Study protocol for a randomized controlled trial: Effect of an everyday cognition training program on cognitive function, emotional state, frailty and functioning in older adults without cognitive impairment.

BACKGROUND: Ageing entails changes in complex cognitive functions that lead to a decrease in autonomy and quality of life. Everyday cognition is the ability to solve cognitively complex problems in the everyday world, enabling instrumental activities of life. Benefits have been found in studies using everyday cognition-based assessment and intervention, as the results predict improvements in everyday performance, not just in specific cognitive functions. A study protocol is presented based on assessment and training in everyday cognition versus traditional cognitive stimulation for the improvement of functionality, emotional state, frailty and cognitive function. METHODS: A parallel randomised controlled clinical trial with two arms will be conducted. It will be carried out by the University of Salamanca (Spain) in eleven centres and associations for the elderly of the City Council of Salamanca. People aged 60 years or older without cognitive impairment will be recruited. Participants will be randomly distributed into two groups: the experimental group will undergo a training programme in everyday cognition and the control group a programme of traditional cognitive stimulation, completing 25 sessions over 7 months. All participants will be assessed at the beginning and at the end of the intervention, where socio-demographic data and the following scales will be collected: The Medical Outcomes Study (MOS), Questionnaire ARMS-e, Everyday Cognition Test (PECC), Scale Yesavage, Test Montreal Cognitive Assessment (MoCA), The Functional Independence Measure (FIM), Fragility Index and Lawton y Brody Scale. DISCUSSION: The present study aims to improve conventional clinical practice on cognitive function training by proposing a specific assessment and intervention of everyday cognition based on the importance of actual cognitive functioning during the resolution of complex tasks of daily life, giving priority to the improvement of autonomy. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT05688163. Registered on: January 18, 2023.

CHEMOBRAIN: estudio descriptivo sobre la función cognitiva en personas con una condición de salud oncológica en tratamiento quimioterapéutico / CHEMOBRAIN: descriptive study on cognitive function in people with a oncological health condition under chemotherapeutic treatment

Objetivos: el objetivo principal de este estudio descriptivo es analizar la presencia de deterioro cognitivo en personas con una condición de salud oncológica sometidas a tratamiento quimioterapéutico. Método: se trata de un estudio descriptivo, observacional, correlacional y transversal, en el que participan 55 pacientes del Hospital Universitario de Salamanca. Los instrumentos utilizados son el cuestionario Evaluación Rápida de las Funciones Cognitivas; el Cuestionario de Fallos de Memoria de la vida Cotidiana; y la Escala de Ansiedad y Depresión Hospitalaria. Resultados: los resultados muestran que un 54,5% de la muestra presenta deterioro cognitivo objetivo y subjetivo (con una correlación significativa de p=0,038). Además, el 65,4% de la muestra presenta síntomas ansioso-depresivos. Sin embargo, ambas variables, no se hanpodido correlacionar de manera estadística significativa. Sí se han establecido correlaciones significativas entre la edad y el deterioro cognitivo (p=0,030). Conclusión: podemos concluir que la presencia de deterioro cognitivo y síntomas ansioso-depresivos es común entre las personas con una condición de salud oncológica, aumentando el deterioro cognitivo con la edad.(AU)

Objective: Cancer is a leading contributor to morbidity and mortality in Spain. While oncological treatments used to combat the disease, they have various side effects, including cognitive impairment or complaints commonly known as "chemobrain." Method: This descript ive, observational,correlational, and cross-sectional study involved 55 patients from the University Hospital of Salamanca. The instruments employed included the Rapid Assessment of Cognitive Functions Questionnaire; the Everyday Life Memory Failure Questionnaire, and the Hospital Anxiety and Depression Scale. Results: The results show that 54.5% of the sample exhibits both objective and subjective cognitive impairment, with a significant correlation of p=0.038. Furthermore, 65.4% of the sample exhibits anxious-depressive symptoms. However, both variables could not be statistically significantly correlated. Significantly, correlations have been established between age and cognitive impairment (p=0.030). Conclusion: Consequently, it can be concluded that cognitive impairment and anxious-depressive symptoms are common among individuals with an oncological health condition, with cognitive impairment being more prevalent among older individuals.(AU)

Efectividad de la robótica en terapia ocupacional para recuperación funcional del miembro superior: revisión sistemática / Effectiveness of robotics in occupational therapy for functional recovery of the upper limb: systematic review

Objetivos: revisar sistemáticamente la evidencia científica actual acerca de la efectividad de la terapia robótica, respecto a la terapia ocupacional convencional, para alcanzar la máxima recuperación funcional de un miembro hemiparético en pacientes que hayan sufrido un accidente cerebrovascular. Métodos: La revisión se llevó a cabo en mayo de 2022, siguiendo el protocolo definido de las normas de la declaración PRISMA. La búsqueda se realizó en las bases de datos y archivos electrónicos Pubmed, Cochrane Library, American Journal of Occupational Therapy, Journal of Neuroengineering and Rehabilitation (BMC), Archives of Physical Medicine and Rehabilitation, Wiley Online Library (Australian Journal of Occupational Therapy), SAGE journals, Journal of Neurologic Physical Therapy, International Journal of Stroke. Se seleccionaron 12 estudios de los 1920 registrados. Resultados: Los resultados mostraban todavía cierta controversia respecto al uso de dispositivos robóticos, determinando su utilidad para competencias concretas y apostando por su inclusión de manera combinada con la terapia ocupacional convencional. Conclusiones: diversos estudios recomiendan la rehabilitación combinada de la terapia ocupacional convencional y la terapia robótica para optimizar la funcionalidad e independencia de los pacientes.(AU)

Objective: Was to systematically review the current scientific evidence about the effectiveness of robotic therapy, compared to conventional occupational therapy, to achieve maximum functional recovery of a hemiparetic limb in patients who have suffered a cerebrovascular accident. Methods: The review was conducted in May 2022, following the defined protocol of the PRISMA statement guidelines. The databases and electronic archives used were Pubmed, Cochrane Library, American Journal of Occupational Therapy, Journal of Neuroengineering and Rehabilitation (BMC), Archives of Physical Medicine and Rehabilitation, Wiley Online Library (Australian Journal of Occupational Therapy), SAGE journals, Journal of Neurologic Physical Therapy, International Journal of Stroke. 12 studies were selected from the 1920 registered. Results: The results still showed some controversy regarding the use of robotic devices, determining their usefulness for specific competencies and advocating their inclusion in combination with conventional occupational therapy. Conclusions: Several studies recommend the combined rehabilitation of conventional occupational therapy and robotic therapy to optimize patients' functionality and independence.(AU)

Living Conditions and the Incidence and Risk of Falls in Community-Dwelling Older Adults: A Multifactorial Study.

Old age represents a social group that is undergoing continuous expansion. The aging population will be prone to chronic diseases and falls, which is a marker of frailty and a public health problem. This study aims to examine the relationship between living conditions and the prevalence of the risk of falls in older adults within the community. As an observational cross-sectional study, intentional sampling was carried out on residents of the metropolitan area over 75 years of age. The socio-demographic data of the subjects and their history of falls were collected. Additionally, the subjects were evaluated on the risk of falling, basic activities of daily living, such as walking and balance, fragility, and their fear of falling. The statistical analyses used were based on the Shapiro-Wilk test for normality, statistics of central tendency with description, mean (M) and dispersion, standard deviation (SD), bivariate contingency tables for studying the relationships between the variables, and the analysis of Pearson's relational statistics (χ2). The comparisons of means were resolved by parametric or non-parametric routes. We obtained the following results: 1. The socio-demographic profile of our sample consisted of adults over 75 years of age, the majority of whom were overweight or obese women living in an urban area, specifically in an apartment, and receiving care; 2. Older people in the studied community had mild dependency and frailty, and were also at severe risk of falls; 3. The prevalence of falls was higher in women than in men in this study. Through these results, we confirmed the relationship between living conditions and the prevalence of risk of falls in older adults within the community.

Multimodal physical exercise and functional rehabilitation program in oncological patients with asthenia. study protocol.

BACKGROUND: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. METHODS: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04761289. (February 18, 2021).  https://clinicaltrials.gov/ct2/show/ NCT04761289.

Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol.

BACKGROUND: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. METHODS: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).

Impacto de un programa de rehabilitación integral funcional en la calidad de vida del paciente oncológico con disnea / Impact of a comprehensive functional rehabilitation programme on the quality of life of the oncological patient with dyspnoea

Antecedentes: La disnea constituye una de las principales causas de pérdida de funcionalidad en el paciente con cáncer. Las medidas farmacológicas consiguen una reducción del síntoma, pero sin generalizar esa mejora a la funcionalidad. Proponemos la inclusión de un programa de rehabilitación integral funcional. El objetivo del estudio fue comprobar la eficacia del programa en la mejora tanto de los niveles de autonomía como de disnea en pacientes con cáncer.MétodosEstudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control. El grupo de intervención, además del tratamiento clínico convencional realizado en el grupo control, recibió el Programa de Rehabilitación Funcional. Los resultados principales a medir fueron la funcionalidad (Barthel), los niveles de disnea (MRC) y la CVRS (Euro-QOL). Enmascaramiento con simple ciego, pero análisis estadístico realizado por personal ajeno al estudio.ResultadosMuestra final de 113 individuos, 52 en el grupo control y 61 en el experimental, procedentes de la Unidad de Oncología del Complejo Hospitalario Universitario de Salamanca. A nivel descriptivo buen balanceo entre grupos en edad, género y diagnóstico. Diferencias estadísticamente significativas entre los miembros de ambos grupos en los niveles de funcionalidad (p = 0,000), en los niveles de disnea (p = 0,001) y en los los sub-ítems pertenecientes al cuestionario Euro-QOL, salvo en el sub-ítem relacionado con el dolor (p = 0,311). No se observan efectos adversos importantes o efectos secundarios. (AU)

Background: Dyspnoea is one of leading causes of loss of autonomy in patients with advanced-stage cancer. Pharmacological measures achieve a reduction of the symptom, but without generalizing this improvement to functionality. We propose the inclusion of a comprehensive functional rehabilitation programme. The purpose is to test the efficacy of an integral respiratory rehabilitation programme to improve autonomy levels and relieve cancer-related dyspnoea.MethodsExperimental design, prospective, longitudinal, randomized study based on a parallel fixed allocation scheme using an experimental group and a control group. The intervention group participated in comprehensive functional rehabilitation, while the control group only received standard drug treatment. Single blind masking, but statistical analysis was performed by non-study personnel.ResultsFinal sample of 113 individuals, 52 in the control group and 61 in the experimental group, from the Oncology Unit of the University Hospital Complex of Salamanca. Statistically significant differences (are observed) between the members of both groups in the levels of functionality (p = .000), in the levels of dyspnoea (p =.001) and in the sub-items of the Euro-QOL questionnaire, except in the sub-item related to pain (p = .311). No major adverse effects or side effects are observed. (AU)

Impact of a comprehensive functional rehabilitation programme on the quality of life of the oncological patient with dyspnoea. / Impacto de un programa de rehabilitación integral funcional en la calidad de vida del paciente oncológico con disnea.

BACKGROUND: Dyspnoea is one of leading causes of loss of autonomy in patients with advanced-stage cancer. Pharmacological measures achieve a reduction of the symptom, but without generalizing this improvement to functionality. We propose the inclusion of a comprehensive functional rehabilitation programme. The purpose is to test the efficacy of an integral respiratory rehabilitation programme to improve autonomy levels and relieve cancer-related dyspnoea. METHODS: Experimental design, prospective, longitudinal, randomized study based on a parallel fixed allocation scheme using an experimental group and a control group. The intervention group participated in comprehensive functional rehabilitation, while the control group only received standard drug treatment. Single blind masking, but statistical analysis was performed by non-study personnel. RESULTS: Final sample of 113 individuals, 52 in the control group and 61 in the experimental group, from the Oncology Unit of the University Hospital Complex of Salamanca. Statistically significant differences (are observed) between the members of both groups in the levels of functionality (p = .000), in the levels of dyspnoea (p =.001) and in the sub-items of the Euro-QOL questionnaire, except in the sub-item related to pain (p = .311). No major adverse effects or side effects are observed. CONCLUSION: Non-pharmacological interventions using a comprehensive functional rehabilitation programme improve functionality and relieve dyspnoea in cancer patients.

Study of Chemotherapy-Induced Cognitive Impairment in Women with Breast Cancer.

BACKGROUND: Oncology patients experience a large number of symptoms and, those referring to cognitive performance has an ever-increasing importance in clinical practice, due to the increase in survival rates and interest in the patient's quality of life. The studies reviewed showed that chemotherapy-related cognitive impairment might occur in 15 and 50% of oncology patients. The main objective of this research was to study the impact of chemotherapy on the cognitive function of patients with locoregional breast cancer. METHOD: Analytical, prospective, longitudinal study using three measures, unifactorial intrasubject design, non-probability, and random selection sampling. The sample comprised women newly diagnosed with locoregional breast cancer in stages I, II, IIIA who received chemotherapy at the University Hospital of Salamanca (Complejo Asistencial Universitario de Salamanca), randomly selected for three years. Semi-structured interviews were conducted, and anxiety and depression (Hospital Anxiety and Depression scale, HAD); quality of life (QLQ-BR23 scale) and the following cognitive variables were assessed-processing speed, attention, memory, and executive functions (subtests of the Wechsler Intelligence Scale and the Trail Making Test). RESULTS: The final sample size included 151 participants; 23 were excluded. A decline in cognitive performance was observed in patients, which did not completely recover two months after chemotherapy was completed. Additionally, worse cognitive performance was observed in patients with anxious or depressive symptoms. There was a negative impact on the quality of life. CONCLUSION: Chemotherapy had an impact on the cognitive performance of oncology patients in most cognitive domains studied.

Estudio sobre los niveles de dependencia en pacientes oncológicos con sintomatología respiratoria / Study on the levels of dependence of the oncological patient with respiratory symptomatology

La incidencia del cáncer (Ca) en España está en aumento (247.771 nuevos diagnósticos). La Supervivencia de pacientes oncológicos a los 5 años es 53%. Principal problema, es la calidad de esa supervivencia. Un Importante factor condicionante son los niveles de dependencia de los pacientes en tratamiento activo. Objetivo principal: Evaluar el nivel de dependencia de los pacientes oncológicos con disnea. METODOLOGÍA: Estudio observacional prospectivo transversal con muestreo no probabilístico de asignación accidental. La muestra se reclutó del Servicio de Oncología Médica del Hospital Universitario de Salamanca. Se procedió a la derivación de los pacientes al programa de terapia ocupacional con la consiguiente inclusión de estos en el estudio. Posteriormente y tras obtener el consentimiento informado firmado, se procedió a evaluar. Se utilizó la escala de Lawton-Brody, y el índice de Barthel. Se diseñó una hoja de registro para datos sociodemográficos y clínicos. RESULTADOS: Muestra total de 180 individuos. Edad media de 68,48 (±10,513) años. El 52,8% varones, por un 47,2% mujeres. El 22,8% presentaban diagnóstico de Ca de mama, un 31,7% Ca pulmonar y un 45,6% Ca relacionado con el aparato digestivo. En cuanto a los niveles de dependencia, escala de Lawton-Brody, puntuación media de 4,31 (±1,832) puntos (niveles de dependencia moderados); índice de Barthel, puntuación media de 42,53 (±2,789) puntos (nivel de dependencia moderado). Peores puntuaciones en diagnóstico anatomopatológico pulmonar. Correlación fuerte y estadísticamente significativa entre ABVD y AIVD (r=0,803, para p<0,05), y correlación significativa (r=-0,403, para p<0,001) entre la edad y la realización de AIVD. CONCLUSIÓN: Los pacientes oncológicos con disnea presentan unos niveles de dependencia moderada.

The incidence of cancer (Ca) in Spain is increasing (247,771 new diagnoses). Survival of cancer patients at 5 years is 53%. The main problem is the quality of that survival. An important conditioning factor is the level of dependence of patients in active treatment. Aim: To evaluate the level of dependence of cancer patients with dyspnea. METHODOLOGY: Cross-sectional prospective observational study with non-probabilistic accidental assignment sampling. Sample was recruited from the Service of Medical Oncology at the Salamanca University Hospital. The patients were referred to the occupational therapy program with their consequent inclusion in the study. Subsequently, and after obtaining signed informed consent, an evaluation was carried out. The Lawton-Brody scale and the Barthel index were used. A record sheet for sociodemographic and clinical data was designed. RESULTS: Total sample of 180 individuals. Average age of 68.48 (± 10.513) years. 52.8% men, by 47.2% women. 22.8% had a diagnosis of breast Ca, 31.7% pulmonary Ca and 45.6% Ca related to the digestive system. Regarding the levels of dependency, Lawton-Brody scale, mean score of 4.31 (± 1,832) points (moderate levels of dependency); Barthel index, mean score of 42.53 (± 2.789) points (moderate level of dependence). Worse scores in pulmonary pathological diagnosis. Strong and statistically significant correlation between ABVD and AIVD (r = 0.803, for p <0.05), and significant correlation (r = -0.403, for p <0.001) between age and AIVD performance. CONCLUSION: Oncology patients with dyspnoea show moderate levels of dependence.

Estudio aleatorizado sobre la influencia de un programa de rehabilitación integral funcional en el control de la astenia relacionada con la enfermedad oncológica / Randomised study on the influence of a comprehensive rehabilitation programme on control of cancer-related asthenia

FUNDAMENTO Y OBJETIVO: La astenia debida a la enfermedad oncológica es un fenómeno multifactorial, tratado habitualmente mediante fármacos. Estos tratamientos suelen controlar el síntoma, pero no consiguen mejorar la funcionalidad de los pacientes. En algunos pacientes pueden inducir o incluso aumentar los niveles de astenia. El objetivo principal de nuestro estudio ha sido comprobar la eficacia de un programa de rehabilitación integral funcional en el control de la astenia relacionada con la enfermedad oncológica. PACIENTES Y MÉTODOS: Este es un estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control, realizado con 192 pacientes del Servicio de Oncología del Hospital Universitario de Salamanca. El grupo de intervención, además de recibir tratamiento farmacológico, participó en un programa de rehabilitación integral funcional. El grupo control solo recibió el tratamiento farmacológico habitual. Los resultados principales medidos fueron los niveles de astenia y la realización de actividades de la vida diaria mediante el cuestionario Perform y la escala triple EVA. RESULTADOS: Los pacientes del grupo experimental obtuvieron después de la intervención una importante disminución en los niveles de astenia evaluada con el cuestionario PERFORM (puntuación inicial del grupo experimental: 19,19; puntuación inicial del grupo control: 20,98. Puntuación final del grupo experimental: 36,12; puntuación final del grupo control: 22,48). Estos resultados son estadísticamente significativos con respecto a los obtenidos por el grupo control (p < 0,001; IC 95%). Los pacientes del grupo de intervención obtuvieron también una mejora estadísticamente significativa (p < 0,001; IC 95%) comparada con la obtenida por los sujetos del grupo control en los ítems de niveles de energía, actividades diarias y calidad de vida evaluados con la escala triple EVA. CONCLUSIONES: Las intervenciones no farmacológicas de un programa de rehabilitación integral funcional mejoran los niveles de astenia debida a la enfermedad oncológica: esto supone un incremento importante de sus actividades de la vida diaria

BACKGROUND AND OBJECTIVE: Cancer-related fatigue is a multifactorial phenomenon, which is usually treated exclusively with medication. These treatments usually only achieve control of symptoms but do not improve the functionality of PATIENTS: In some patients they can induce or increase fatigue levels. Our aim is to test the effectiveness of a «comprehensive functional rehabilitation programme» in controlling fatigue-related cancer. PATIENTS AND METHOD: This is an experimental, prospective, longitudinal, randomized study using a parallel fixed allocation scheme with experimental and control group with 192 patients from the Oncology Service of Salamanca University Hospital. The intervention group received pharmacological treatment and then participated in a «comprehensive functional rehabilitation programme»; the control group received only pharmacological treatment. The main outcomes measured were asthenia levels and daily activities through the PERFORMA questionnaire and triple VAS. RESULTS: Patients in the experimental group decrease fatigue levels in PERFORM Questionnaire (Initial score group, 19.19, initial score, control group, 20.98, final score, 36.12, final score, control group, 22.48). We found significant differences (p < 0.001, IC 95%) with patients of CONTROL GROUP: Patients of intervention group improve the energy levels, daily activities and quality of life assessed with the EVA triple scale and also we found again significant differences (p < 0.001, IC 95%) with patients of CONTROL GROUP: CONCLUSIONS: The non- pharmacological interventions of functional rehabilitation program comprehensive decrease fatigue related cancer, therefore patients participating in this program better perform their daily activities

Influencia de un programa de educación al esfuerzo en la mejora de la calidad de vida de los pacientes oncológicos con astenia / Effectiveness of educational program on quality of life of fatigue reported by the oncologic disease

Justificación: La revisión de la literatura pone de manifiesto el impacto negativo que la astenia tumoral tiene sobre la calidad de vida y recomienda utilizar además del tratamiento farmacológico para controlar el síntoma, otras terapias centradas en aumentar la autonomía. Nuestro objetivo ha sido comprobar la eficacia del "Programa de entrenamiento en la realización de las actividades de la vida diaria", en la mejora de la Calidad de Vida Relacionada con la Salud (CVRS) de los pacientes oncológicos con astenia. Metodología: Estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control. El instrumento de evaluación para medir la variable dependiente fue el cuestionario SF-12 v2. El estudio se realizó con 180 sujetos reclutados entre diciembre de 2013 y septiembre de 2015. Resultados: Después de la intervención encontramos diferencias estadísticamente significativas (p<0,01) en todos los ítems de calidad de vida en los pacientes incluidos en el grupo experimental, exceptuando el ítem "dolor corporal" (p>0,05). Sin embargo no hemos encontrado relación entre la edad y la mejora de la calidad de vida. Conclusiones: La utilización sistemática y controlada del "Programa de entrenamiento en la realización de las actividades de la vida diaria" mejora todos los niveles de CVRS de los pacientes oncológicos por lo que después de estos resultados nuestro último objetivo será la implementación de este programa y su utilización en nuestra práctica clínica diaria

Background: The review of the literature show a negative impact of the fatigue on quality of life and recommend, in addition of the use of traditional drug treatment to control symptoms, other therapies focused into improve the autonomy. Our aim is to test the efficacy of improving the levels of quality of life related to health (HRQOL) of cancer patients using a "daily activity training program" to control fatigue reported by the oncological disease. Methods/design: experimental, prospective, longitudinal and randomized study using a parallel fixed allocation scheme with experimental and control group. We used the SF-12 v2 questionnaire to measure HRQL .The study was conducted in 180 subjects recruited between December 2013 and September 2015. Results: We found statistically significant differences after intervention (p <0.001) in all items related to quality of life in the experimental group patients, except for the item "bodily pain"(p>0, 05). However, we found no relationship between age and improving of the quality of life. In summary systematic and controlled use of our "daily activity training program" improve all levels of quality of life related to health (HRQOL) of cancer patients. Therefore after these results our ultimate goal will be the implementation of this program and its use in our daily practice

Estudio aleatorizado de un programa de entrenamiento de cognición cotidiana frente a estimulación cognitiva tradicional en adultos mayores / Randomized study of a everyday cognition training program versus traditional cognitive stimulation in elderly adults

La cognición cotidiana consiste en la aplicación de las habilidades cognitivas básicas y el conocimiento del dominio específico para la resolución de problemas que se integran dentro de los dominios instrumentales de funcionamiento. Para valorar la cognición cotidiana, existen evaluaciones que presentan problemas cotidianos cognitivamente desafiantes, pertenecientes a actividades instrumentales, cuyo objetivo es evaluar el funcionamiento cognitivo dentro de estos dominios en el mundo real. Objetivo principal: Analizar la diferencia existente entre la realización de programas de estimulación cognitiva tradicionales y programas de intervención directa en cognición cotidiana. Metodología: Estudio experimental, aleatorizado, estratificado, prospectivo, longitudinal mediante un esquema de asignación fija con grupo experimental y grupo control. La población a estudio fueron adultos mayores sanos de la ciudad de Salamanca que participaron en los programas de terapia ocupacional. La intervención constó de un programa específico de estimulación en cognición cotidiana. Para la evaluación se utilizó la ERFC (evaluación rápida de las funciones cognitivas) para medir la función cognitiva global y la ECB (Everyday Cognition Battery) para medir la cognición cotidiana. Resultados: Muestra total de pacientes (n = 147) compuesta por 19 hombres y 128 mujeres, con una edad media de 75 años. Se observaron diferencias estadísticamente significativas (p < 0,001) en la variable ECB, así como diferencias estadísticamente significativas (p < 0,05) en los ítems "total", "cálculo", "razonamiento", "comprensión" y "reconocimiento visual". Conclusiones: La utilización combinada de estimulación cognitiva tradicional y entrenamiento en cognición cotidiana presenta mayores beneficios en términos de cognición cotidiana que la utilización exclusiva de estimulación cognitiva en adultos mayores

Everyday cognition consists in the application of basic cognitive skills and the knowledge about a specific domain in problem solving which are integrated within the functional instrumental domains. In order to assess everyday cognition, there are assessments which include challenging cognitive tasks which are categorized as instrumental domains. The aim of these assessments is to assess cognition in the real world. Main objective: To analyze the difference among the implementation conventional of cognitive stimulation programs and the implementation of everyday cognition programs. Methods: Longitudinal prospective stratified randomized control trial. The population study will be older adults living in Salamanca who will participate in occupational therapy programs. The intervention will consist of a specific everyday cognition stimulation program. For the evaluation we used the ERFC (rapid assessment of cognitive functions) to measure global cognitive function and the ECB (everyday cognition battery) to measure daily cognition. Results: Sample size (n=147) composed of 19 males and 128 females with an average age of 75. Statistically significant difference is observed (p<0.001) in ECB variable (Everyday Cognition Battery), and in "total", "calculation", "reasoning", "comprehension" and "visual recognition" items as well (p<0.05). Conclusions: The combination of conventional cognitive stimulation and everyday cognition training has more benefits in terms of everyday cognition than the administration of cognitive stimulation by itself in older adults