Home-based deep breathing for depression in patients with coronary heart disease: a randomised controlled trial.

OBJECTIVES: The primary aim of this study was to examine the effect of a home-based deep-breathing training programme on depressive symptoms as compared with a control condition (i.e., weekly telephone support) in patients with coronary heart disease (CHD). DESIGN: This efficacy trial used a randomised controlled, parallel group design. PARTICIPANTS AND METHODS: A total of 62 CHD patients with a Beck Depression Inventory-II (BDI-II) >10 were randomised to receive either home-based deep-breathing training (experimental group, n=28) or weekly telephone support (control group, n=34). Both participants and data assessors were blinded to the study hypothesis. The primary outcome measure was the change in the self-reported depressive symptom severity, measured by the BDI-II. The secondary outcome was the change in the Patient Health Questionnaure-9 (PHQ-9)-assessed depressive symptom severity. Depressive symptoms were assessed at baseline and post-test in both groups. For the experimental group, depressive symptoms were also assessed at the end of the first 2 weeks of training. RESULTS: The post-test BDI-II and PHQ-9 were significantly lower in the experimental group than in the control group (p<0.001 and p<0.001, respectively). The decreases in BDI-II, from baseline, at post-test were significantly greater in the experimental group as compared with the control group (95% confidence interval (CI): -12.554 to -5.408, p<0.001). Similarly, the pre-test-to-post-test change in PHQ-9 scores was significantly greater in the experimental group as compared with the control group (95% CI: -5.59 to -0.092, p=0.007). Examining the changes in BDI-II and PHQ-9 within the experimental group by the repeated-measures analysis of variance (ANOVA) revealed that both measures of depressive symptoms decreased significantly over time (both p<0.001). The percentage of participants with a BDI-II >or=17 decreased over time from 28.6% at baseline, and 17.9% during treatment, to 10.7% post-test. CONCLUSIONS: Home-based deep-breathing training is effective in reducing depressive symptoms as compared with telephone support in patients with CHD.

Electrothermal treatment of thumb basal joint instability.

PURPOSE: This study examined whether radiofrequency electrothermal treatment of thumb basal joint instability could produce clinical improvement and result in successful functional outcomes for patients. METHODS: From August 2001 to April 2006, we treated 17 thumbs with symptomatic thumb basal joint instability using arthroscopic electrothermal shrinkage of the volar ligaments and joint capsule with a monopolar radiofrequency probe. The sample included 11 men and 6 women with a mean age of 35.3 years (range, 20 to 60 years). All patients underwent regular clinical follow-up at a mean of 41 months (range, 24 to 80 months). RESULTS: Pain improved in all thumbs after surgery. Thumb pinch strength significantly improved in all thumbs after surgery (P < .01). All patients were satisfied with the results and returned to their preinjury activities. CONCLUSIONS: By use of the described method of arthroscopic electrothermal shrinkage of the volar ligaments and joint capsule in patients with symptomatic thumb basal joint instability, most patients had good subjective results and the pinch strength improved significantly in most patients. Of 17 thumbs, 16 had satisfactory subjective and functional stability at a minimum 2 years' follow-up. LEVEL OF EVIDENCE: Level IV, therapeutic case series.