motora/rehabilitación , Preescolar , Destreza Motora/fisiología , Australia , Resistencia Física/fisiología , Marcha/fisiología , Diseño de Equipo
11.
PeerJ ; 12: e17670, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38978757

RESUMEN

Background: This study aimed to compare the perceived masticatory ability (PrMA) in completely edentulous patients (EDPs) with thermoplastic conventional complete dentures (CDs) versus single implant-retained mandibular overdentures. Methods: The current study was conducted in the outpatient Prosthodontic Clinic, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. PrMA was evaluated in 45 completely edentulous patients (46% males, mean age 50.4 ± 4.7 years). Each patient received a thermoplastic PMMA complete denture (Polyan IC TM Bredent GmbH & Co.KG, Germany). The PrMA was evaluated at one-month and six-month intervals of denture use. An immediate loading single implant was placed into the mid-symphyseal for each patient, and the denture was adjusted. Subsequently, the PrMA was reevaluated after one month and six months. The data were collected and statistically analyzed using the SPSS@V25 to assess the changes in PrMA. Results: The PrMA demonstrated improvement after six months of thermoplastic conventional denture use. However, this improvement was not statistically significant (p = 0.405). In addition, the PrMA showed a substantial increase following a single implant placement at one and six months (p < 0.001) of the overdenture use compared to the conventional denture. The PrMA insignificantly improved (p = 0.397) after six months of the single implant retained overdenture use. Discussion: The study's findings indicate that using immediate loading single implant-retained mandibular overdentures significantly improved PrMA in completely edentulous patients.


Asunto(s)
Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Masticación , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Masticación/fisiología , Boca Edéntula/rehabilitación , Dentadura Completa , Mandíbula/cirugía , Egipto , Implantes Dentales de Diente Único
12.
BMJ Open ; 14(7): e074325, 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38964791

RESUMEN

OBJECTIVE: To assess the effects of telerehabilitation on clinical symptoms, physical function, psychological function and quality of life (QoL) in patients with post-COVID-19. DESIGN: Systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES: PubMed, Web of Science, Embase and Cochrane Library were searched for publications from 1 January 2020 to 17 April 2024. ELIGIBILITY CRITERIA: RCTs investigating the effects of telerehabilitation in patients with post-COVID-19 were included. The outcomes of interest encompassed clinical symptoms, physical function, psychological function and QoL. Only studies reported in English were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data and evaluated the risk of bias. Statistical analysis was conducted using Review Manager V.5.3, employing mean difference (MD) with a 95% CI, and the corresponding P value was used to ascertain the treatment effect between groups. Heterogeneity was quantified using the I2 statistic. The quality of evidence was assessed by GRADE. RESULTS: 16 RCTs (n=1129) were included in this systematic review, 15 of which (n=1095, 16 comparisons) were included in the meta-analysis. The primary pooled analysis demonstrated that, compared with no rehabilitation or usual care, telerehabilitation can improve physical function (measured by 30 s sit-to-stand test [6 RCTs, n=310, MD=1.58 stands, 95% CI 0.50 to 2.66; p=0.004]; 6 min walking distance [6 RCTs, n=324, MD=76.90 m, 95% CI 49.47 to 104.33; p<0.00001]; and physical function from the 36-item short-form health survey [5 RCTs, n=380, MD=6.12 units, 95% CI 2.85 to 9.38; p=0.0002]). However, the pooled results did not indicate significant improvements in clinical symptoms, pulmonary function, psychological function or QoL. The quality of the evidence was graded as low for physical function and Hospital Anxiety and Depression Scale-anxiety and very low for other assessed outcomes. The overall treatment completion rate was 78.26%, with no reports of severe adverse events in any included trials. CONCLUSIONS: Despite the lack of significant improvements in certain variables, telerehabilitation could be an effective and safe option for enhancing physical function in patients with post-COVID-19. It is advisable to conduct further well-designed trials to continue in-depth exploration of this topic. STUDY REGISTRATION: PROSPERO, CRD42023404647.


Asunto(s)
COVID-19 , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Telerrehabilitación , Humanos , COVID-19/rehabilitación , SARS-CoV-2 , Resultado del Tratamiento
13.
BMJ Open ; 14(7): e080646, 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38969380

RESUMEN

OBJECTIVES: To identify within-stakeholder agreement and between-stakeholder differences in beliefs regarding exercise for osteoarthritis among general practitioners (GPs), physiotherapists (PTs) and people with hip and knee osteoarthritis (PwOA). A secondary objective was to explore the association between referral patterns and beliefs of PwOA. DESIGN: Cross-sectional. SETTING: Online surveys administered to GPs, PTs and PwOA in Ireland via social media and healthcare networks. PARTICIPANTS: 421 valid responses (n=161 GPs, n=163 PTs, n=97 PwOA). PRIMARY AND SECONDARY OUTCOME MEASURES: Nine belief statements related to exercise effectiveness, safety and delivery were rated on a 5-point Likert scale and analysed for within-stakeholder consensus. χ2 tests assessed differences in agreement between groups. Multivariable linear regression models tested associations between beliefs in PwOA and referral to/attendance at physiotherapy. RESULTS: Positive within-stakeholder consensus (>75% agreement) was reached for most statements (7/9 GPs, 6/9 PTs, 5/9 PwOA). However, beliefs of PwOA were significantly less positive compared with healthcare professionals for six statements. All stakeholders disagreed that exercise is effective regardless of the level of pain. Attendance at physiotherapy (49% of PwOA), rather than referral to physiotherapy from a GP only, was associated with positive exercise beliefs for PwOA (ß=0.287 (95% CI 0.299 to 1.821)). CONCLUSIONS: Beliefs about exercise therapy for osteoarthritis are predominantly positive across all stakeholders, although less positive in PwOA. PwOA are more likely to have positive beliefs if they have seen a PT for their osteoarthritis. Knowledge translation should highlight the effectiveness of exercise for all levels of pain and osteoarthritis disease.


Asunto(s)
Terapia por Ejercicio , Osteoartritis de la Cadera , Osteoartritis de la Rodilla , Fisioterapeutas , Humanos , Estudios Transversales , Osteoartritis de la Rodilla/terapia , Osteoartritis de la Rodilla/rehabilitación , Irlanda , Osteoartritis de la Cadera/rehabilitación , Osteoartritis de la Cadera/terapia , Terapia por Ejercicio/métodos , Masculino , Femenino , Persona de Mediana Edad , Actitud del Personal de Salud , Encuestas y Cuestionarios , Médicos Generales , Adulto , Anciano , Guías de Práctica Clínica como Asunto , Derivación y Consulta , Conocimientos, Actitudes y Práctica en Salud
14.
Age Ageing ; 53(7)2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38970548

RESUMEN

BACKGROUND: Although surgery is the gold standard following a hip fracture, the potential for rehabilitation and survival rates are low in frail older patients. Some patients may derive more benefit from palliative care. The objectives of this review were to identify the available strategies to improve end-of-life decision-making and palliative care for frail patients with hip fractures and to synthetise their level of support. METHODS: We conducted a scoping review of the scientific and grey literature, searching seven databases and websites of associations. We included all study designs, expert opinion articles and clinical practice guidelines (CPGs). Data were synthetised according to the Approach to Patient with Limited Life Expectancy and Hip Fracture framework. The number of research items and their level of evidence were tabulated for each of the recommended strategies. RESULTS: Of the 10 591 items identified, 34 were eligible. The majority of included articles were original research studies (n = 15). Half of the articles and CPGs focused on intervention categories (55%) such as goals of care discussion and comfort care, followed by factors to consider in the end-of-life decision-making process (25%) and prognosis assessments (20%), mainly through the estimation of life expectancy. The level of evidence for these strategies remains low, given the limited number of prospective studies supporting them. CONCLUSIONS: This scoping review highlighted that end-of-life care in frail older patients with a hip fracture remains understudied. The strategies identified could be prioritised for future research to improve the well-being of the target population while promoting sustainable resource management.


Asunto(s)
Anciano Frágil , Fracturas de Cadera , Cuidados Paliativos , Cuidado Terminal , Humanos , Fracturas de Cadera/rehabilitación , Fracturas de Cadera/terapia , Anciano , Toma de Decisiones , Anciano de 80 o más Años , Fragilidad/diagnóstico
16.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 46(3): 393-401, 2024 Jun.
Artículo en Chino | MEDLINE | ID: mdl-38953263

RESUMEN

Cardiovascular diseases,such as coronary heart disease (CHD),are the main causes of death in humans.Cardiac rehabilitation with exercise therapy as the core contents is a rehabilitation program specially designed for the patients with cardiovascular diseases,aiming to help the patients improve their physical functions and return to social activities as soon as possible.Active cardiac rehabilitation can not only reduce the morbidity and mortality of CHD and improve the cardiopulmonary function of patients but also reduce the medical and economic burden.This article summarizes the effect of physical function on CHD patients,the current application mode of exercise therapy in cardiac rehabilitation,and the formulation principles of different exercise prescriptions in cardiac rehabilitation,aiming to provide a reference for the application of exercise therapy in CHD patients.


Asunto(s)
Enfermedad Coronaria , Terapia por Ejercicio , Humanos , Terapia por Ejercicio/métodos , Enfermedad Coronaria/rehabilitación , Enfermedad Coronaria/prevención & control , Enfermedad Coronaria/terapia , Rehabilitación Cardiaca/métodos
18.
Child Care Health Dev ; 50(4): e13293, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38953549

RESUMEN

BACKGROUND: A large proportion of adolescents with developmental coordination disorder (DCD) are physically inactive. Physical literacy has been described as an important determinant in promoting health behaviours. The potential of exergames to improve physical literacy and activity has been recognized in typically developing children. The aim of the present scoping review was to identify and map the available evidence of this potential for adolescents with DCD. METHODS: A scoping review was performed via a literature search in PubMed, Web of Science, Embase, ERIC and CINHAIL. RESULTS: From 2860 search records, six studies (two studies in DCD and four studies in cerebral palsy [CP]) assessed physical activity, 12 studies discussed exergame features and 16 studies assessed physical literacy domains. In DCD, one study showed positive effects of exergaming on physical activity and the other failed to show any significant effects of exergaming. In CP, all four studies demonstrated positive effects of exergaming on energy expenditure and daily physical activity. Furthermore, positive effects of exergames on the different physical literacy domains were shown, namely motor competence, self-concept and affect, motivation and social/experiential. Finally, exergame features including multiplayer modes, realism, game rewards, challenges and enjoyment were shown to have a significant effect on motivating and encouraging adolescents to exert more effort while playing. CONCLUSION: Based on the positive effects of exergaming on physical activity in other populations, more in-depth research in adolescents with DCD is warranted such that the decline in physical activity behaviour that is present in individuals with DCD can be counteracted. Physical literacy should be regarded as an important determinant in this regard.


Asunto(s)
Parálisis Cerebral , Ejercicio Físico , Trastornos de la Destreza Motora , Juegos de Video , Humanos , Adolescente , Parálisis Cerebral/rehabilitación , Parálisis Cerebral/psicología , Trastornos de la Destreza Motora/rehabilitación , Trastornos de la Destreza Motora/psicología , Ejercicio Físico/psicología , Terapia por Ejercicio/métodos , Alfabetización en Salud , Conductas Relacionadas con la Salud , Motivación
19.
Eur J Sport Sci ; 24(7): 1021-1031, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38956790

RESUMEN

The aims of this study were to assess (i) the load-velocity relationship during the box squat exercise in women survivors of breast cancer, (ii) which velocity variable (mean velocity [MV], mean propulsive velocity [MPV], or peak velocity [PV]) shows stronger relationship with the relative load (%1RM), and (iii) which regression model (linear [LA] or polynomic [PA]) provides a greater fit for predicting the velocities associated with each %1RM. Nineteen women survivors of breast cancer (age: 53.2 ± 6.9 years, weight: 70.9 ± 13.1 kg, and height: 163.5 ± 7.4 cm) completed an incremental load test up to one-repetition maximum in the box squat exercise. The MV, MPV, and the PV were measured during the concentric phase of each repetition with a linear velocity transducer. These measurements were analyzed by regression models using LA and PA. Strong correlations of MV with %1RM (R2 = 0.903/0.904; the standard error of the estimate (SEE) = 0.05 m.s-1 by LA/PA) and MPV (R2 = 0.900; SEE = 0.06 m.s-1 by LA and PA) were observed. In contrast, PV showed a weaker association with %1RM (R2 = 0.704; SEE = 0.15 m.s-1 by LA and PA). The MV and MPV of 1RM was 0.22 ± 0.04 m·s-1, whereas the PV at 1RM was 0.63 ± 0.18 m.s-1. These findings suggest that the use of MV to prescribe relative loads during resistance training, as well as LA and PA regression models, accurately predicted velocities for each %1RM. Assessing and prescribing resistance exercises during breast cancer rehabilitation can be facilitated through the monitoring of movement velocity.


Asunto(s)
Neoplasias de la Mama , Entrenamiento de Fuerza , Humanos , Femenino , Neoplasias de la Mama/rehabilitación , Persona de Mediana Edad , Fuerza Muscular/fisiología , Adulto , Supervivientes de Cáncer , Terapia por Ejercicio/métodos
20.
Eur J Sport Sci ; 24(7): 938-949, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38956794

RESUMEN

Knee osteoarthritis is associated with deficits in muscle strength, muscle mass, and physical functioning. These muscle-related deficits are acutely exacerbated following total knee arthroplasty (TKA) and persist long after surgery, despite the application of standardized rehabilitation programs that include physical/functional training. Resistance exercise training (RET) has been shown to be a highly effective strategy to improve muscle-related outcomes in healthy as well as clinical populations. However, the use of RET in traditional rehabilitation programs after TKA is limited. In this narrative review, we provide an updated view on whether adding RET to the standard rehabilitation (SR) in the recovery period (up to 1 year) after TKA leads to greater improvements in muscle-related outcomes when compared to SR alone. Overall, research findings clearly indicate that both muscle strength and muscle mass can be improved to a greater extent with RET-based rehabilitation compared to SR. Additionally, measures of physical functioning that rely on quadriceps strength and balance (e.g., stair climbing, chair standing, etc.) also appear to benefit more from a RET-based program compared to SR, especially in patients with low levels of physical functioning. Importantly though, for RET to be optimally effective, it should be performed at 70%-80% of the one-repetition maximum, with 3-4 sets per exercise, with a minimum of 3 times per week for 8 weeks. Based upon this narrative review, we recommend that such high-intensity progressive RET should be incorporated into standard programs during rehabilitation after TKA.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Fuerza Muscular , Osteoartritis de la Rodilla , Entrenamiento de Fuerza , Humanos , Artroplastia de Reemplazo de Rodilla/rehabilitación , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/rehabilitación , Músculo Cuádriceps/fisiología , Equilibrio Postural
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