Reduction In Fatigue Research Articles

Predicting circadian phase in community-dwelling later-life adults using actigraphy data.

The accurate estimation of circadian phase in the real-world has a variety of applications, including chronotherapeutic drug delivery, reduction of fatigue, and optimal jet lag or shift work scheduling. Recent work has developed and adapted algorithms to predict time-consuming and costly laboratory circadian phase measurements using mathematical models with actigraphy or other wearable data. Here, we validate and extend these results in a home-based cohort of later-life adults, ranging in age from 58 to 86 years. Analysis of this population serves as a valuable extension to our understanding of phase prediction, since key features of circadian timekeeping (including circadian amplitude, response to light stimuli, and susceptibility to circadian misalignment) may become altered in older populations and when observed in real-life settings. We assessed the ability of four models to predict ground truth dim light melatonin onset, and found that all the models could generate predictions with mean absolute errors of approximately 1.4 h or below using actigraph activity data. Simulations of the model with activity performed as well or better than the light-based modelling predictions, validating previous findings in this novel cohort. Interestingly, the models performed comparably to actigraph-derived sleep metrics, with the higher-order and nonphotic activity-based models in particular demonstrating superior performance. This work provides evidence that circadian rhythms can be reasonably estimated in later-life adults living in home settings through mathematical modelling of data from wearable devices.

Anthropometry, Neuroergonomics and Immersive Technologies for the Workplace’s Future: Safer, Self-Sustainable and Digital

Objective: The objective of this research is to identify the best ways to organize tasks, design interfaces and optimize work processes while respecting the cognitive limits, body size and know-how of the workforce. Theoretical Framework: It is possible to prevent occupational and work-related diseases. The future of work is being shaped by a convergence of disciplines that seek to optimize the interaction between humans and machines. Method: The method used included publications related to the topic on immersive training, movement programming and respect for anthropometric differences between genders. Results and Discussion: The results indicate a reduction in mental fatigue, a reduction in the cognitive load in tasks with the creation of work routines and greater attention and productivity. Research Implications: This review research shows how neuroergonomics, anthropometry and immersive technologies, considered pillars of transformation, have the potential to create safer, more efficient work environments adapted to the individual needs of workers. Originality/Value: The study of the physical dimensions and physical-mental characteristics of the human body in the design of equipment and workspaces makes it possible to create more comfortable and safe environments, reducing the risk of repetitive strain injuries and occupational diseases.

A human digital twin approach for fatigue-aware task planning in human-robot collaborative assembly

Human-robot collaboration (HRC) has emerged as a pivotal paradigm in manufacturing, integrating the strengths of both human and robot capabilities. Neglecting human physical fatigue may adversely affect worker health and, in extreme cases, may lead to musculoskeletal disorders. However, human fatigue has rarely been considered for decision-making in HRC manufacturing systems. Integrating adaptive decision-making to optimise human fatigue in HRC manufacturing systems is crucial. Nonetheless, real-time perception and estimation of human fatigue and decision-making informed by human fatigue face considerable challenges. To address these challenges, this paper introduces a human digital twin method, a bidirectional communication system for physical fatigue assessment and reduction in human-robot collaborative assembly tasks. The methodology encompasses an IK-BiLSTM-AM-based surrogate model, which consists of inverse kinematics analysis (IK), bidirectional long short-term memory (BiLSTM), and attention mechanism (AM), for real-time muscle force estimation integrated with a muscle force-fatigue model for muscle fatigue assessment. An And-Or graph and optimisation model-based HRC task planner is also developed to alleviate physical fatigue via task allocation. The efficacy of this approach has been validated through proof-of-concept assembly experiments involving multiple subjects. The results show that the IK-BiLSTM-AM model achieves a minimum of 8% greater accuracy in muscle force estimation than the baseline methods. The 12-subject assessment results indicate that the task planner effectively reduces the physical fatigue of workers while performing collaborative assembly tasks.

The effects of 3-month supplementation with synbiotic on patient-reported outcomes, exercise tolerance, and brain and muscle metabolism in adult patients with post-COVID-19 chronic fatigue syndrome (STOP-FATIGUE): a randomized Placebo-controlled clinical trial.

Considering the observed gastrointestinal issues linked to post-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), beneficially modulating the gut microbiota could offer a safe, cost-effective nutritional strategy. This trial aimed to evaluate the effects of medium-term synbiotic supplementation on patient-reported outcomes, exercise tolerance, and tissue metabolism in patients with post-COVID-19 ME/CFS. Between September 2022 and December 2023, we investigated the impact of 3-month supplementation with a synbiotic mixture including L. rhamnosus DSM 32550, Humiome® L. plantarum DSM 34532, B. lactis DSM 32269, B. longum DSM 32946, fructooligosaccharides and zinc, on predetermined primary and secondary outcome measures in twenty six post-COVID-19 ME/CFS patients utilizing a parallel-group, randomized, placebo-controlled, double-blind design. Both the synbiotic and placebo intake resulted in a significant reduction in general fatigue after 3months compared to the baseline values (P ≤ 0.05). This was accompanied by a significant interaction effect (time vs. treatment) for post-exercise malaise (P = 0.02), with synbiotic superior to placebo to attenuate post-exercise malaise. The synbiotic also demonstrated a significant advantage over placebo in increasing choline levels at the thalamus (P = 0.02), and creatine levels at left frontal white matter (P = 0.05) and left frontal grey matter (P = 0.04). Taking the synbiotic mixture for three months improves tissue metabolism and mitigates clinical features of post-COVID-19 fatigue syndrome. The presented data show promise in addressing the widespread issue of ME/CFS following the COVID-19 pandemic; however, further validation is needed before endorsing the synbiotics within this clinical context. The study is registered at ClinicalTrials.gov (NCT06013072).

Development and Assessment of a Carpooling Applied System: Perspective of Users from Public-Education Sector

The heavy reliance on private cars is linked not only to harmful environmental impacts, such as gas emissions and global warming, but also to other issues like traffic congestion, road infrastructure maintenance, and the limited availability of parking spaces—significant concerns in many cities. To address these challenges, carpooling has been shown to be an effective solution, as it directly reduces emissions, alleviates congestion, and mitigates the environmental effects of transportation.The aim of this research is to enhance the understanding of carpooling in our society. To achieve this, a carpooling initiative among teachers for their commuting journeys was developed and implemented, followed by an evaluation of the system by a panel of experts. The results showed a 31.9% reduction in the number of cars on the road among participants, with a total of 109,080 km saved based on the reduced number of vehicles.The primary motivation for participants to adopt carpooling was fuel savings, while the reduction of physical fatigue from driving was identified as the second most important factor. Although some barriers to participation were identified, their impact was generally lower than that of the perceived benefits. These findings suggest that carpooling programs should focus on optimizing matching conditions and addressing individual concerns to promote wider adoption.

Evaluating Meaningful Changes in Patient-Reported Outcome Measurement Information System-Fatigue Scores from Three Phase 3 Clinical Trials of Sarilumab for Patients With Rheumatoid Arthritis.

The aim of this study was to evaluate changes in fatigue measured by Patient-Reported Outcome Measurement Information System (PROMIS)-Fatigue scores in patients with rheumatoid arthritis (RA) who received sarilumab and to assess the proportion of patients achieving clinically meaningful change. Data from three phase 3 randomized controlled trials of patients with RA who received sarilumab-MOBILITY, TARGET, and MONARCH-were evaluated. The 10 RA-relevant items from the 13-item Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue were scored in the PROMIS T score metric. Mean changes in 10-item PROMIS-Fatigue T score (PROMIS-Fatigue 10a) were compared, proportions of patients reporting meaningful within-person change thresholds were assessed, and results were visualized using empirical cumulative distribution function (eCDF) curves. Patients with RA reported high baseline fatigue. Using PROMIS-Fatigue 10a, at week 24, patients receiving 150 or 200 mg sarilumab every other week in MOBILITY and TARGET had rapidly and significantly improved mean levels of fatigue compared to those who received placebo. When compared to patients who received adalimumab in MONARCH, patients who received sarilumab had a trend toward increased improvement. eCDF curves showed separation between active treatment versus placebo with both sarilumab doses and across the score range for improvement. Higher proportions of patients reported three-, five-, and seven-point improvements in PROMIS-Fatigue scores in groups who received active treatment. Substantial proportions of patients with RA who received sarilumab reported meaningful change in fatigue measured by PROMIS-Fatigue 10a over time. This study demonstrates the ability to convert FACIT-Fatigue score onto the PROMIS T score metric, the rapid reduction in fatigue with biologic therapies, and the use of novel eCDF curves to show individual patient-level change.

Effects of the CALM intervention on cancer-related fatigue and heart rate variability in NSCLC: a randomized trial.

To evaluate the effects of CALM intervention on cancer-related fatigue (CRF), quality of life (QOL), and heart rate variability (HRV) in non-small cell lung cancer (NSCLC) patients. A total of 153 NSCLC patients were enrolled in the study. Participants were randomly assigned to the CALM group and usual care (UC) group. Patients in the CALM group were received 6 CALM intervention sessions over a 12-week period and evaluated using CRF, QOL and HRV at baseline (T0) and after 2, 4, and 6 intervention sessions. The CALM group showed significant differences in total CRF, behavioral/daily life CRF, emotional/affective CRF, sensory/physical CRF, cognitive CRF and QOL before and after CALM intervention sessions (F = 643.47, F = 208.34, F = 354.52, F = 285.69, F = 334.29, F = 245.77, p < 0.001). The CALM group showed significant increases in standard deviation of normal R-R interval (SDNN) and high-frequency power (HF) (z = -4.94, p < 0.001,z = -4.30, p < 0.001). Significant negative correlations were observed between CRF and SDNN, HF and QOL across all participants. The CALM intervention had a positive impact on overall physical and mental health, fatigue reduction, quality of life and autonomic dysfunction in NSCLC patients. Heart rate variability may serve as an observational indicator of physical and mental health.

A Double-Blinded Randomized Controlled Trial: Can Pulsed Electromagnetic Field Therapy Be a Novel Method for Treating Chronic Rhinosinusitis?

Background and Objectives: Pulsed electromagnetic field (PEMF) therapy offers a promising approach to treating inflammatory diseases. Its notable anti-inflammatory and antimicrobial effects and enhancement of microcirculation in the nasal mucosa make it a valuable treatment option. Despite its potential, the use of PEMF for chronic rhinosinusitis (CRS) is still in its early stages, with limited exploration of its effectiveness. This study aimed to assess the impact of PEMF on alleviating symptoms such as fatigue, headaches, sinus opacifications, and ostiomeatal complex issues associated with CRS. Materials and Methods: Forty-seven patients of both genders with CRS, aged 19 to 40 years, were involved in this study. The participants were randomly assigned to either a magnetic or a control group. The magnetic group underwent a 10 min PEMF session with a 20-gauss magnetic field strength at 7 Hz thrice a week for a month. The control group received the same PEMF application as an inactive device. Before and after the intervention, researchers assessed fatigue levels with a visual analog fatigue scale (VAFS), headache intensity via a numerical pain-rating scale, and the status of sinus opacifications and ostiomeatal complex obstructions by computerized tomography (CT). Results: The study findings showed a significant reduction in fatigue and headache scores in the magnetic group compared to the control group (p < 0.05). Additionally, there was a notable improvement in sinus opacifications and ostiomeatal complex obstructions among participants who received PEMF therapy. Conclusions: PEMF therapy effectively reduces fatigue, headaches, and sinus opacifications in CRS patients, suggesting its potential for inclusion in CRS management guidelines to improve patient outcomes and quality of life. The results of this study indicate that PEMF represents a noninvasive and cost-effective approach for treating adults with mild-to-moderate CRS.

Full textile-based body-coupled electrical stimulation for wireless, battery-free, and wearable bioelectronics

Electrical stimulation is effective for various therapeutic applications; however, to increase convenience, it is crucial to eliminate generators and batteries for wireless power transmission. This paper presents a full textile-based body-coupled electrical stimulation (BCES) system designed for wireless electrical stimulation using energy loss from electronic devices and static electricity from physical activity. We developed the BCES socks by knitting conductive threads to ensure stability and comfort. BCES socks generate electric fields ranging from tens to hundreds of millivolts per millimeter, which are sufficient to activate muscle fibers. Experimental and computational analyses confirmed the effective concentration of the electric fields. Human trials demonstrated significant improvements in exercise performance, with a 21.47% increase in calf raise frequency, an 11.97% increase in repetition count, and a 6.25% reduction in muscle fatigue. These results indicate the potential of BCES socks as a practical battery-free solution for enhancing muscle activity and reducing fatigue.

Dietary supplement consumption and associated factors among Algerian population residing in Tebessa: Cross-sectional survey

ObjectiveThis study aimed to assess the prevalence of dietary supplement consumption among Algerians in Tebessa. Materials and methodsThis was a descriptive cross-sectional survey carried out over two months. The study included 216 Algerian men and women selected via simple random sampling. Approximately half of the participants were under 27 years old, with a mean age of 30 years. Variables assessed included the use of dietary supplements, reasons for consumption, frequency of use, types of supplements used, sources of purchase, and sources of advice regarding consumption. Continuous and categorical variables were compared using the Mann–Whitney test and Chi2 test, respectively. Logistic regression was employed to examine associations between dietary supplement consumption and explanatory variables, including socioeconomic factors. ResultsThe prevalence of dietary supplement use was 88.4%. The most common reasons cited for consumption were muscle mass enhancement and fatigue reduction. Vitamins were the most frequently used supplements, followed by trace elements. Consumption patterns were significantly associated with socioeconomic factors. ConclusionsA large part of the population has consumed food supplements for different reasons. This consumption could be beneficial for their health. Therefore, information-based on scientific evidence is important to prevent inappropriate use of dietary supplements by consumers. This study could serve as the foundation for a nationwide multicenter study to gain a better understanding of dietary supplement use among Algerians.

The Relationship between Spiritual Intelligence and Fatigue and Moral Distress in Emergency Nurses: A Cross-Sectional Study

Background: Emergency nurses face various challenging conditions and many moral distress that may associated with fatigue from providing care. The spiritual intelligence of nurses has been found to have an impact on the quality of care. This study aimed to investigate the relationship between the spiritual intelligence of emergency nurses with fatigue from providing care and moral distress in emergency nurses. Materials and Methods: This descriptive-analytical cross-sectional study was conducted on 200 nurses working in the emergency departments of hospitals in Semnan and Sabzevar, who were selected by stratified random method. They were asked to complete the spiritual intelligence, nurse fatigue scale, and moral distress questionnaire through self-reporting. The data were analyzed using SPSS 26 and Amos software, path analysis, and correlation tests. Results: An increase in spiritual intelligence leads to a significant reduction in moral distress (p = 0.01) and fatigue from caregiving (p = 0.001). In contrast, an increase in moral distress leads to a considerable increase in fatigue from caregiving (p = 0.001). Conclusions: The results showed that spiritual intelligence has an inverse relationship with moral distress and fatigue from providing care. Moral distress has a direct relationship with fatigue from providing care. Therefore, interventions in the field of increasing spiritual intelligence and reducing moral distress and fatigue from providing care are recommended.

Foot Reflexology for Managing Menopausal Symptoms in Women: A Systematic Review and Meta-Analysis

Background: Menopause can cause a variety of unpleasant symptoms, such as hot flashes, night sweats, mood swings, and sleep disturbances. Although hormone replacement therapy is frequently utilized to help manage these issues, long-term use of this treatment approach carries certain potential risks. Objective: This study aims to examine the effects of foot reflexology, a type of massage therapy that focuses on applying pressure to specific reflex points on the feet, on menopausal symptoms (primary outcome) and anxiety, fatigue, and depression (secondary outcomes). Methods: A systematic electronic search for relevant studies was conducted in PubMed, Scopus, Web of Science, the Cochrane Library, SID, Magiran, and Google Scholar until September 21, 2023. In addition to the electronic database searches, manual searches were also performed. This manual search process included scanning the reference lists of the included studies and handsearching key journals in the topic area. The risk of bias was assessed via the RoB 2.0 and ROBIN-I tools. Heterogeneity was evaluated via the I² statistic, and in cases of high heterogeneity, a random effects model was used instead of a fixed effects model. Subgroup analyses were performed for the primary outcome on the basis of menopausal symptoms (vasomotor/psychosocial/physical/sexual). The certainty of evidence was assessed via the GRADE approach. Results: A total of 186 articles were retrieved from database searches, and an additional 9 articles were identified through manual searches. Ultimately, 8 studies were included in the systematic review, and 6 studies were included in the meta-analysis. The meta-analysis revealed that foot reflexology had a significant effect on menopausal symptoms, with an average reduction of 3.41 points on the associated measurement scale (95% confidence interval (CI): -4.81 to -2.01; low-certainty evidence). It also significantly reduced fatigue, with an average reduction of 5.84 points (95% CI: - 11.61 to -0.06; very low-certainty evidence). However, there was no significant impact on anxiety (SMD: -0.89, 95% CI: -1.96--0.18; very low-certainty evidence) or depression (SMD: -0.73, 95% CI: -1.80--0.34; very low-certainty evidence) compared with the control group. Conclusion: The present study demonstrated that the use of foot reflexology as a nonhormonal and noninvasive intervention led to a significant reduction in menopausal symptoms and fatigue among women. Given the limited number of studies available in this area and the low to very low-level certainty of the evidence for the desired outcomes, further research with appropriate methodologies to ensure accurate conclusions in this field is strongly recommended.

Comfort advantages demonstrated with a novel soft contact lens: A randomized clinical trial

PurposeTo compare comfort outcomes between a novel daily disposable contact lens – designed to maximize comfort – and an established control. The hypothesis was that the test lens would be superior to the control for four key comfort questionnaire items: end-of-day comfort, all-day comfort, visual comfort while driving at night, and reduction of ocular fatigue from digital device use. MethodsThis randomized, controlled, subject-masked, parallel-arm study enrolled young (18–39 years), healthy, myopic, contact lens wearers with an up-to-date prescription at 19 investigational sites in the United States. Subjects wore either the test (ACUVUE® OASYS MAX 1-Day, senofilcon A) or control (Dailies Total1®, delefilcon A) lens for 2 weeks of bilateral, daily disposable wear before completing comfort questionnaire items, each of which had 5 or 6 response options. For each item, the odds ratio for positive (top-two-box) responses was estimated from a binomial generalized linear mixed model. A gatekeeping approach combined with the truncated Hochberg procedure was used for multiplicity adjustment. ResultsOf 344 enrolled subjects, 342 subjects were randomized and dispensed lenses, with 171 subjects per lens group. Among the 342 subjects, 68.4% were female, 83.6% were White, and the average age was 29.7 (±5.53) years. The test lens was statistically superior to the control for all four comfort questions: odds ratios (test vs. control) were 2.01 (95% CI: 1.25, 3.22) for end-of-day comfort, 2.17 (alpha-adjusted CI: 1.30, 3.64) for all-day comfort, 2.00 (alpha-adjusted CI: 1.18, 3.41) for reducing ocular fatigue from digital device use, and 1.77 (95% CI: 1.04, 3.02) for comfortable vision while driving at night. ConclusionThe test lens demonstrated statistically superior physical and visual comfort, as measured by the four comfort endpoints, compared to the control. The test lens had significantly greater odds of favorable responses for all comfort items compared to the control.

Patient-Reported Outcomes of Pain, Stiffness, and Fatigue Reduction in Rheumatoid and Psoriatic Arthritis With Cannabinoid Use.

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are autoimmune conditions that can progressively destroy joints, causing chronic, often debilitating pain, and drastically affecting the quality of life. Novel pharmaceutical remedies have recently been developed, which allow for better symptom management. However, the complex pain experienced is challenging to control fully, leading this patient population to seek alternative treatments. Though cannabis has been legalized for medical use in most states in the United States, the safety and efficacy of its use in inflammatory arthritis have still not been satisfactorily established.We conducted a cross-sectional study on patients with RA and PsA who visited a rheumatology outpatient clinic from October 2019 to March 2020. We conducted a brief, voluntary, and anonymous Qualtrics survey of specific questions regarding their use of cannabinoids and their forms, sources, methods, side effects, and perceived efficacy. The survey initially involved 302 eligible candidates, but only 290 patients completed it. Among them, 84.9% (n, 247) reported a diagnosis of RA, while 15.1% (n, 44) reported PsA. Demographically, 82.3% (n, 238) were female, and 17.7% (n, 52) were male, with mean ages of 57.1 years for RA and 56.2 years for PsA. Around 16.95% (n=40) of RA and 11.63% (n=5) of PsA patients reported cannabinoid use, primarily inhaled for RA and topical/liquid for PsA. Post-cannabis use, a significant decrease in pain scale was noted (mean difference: 2.267, p < 0.001), with improvements in stiffness, fatigue, and swelling reported. Side effects were minimal, and most patients were willing to discuss cannabinoid treatment with their physician (80.9% RA [n=199], 86.4% PsA [n=38]). In conclusion, our study indicates that a notable portion of the patients with inflammatory arthritis including RA and PsA reported a history of use or ongoing cannabinoid use. Furthermore, the patients reported a short-term reduction of pain, fatigue, and swelling, though it is unclear if these findings are related to a placebo effect.

EFEITOS DOS EXERCÍCIOS NA MELHORA DA DOR PACIENTES COM FIBROMIALGIA: REVISÃO INTEGRATIVA

FM is a complex rheumatic condition characterized by chronic pain without evident inflammation. It primarily affects women between the ages of 55 and 74, impairing quality of life due to pain, fatigue, sleep disturbances, and emotional symptoms. Objective: To identify and report the effects of physical exercise on pain improvement in patients with FM. Methodology: An integrative literature review was conducted using the PICo strategy, covering primary studies from randomized clinical trials published between 2019 and 2024. The search was carried out in the LILACS, PubMed, SciELO, and PEDro databases, focusing on the benefits of exercise in pain management. The inclusion criteria were limited to full-text articles in Portuguese and English. Results: A total of 642 studies were analyzed, of which 9 were included in the final sample. These studies showed that aerobic, resistance, aquatic, and stretching exercises significantly contributed to the reduction of pain and fatigue. Additionally, there was an improvement in sleep quality, functional capacity, and emotional well-being, with a decrease in symptoms such as anxiety and depression. However, some studies did not show statistically significant results. Conclusion: It is concluded that physical exercise, when supervised and adjusted to individual needs, is an effective intervention in the management of fibromyalgia, providing pain relief and improving quality of life. Further studies are needed to investigate the interaction of exercises with other treatments, such as pharmacotherapy, and to evaluate long-term effects.

Yoga for Cancer Survivors (YOCAS): A Systematic Review of the YOCAS Program's Impact on Physical and Psychological Well-Being.

Cancer survivors frequently experience prolonged physical and psychological symptoms including cancer-related fatigue (CRF), sleep disturbances, cognitive impairment, and musculoskeletal pain. Conventional treatments for these symptoms have demonstrated limited efficacy, emphasising the need for complementary therapies. The Yoga for Cancer Survivors (YOCAS) program is a structured mind-body intervention designed to address these challenges. This systematic review evaluated the efficacy of YOCAS in managing CRF, sleep quality, cognitive function, and musculoskeletal symptoms in cancer survivors using randomised controlled trials (RCTs).A comprehensive search was conducted across the Google Scholar, Scopus, Cochrane Library, and PubMed databases for RCTs published between January 2000 and September 2024. Eligible studies included adult cancer survivors who had completed primary treatment and compared YOCAS interventions to control groups. The primary outcomes were cancer-related fatigue, sleep quality, cognitive function, and musculoskeletal symptoms. The risk of bias was evaluated using the Cochrane Risk of Bias Tool, and the findings were synthesised.Six RCTs, involving 1,717participants, met the inclusion criteria. The YOCAS program demonstrated significant improvements in the reduction of cancer-related fatigue and sleep quality. Cognitive function and memory were improved, particularly among breast cancer survivors, with reduced musculoskeletal pain reported in participants undergoing hormonal therapy. Despite variations in study design, the risk of bias was generally low.​​​​​​​The YOCAS program effectively reduced cancer-related fatigue, improved sleep quality, and addressed the cognitive and musculoskeletal symptoms in cancer survivors. Given its low risk and broad applicability, YOCAS shows promise as a complementary therapy for cancer survivorship care. Future research should focus on the long-term sustainability of these benefits and explore the impact of the program across diverse cancer populations.

Heart Failure Symptoms Improve With More Intense Physical Activity.

Little is known about how changes in physical activity (PA) over time may influence symptoms in people with heart failure (HF). A secondary analysis was conducted with data from an RCT of an exercise intervention in patients with ICDs (implantable cardioverter defibrillator) and a HF diagnosis (n = 96). Data were collected at baseline and 2months of PA intervention. Physical activity (PA Steps = mean steps/day; PA Intensity = mean steps/min for most intense 30minutes/day) were measured over 5days at each timepoint. Physical symptoms were measured using the Patient Concerns Assessment, the SF-36 Vitality, and Bodily Pain subscales for fatigue and pain. Psychological symptoms were assessed using the Patient Health Questionnaire-9, and the State-Trait Anxiety Index. Associations between PA and physical and psychological symptoms were analyzed with multivariate regression. Patients (n = 96) were predominately male (83%) and Caucasian (79%), aged 55.8 ± 12.3years, BMI of 29.7 ± 5.1, with heart failure with reduced ejection fraction (HFrEF; 30.9 ± 9.9%). An increase in PA Steps was associated with improvement in anxiety (β = -1.178, p = .048). An increase in PA Intensity was associated with significant reductions in depression (β = -0.127, p = .021), anxiety (β = -0.234, p = .037), and fatigue (β = 0.528, p = .022). Decreases in PA Steps and PA Intensity were not associated with changes in any symptoms. For HF patients with an ICD, more intense PA over 2months was associated with improved psychological symptoms and reduced fatigue. Decreases in PA (total and intensity) were not associated with changes in symptoms. Interventions promoting increasing the intensity of PA over time may be an effective approach to reduce some HF symptoms.

Game-Based eHealth Interventions for the Reduction of Fatigue in People With Chronic Diseases: Systematic Review and Meta-Analysis.

Fatigue is a common and debilitating side effect of chronic diseases, significantly impacting patients' quality of life. While physical exercise and psychological treatments have been shown to reduce fatigue, patients often struggle with adherence to these interventions in clinical practice. Game-based eHealth interventions are believed to address adherence issues by making the intervention more accessible and engaging. This study aims to compile empirical evidence on game-based eHealth interventions for fatigue in individuals with chronic diseases and to evaluate their effectiveness in alleviating fatigue. A comprehensive literature search was performed across Embase, MEDLINE ALL, PsycINFO, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar in August 2021. Study characteristics and outcomes from the included studies were extracted, and a random-effects meta-analysis was conducted. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity. Of 1742 studies identified, 17 were included in the meta-analysis. These studies covered 5 different chronic diseases: multiple sclerosis (n=10), cancer (n=3), renal disease (n=2), stroke (n=1), and Parkinson disease (n=1). All but 1 study used exergaming interventions. The meta-analysis revealed a significant moderate effect size in reducing fatigue favoring the experimental interventions (standardized mean difference [SMD] -0.65, 95% CI -1.09 to -0.21, P=.003) compared with control conditions consisting of conventional care and no care. However, heterogeneity was high (I2=85.87%). Subgroup analyses were conducted for the 2 most prevalent diseases. The effect size for the multiple sclerosis subgroup showed a trend in favor of eHealth interventions (SMD -0.47, 95% CI -0.95 to 0.01, P=.05, I2=63.10%), but was not significant for the cancer group (SMD 0.61, 95% CI -0.36 to 1.58, P=.22). Balance exercises appeared particularly effective in reducing fatigue (SMD -1.19, 95% CI -1.95 to -0.42, P=.002). Game-based eHealth interventions appear effective in reducing fatigue in individuals with chronic diseases. Further research is needed to reinforce these findings and explore their impact on specific diseases. Additionally, there is a lack of investigation into interventions beyond exergaming within the field of game-based learning.

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study

BackgroundThe response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time. Methods297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships. ResultsLCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional. ConclusionsOn a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.

Sex-Based Effects of Branched-Chain Amino Acids on Strength Training Performance and Body Composition.

Branched-chain amino acids (BCAAs) are widely studied for their effects on muscle recovery and performance. This study examined the effects of BCAA supplementation on anthropometric data, physical performance, delayed onset muscle soreness (DOMS), and fatigue in recreational weightlifters. The trial involved 100 participants (50 men and 50 women), randomized into BCAA and placebo groups. Subjects in the BCAA group took five daily capsules of 500 mg L-leucine, 250 mg L-isoleucine, and 250 mg L-valine for six months. A two-way ANOVA was used to analyze the main and interaction effects of sex and treatment. Notable findings include significant improvements in muscle recovery, as indicated by reduced DOMS, particularly in women who showed a decrement of 18.1 ± 9.4 mm compared to 0.8 ± 1.2 mm in the placebo group of a horizontal 100 mm line. Fatigue perception was also significantly lower in the BCAA group, with women reporting a greater decrease (2.6 ± 1.5 scores) compared to the placebo group (0.6 ± 0.7 scores). Strength gains were prominent, especially in men, with a 10% increase in bench press maximum observed in the BCAA group. The interaction between sex and treatment was significant, suggesting sex-specific responses to BCAA supplementation. These results underscore the effectiveness of BCAA supplementation in enhancing muscle recovery, reducing fatigue, and improving strength. This study also highlights sex-specific responses, with women benefiting more in terms of DOMS and fatigue reduction, while men experienced greater strength gains, suggesting a need for tailored supplementation strategies.