Improve Quality Of Life Research Articles

Effectiveness of Group Cognitive Behavioral Therapy on Quality of Life and Psychological Wellbeing of Patients With Parkinson Disease: A Randomized Controlled Trial.

This study investigates the impact of group cognitive behavioral therapy (CBT) on depression reduction and quality of life improvement among individuals with Parkinson disease. A randomized clinical trial with pretest and posttest measurements involved 90 participants referred to Roozbeh Hospital in Tehran in 2023, who were randomly assigned to either an experimental group (n = 45) or a control group (n = 45). The experimental group underwent a 3-month CBT intervention comprising 12 sessions of 90 minutes each. Both groups completed the Beck Depression Inventory and the World Health Organization Quality of Life Questionnaire preintervention and postintervention. Data analysis via multivariate analysis of covariance using SPSS-25 revealed significant improvements in reducing depression and enhancing quality of life in the experimental group compared with the control group (p ≤ 0.01). These findings indicate that CBT is an effective treatment for reducing depression and improving the quality of life of individuals with Parkinson disease, demonstrating its clinical applicability in therapeutic settings.

Piano level laser therapy versus epidermal growth factor injection for painful myogenic temporomandibular disorder (a randomized clinical trial).

The aim of this clinical trial was to evaluate the effectiveness of Piano level laser therapy using Nd-YAG laser and intramuscular EGF injection in pain alleviation, function, and quality of life improvement in patients suffering from myogenic TMD. A randomized clinical trial was performed on 29 patients suffering from chronic painful myogenic TMD based on diagnostic criteria for temporomandibular disorders. Group I (n = 13patients) was treated using 1064nm Nd-YAG Laser (4 sessions once/week). Group II (n = 14 patients) was treated by intramuscular injection of EGF. Pain using numerical rating score, pain free opening and unassisted maximum opening were measured at baseline, 7,14,21 days, 1 and 3 months. Quality of life using OHIP-14 was assessed at baseline, 1 and 3 months. Results showed that there was a significant pain reduction (P < 0.000) and increase in pain free opening (P < 0.0001) in both test groups. However, only group I showed a significant increase in maximum opening (P = 0.007). Quality of life significantly improved in both groups (P = 0.0001). There was no significant difference between the two treatments in pain scores, pain free opening, maximum opening nor quality of life. Both treatment modalities offered effective and cost-effective non- to minimally invasive treatment options for myogenic TMD with no side effects. Myogenic TMD forms a public health issue and is a common musculoskeletal problem causing pain and disability. The proposal of effective, non-invasive, and affordable treatment options can help solve this issue.

Photobiomodulation preconditioning for oral mucositis prevention and quality of life improvement in chemotherapy patients: a randomized clinical trial

BackgroundGiven the suffering experienced by cancer patients, effective solutions must be found to prevent painful and debilitating side effects of anti-cancer treatment. This trial aims to study the effect of preconditioning with photobiomodulation in preventing oral mucositis and xerostomia in cancer patients undergoing chemotherapy alone for the first time, and to examine its role in improving patients’ quality of life.Materials and methodsThis is a prospective, randomized, double-blind clinical trial including 45 patients divided into three age- and sex-matched groups. Group 1 received basic oral care instructions before undergoing chemotherapy. Group 2 received basic oral care instructions plus photobiomodulation using an intraoral 650 nm diode laser. Group 3 received basic oral care instructions plus photobiomodulation using a 650 nm diode laser intraorally and a 980 nm diode laser extraorally.ResultsAfter one week of follow-up, 73.3% of patients in Group 2 and 80% in Group 3 did not develop oral mucositis. The remaining patients in both groups experienced only mild erythema. In contrast, all patients in Group 1 developed oral mucositis, ranging from mild erythema to ulceration greater than 3 cm². After two weeks of follow-up, 80% of patients in Group 2 and 86.7% in Group 3 remained free of oral mucositis. The remaining patients in both groups experienced only mild erythema. In contrast, 93.3% of patients in Group 1 developed oral mucositis, with cases ranging from mild erythema to ulcers larger than 3 cm². There were statistically significant differences between the three groups in oral mucositis assessment scale after one week and after two weeks (p < 0.001). Specifically, ulcerative mucositis was not observed in both laser groups, while it was observed in 13.3% of patients in Group 1. However, these differences were not statistically significant (p = 0.129). Regarding Late Effects in Normal Tissue (LENT-SOMA) scale, there was a statistically significant difference between the three groups studied (p = 0.037). There was also a statistically significant difference in the Oral Health Impact Profile (OHIP-14) between the three groups studied (p = 0.003 after one week, p = 0.023 after two weeks).ConclusionPreconditioning before starting chemotherapy, whether with the intraoral red laser alone or in combination with the extraoral infrared laser, has shown significant results in preventing oral mucositis and dry mouth, and it has also played a major role in improving patients’ quality of life.Trial registrationThis trial was registered in ISRCTN registry under no ISRCTN70634383 (https://doi.org/10.1186/ISRCTN70634383) on 24/07/2023.

Improvement in symptom severity, asthma control, and quality of life in pediatric patients with seasonal allergic rhinitis

Objectives: To evaluate the allergic rhinitis (AR) symptoms, asthma control, and quality of life (QoL) outcomes following treatment in children with seasonal allergic rhinitis (SAR), with and without asthma. Methods: Children diagnosed with SAR and presenting during the pollen season were included in the study. Symptom severity of SAR was assessed using the Total Nasal Symptom Score (TNSS), Total Ocular Symptom Score (TOSS), and Visual Analog Scale (VAS). Asthma control was measured using the Childhood Asthma Control Test (C-ACT), Asthma Control Test (ACT), and CARATkids. Quality of life (QoL) was evaluated using the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire. Data were collected at admission, the first month, and the second month of treatment. Results: Fifty-five children aged 5-16 years with SAR were evaluated of whom twenty three (42%) had asthma. Sensitivities to grass, tree, and weed allergens were observed in 74.5%, 50.9%, and 80% of patients, respectively. During the study period, TNSS, TOSS, and VAS scores significantly decreased (P&amp;lt;0.05 for all). Significant improvements were also observed in CARATkids, C-ACT and ACT scores among SAR patients with asthma (P&amp;lt;0.05 for all). All domains of QoL score showed significant improvement (P&amp;lt;0.001 for all), and positively correlated with TNSS, TOSS, and VAS scores. In SAR patients with asthma, ACT and C-ACT scores demonstrated a positive correlation with QoL scores, while CARATkids scores showed a negative correlation. Conclusions: Treatment for SAR in children significantly reduces symptom severity, improves asthma control, and enhances QoL. Effective management of SAR is crucial for alleviating the disease burden and improving patients' overall well-being.

Camp Wonder Provides Short-Term Health-Related Quality of Life Benefits for Participants With Chronic Skin Disease.

Chronic skin diseases in children can significantly impair their quality of life (QOL) due to physical discomfort and psychosocial challenges. Disease-focused summer camps, like Camp Wonder (CW), offer a supportive environment for children to engage in activities and build friendships, potentially improving their QOL. This prospective cohort study evaluated the short-term QOL benefits of CW as measured by the Children's Dermatology Life Quality Index (CDLQI). Data were collected from 58 camp participants aged 8-17 years. The CDLQI was administered on the first and last days of CW. The paired sample t-test was used to compare pre-camp and post-camp CDLQI scores. A multiple linear regression analysis examined predictors of QOL improvement, including age, diagnosis category, sex, and initial CDLQI severity. CW participants showed significant improvements in total CDLQI scores (mean change = -3.8 points, p < 0.0001) and in all constituent domains. Participants with "very large" initial QOL impacts experienced an average reduction of 8.4 points, while those with "extremely large" impacts had a reduction of 15.3 points relative to the reference group. Age, sex, and diagnosis were not significant predictors of QOL changes. CW provides significant short-term QOL benefits, particularly for children with severe impairments due to chronic skin disease. These findings suggest that summer camp experiences may be useful as part of a comprehensive care strategy, especially for pediatric patients with severe QOL impacts.

Adaptive Judo and neuropathy: a mini review on motor skills, balance, and quality of life improvement

IntroductionPeripheral neuropathies are progressive conditions characterized by muscle weakness, impaired balance, and reduced quality of life. Rehabilitation programs and adaptive sports have shown promise in mitigating these effects. This paper explores the potential of adaptive Judo to improve motor skills, balance, and overall quality of life in patients with neuropathy.MethodsWe review existing literature, analyze the benefits of Judo’s physical and cognitive demands, and propose adaptive guidelines for its implementation.ResultsThis study highlights Judo’s potential as a cost-effective and scalable intervention to support neuropathic patients.ConclusionThis review emphasizes the evidence-based benefits of adapted Judo training has the potential to transform both the physical and emotional health of neuropathic individuals.

Impact of pharmacist-led intervention for reducing drug-related problems and improving quality of life among chronic kidney disease patients: A randomized controlled trial.

Chronic kidney disease (CKD) patients suffer from different comorbid conditions and are prone toward drug-related problems (DRPs) which affect their clinical parameters as well as quality of life (QoL). This study was aimed to evaluate the impact of clinical pharmacist-led interventions on the mean number of DRPs and the mean QoL score difference per patient DRPs in CKD patients. An open-labeled, randomized control trial performed from April 2023 to July 2023 in the nephrology unit of a tertiary care setting in Peshawar Pakistan. Those patients who met the inclusion criteria were randomized into two groups 1:1, i.e., control and intervention group. Clinical pharmacists identified the DRPs at baseline using Pharmaceutical Care Network Europe (PCNE) 9.1 guidelines. The QoL of patients were assessed at baseline and endpoint by using the Functional Assessment of Non-Life-Threatening Conditions (FANLTC) questionnaire. A total of 100 patients were recruited having 50 in each group. The pharmacist identified a total of n = 230 DRPs in the intervention group, majority of the DRPs were attributed to inappropriate drug selection according to guidelines/formulary"; "inappropriate combinations of drugs or with herbal medications or dietary supplements"; and situations where "too many different drugs or active ingredients were prescribed". There was 46.52% reduction in the DRPs while comparing baseline and endpoint interventions suggested by pharmacist in the intervention group. The clinical pharmacist provided interventions in order to resolve the DRPs, and 37.40% interventions were accepted and fully implemented; 31.30% of the interventions were accepted and partially implemented. The clinical pharmacist identification and proposed intervention for DRPs contributed to a statistically significant improvement in QoL, from mean ± SD scored 58.64 ± 9.10 at the baseline to 74.48 ± 10.11 at the endpoint, with a p-value of < 0.001. A significant improvement in the QoL and laboratory parameters for patients with CKD following clinical pharmacist-led interventions having proposed interventions were implemented successfully from baseline to endpoint; however, a considerable number of proposed interventions were not accepted and implemented.

Updated results of the PATH study: Adjuvant therapy with donafenib plus a PD-1 inhibitor for patients with hepatocellular carcinoma at high risk of recurrence after resection.

571 Background: There is no universally accepted standard treatment option or strategy for post-surgery adjuvant therapy in hepatocellular carcinoma (HCC). Among BCLC A/B patients (pts) with MVI, adjuvant transarterial chemoembolization has been reported to provide a 1-year recurrence-free survival (RFS) rate of around 60-70%. We conducted a pilot study to explore the utility of donafenib combined with a PD-1 inhibitor as adjuvant therapy for pts at high risk of recurrence. Herein, we present the updated results with a median follow-up of 11.6 months. Methods: It was planned to enroll 30 HCC pts who had undergone radical surgery and presented with at least one of the following risk factors: a) Presence of microvascular invasion (MVI); b) Presence of satellite nodule(s); c) More than three tumor nodules; d) Portal vein tumor thrombus. Pts with invasion of the main portal venous system were excluded. Donafenib combined with a PD-1 inhibitor (i.e., toripalimab) was initiated at 4 to 8 weeks post-resection and was to be continued for up to six months, unless recurrence occurred or there was an intolerable adverse reaction. No other adjuvant therapies were permitted before enrollment and during the study, except for anti-virus treatment. The primary endpoint was the cumulative 1-year RFS rate. The secondary endpoints included overall survival, quality of life (QoL) measured with the FACT- Hepatobiliary questionnaire, and safety. Results: From June 2020 to November 2023, a total of 30 pts were recruited. 27 pts were included in the efficacy analysis. The median time from surgery to enrollment was 1.4 months. MVI was the most common risk factor (n=25, 92.6%). The majority of the pts had only one risk factor (n=23, 85.2%). As of the data cutoff on August 13, 2024, relapse had occurred in four pts and the median RFS was not reached. The 1-year RFS rate was 81.6% (90% CI, 67.8%-95.4%) in all evaluable pts. QoL showed a mild increase from baseline while on adjuvant therapy. No deaths were observed. In the 30 pts who had received at least one dose, the incidence of any grade and grade 3 treatment-related adverse events (TRAEs) were 90.0% (27/30) and 40.0% (12/30), respectively. No grade 4 or 5 TRAEs were reported. The grade 3 TRAEs occurring in at least two pts were palmar-plantar erythrodysesthesia syndrome (13.3%), rash (13.3%), increased alanine aminotransferase (10.0%), and increased aspartate aminotransferase (6.7%). Conclusions: The study's duration exceeded expectations due to slow recruitment. Nonetheless, it showed a promising outcome with a regimen of 6 months of adjuvant therapy with donafenib plus toripalimab in BCLC A/B pts at high risk of recurrence. An improvement in QoL was observed among patients during the adjuvant therapy. No new safety issues were identified. Clinical trial information: NCT04418401 .

Study of quality of life in patients treated with autologous serum eye drops

Dry eye syndrome is a multifactorial disease with a complex pathophysiology. The associated morbidity is a worldwide public health problem. The development of autologous serum-based eye drops is an interesting treatment but presents some constraints. This is a retrospective, observational, single-center study of 43 patients (73 eyes) treated with autologous serum-based eye drops for dry eye syndrome at the University Hospital of Caen between 2014 and 2023. The patients' subjective symptoms, as well as the various modalities of evaluation of their daily quality of life were collected using questionnaires inspired by the OSDI questionnaire. The other elements used in this study were reported from the patients' medical files. We observed a mean improvement in quality of life of 44% in the treated subjects. Quality of life correlates with the improvement in the subject's quality of life score and overall health (P<0.01) but, nevertheless, depends on the severity of the initial clinical damage and the presence or absence of a corneal ulcer (P=0.013). We also found a reduction in the number of daily drops (65.4%) and an improvement in daily activities (85.1%). This study's results are consistent with previous work reporting the efficacy of autologous serum on the quality of life of treated patients. Consideration of the patient as a whole, integrating quality of life assessment with clinical examination, is essential when dealing with dry eye and its innovative therapeutics.

A Systematic Review of Sleep Disturbance in Idiopathic Intracranial Hypertension.

Sleep disturbances, particularly obstructive sleep apnea (OSA), may have a significant impact on the outcomes of patients with idiopathic intracranial hypertension (IIH). We conducted a PRISMA-compliant systematic literature review to study sleep disturbance in adult patients with IIH. The current literature on the relationship between IIH and sleep is quite limited. Research has found that sleep disturbances are associated with lower quality of life and may worsen several symptoms associated with IIH, such as headache, cognitive deficits, and neuropsychiatric issues. OSA was more prevalent in patients with IIH than in healthy controls. Several studies found that OSA was associated with worse IIH symptoms and treatment of OSA helped improve these parameters. Limitations included available literature and heterogeneity in sleep metrics and OSA diagnostic criteria between studies. Overall, further study of sleep disturbances in patients with IIH may encourage earlier screening, improved treatment options, and long-term improvements in quality of life.

A Systematic Review of Community-Based Exercise Interventions for Adults with Intellectual Disabilities

Background: Adults with intellectual disabilities are a particularly inactive sub-population who experience disproportionally poorer health and social exclusion when compared with the wider general population. This systematic review aimed to identify whether community-based exercise interventions were theoretically underpinned, whether they had an active single- or multi-exercise component, and how the interventions were objectively and/or subjectively measured, as well as deducing if they improved the health of this population. Method: A systematic search of five databases was conducted up to May 2024. The study was registered in PROSPERO and followed PRISMA reporting guidelines. Study methodological quality was appraised using the Critical Appraisal Skills Programme. Risk of bias was determined using the Cochrane collaboration tools ROB 2 and ROB 2 CRT. Articles were eligible for inclusion if they recruited adults with intellectual disability, were community-based, had an active exercise component and measured physical activity (PA) levels as an outcome measure. Results: In total, 9034 records were identified, with five studies meeting the eligibility criteria. All studies used a feasibility RCT or RCT methodology and all focused on weight loss or PA levels as the primary outcome measure. Two studies focused on walking as a single exercise, two combined walking with nutrition/weight loss, and one combined walking with aerobics. One multi-component walking and aerobics intervention led to statistically significant improvements in PA. Multi-component community-based exercise interventions led to statistically significant improvements in body composition measures. No studies showed statistically significant improvements in quality of life. Risk of bias was rated moderate to high across all included studies. Conclusions: Caution should be taken in drawing firm conclusions due to the small number of included studies, small sample sizes and high risk of bias. Multi-component community-based interventions are more effective at improving PA levels in adults with intellectual disabilities than walking-only studies. Future studies should be theoretically underpinned and explore the use of peer and student models of social support. The use of fitness facilities such as leisure centres and gyms requires further exploration in this population.

Exploring Advances in Natural Plant Molecules for Allergic Rhinitis Immunomodulation in Vivo and in Vitro.

Allergic rhinitis (AR) is a prevalent allergic disease that imposes significant economic burdens and life pressures on individuals, families, and society, particularly in the context of accelerating globalization and increasing pathogenic factors. Current clinical therapies for AR include antihistamines, glucocorticoids administered via various routes, leukotriene receptor antagonists, immunotherapy, and several decongestants. These treatments have demonstrated efficacy in alleviating clinical symptoms and pathological states. However, with the growing awareness of AR and rising expectations for improvements in quality of life, these treatments have become associated with a higher incidence of side effects and an elevated risk of drug resistance. Furthermore, the development of AR is intricately associated with dysregulation of the immune system, yet the underlying pathogenetic mechanisms remain incompletely understood. In contrast, widely available natural plant molecules offer multiple targeting pathways that uniquely modify the typical pathophysiology of AR through immunomodulatory processes. This review presents a comprehensive analysis of both in vivo and in vitro studies on natural plant molecules that modulate immunity for treating AR. Additionally, we examine their specific mechanisms of action in animal models to provide new insights for developing safe and effective targeted therapies while guiding experimental and clinical applications against AR.

An Occupational Therapy-Based Self-Management Program for People with Schizophrenia: A One-Year Follow-up Study

This study investigated the effectiveness of an occupational therapy-based self-management program (OT-SMP) on the knowledge, insight, medication adherence, clinical symptoms, functioning, and quality of life (QOL) of people with schizophrenia. Forty-eight clients attended OT-SMP, including psychoeducation and individualized sessions once a week for 12 weeks, in addition to routine treatment. After OT-SMP, there were significant improvements in knowledge, insight awareness, medication adherence, clinical symptoms, functioning, and QOL. Furthermore, both the 6-month and 12-month follow-ups maintained these achievements. Study findings demonstrate the importance of implementing person-tailored and goal-oriented structured interventions by occupational therapists to support people with illness management problems.

STANDARDIZED ADAPTED CARDIAC REHABILITATION AT AN INPATIENT REHABILITATION FACILITY

https://youtu.be/hXlMMThneUU INTRODUCTION Inpatient rehabilitation facilities (IRFs) serve as an interim level of care for many patients with cardiac dysfunction but are not included among the three phases of cardiac rehabilitation (CR). The education on modifiable risk factors, cardiovascular exercise, and flexibility training given to patients with cardiac diseases are delivered in the acute hospital (phase I) and the outpatient setting (phase II). Our hypothesis was that adapting phase II components to this interim setting would improve outcomes and bridge the gap between phases. In this study, the feasibility of a standardized adapted CR protocol for IRFs and effect on functional outcomes was assessed. METHODS This prospective cohort study screened 60 patients over a 6-month period. Patients with primary cardiac diagnoses were screened for inclusion. Both surgical and non-surgical candidates were included. Exclusion criteria were based on the phase II CR criteria of the American College of Sports Medicine (ACSM). Patients received continuous ECG monitoring and physician clearance prior to participation. The standardized adapted CR protocol included individual prescription for cardiopulmonary endurance exercise consistent with ACSM Phase II CR guidelines, flexibility training, and education on modifiable risk factors. Standardized outcome measures included the 6-minute walk test, Borg rating of perceived exertion scale (6-20), EQ-5D-5L quality of life measure, and Section GG (mobility) scores of the Centers for Medicare &amp; Medicaid Services Inpatient Rehabilitation Facility Patient Assessment Instrument. A one-month follow-up evaluated attendance to phase II CR, and quality of life (including maintenance of functional gains). Physical therapy staff were surveyed to identify limitations. RESULTS Forty-one patients were deemed eligible to participate. Thirty-two patients participated in at least one endurance session with an average of 3 (+ 1) 20-minute sessions completed. Borg scores (14 + 1) reached the recommended range (somewhat hard to hard) during sessions. Participants demonstrated a statistically significant improvement in their GG mobility scores. Sixty-nine percent reached the 6-minute walk minimal clinically important difference (MCID), and 59% met the quality-of-life MCID, despite their short length of stay in the IRF setting (11 + 4 days). Survey results indicated short length of stay, the need to address functional goals over exercise, inability to tolerate 20 minutes of cumulative aerobic exercise, and compliance of protocol amongst therapists were limiting factors to endurance protocol adherence. CONCLUSIONS A standardized adapted CR protocol was feasible within an IRF setting, providing targeted education, increased awareness of phase II CR options, and clear and specific guidelines for creation of individualized exercise programs. Patients demonstrated improvements in functional mobility, cardiovascular endurance, and quality of life.

Multi-Institutional Comparison of Quality of Life Between Open Versus Endoscopic Skull Base Approaches.

The primary objective of this prospective review was to compare quality of life between patients undergoing endoscopic and open skull base approaches. Prospective Review. Five centers recruited consecutive patients treated surgically for skull base neoplasms between 2012 to 2018. The Skull Base Inventory (SBI), Anterior Skull Base (ASB), and Sinonasal Outcome Test (SNOT-22) were administered up to 12 months post-operatively. Mean change from baseline scores were compared with univariable and multivariable analyses. A total of 180 patients were included: 108 (60%) F and 72 (40%) M, of whom 126 (70%) underwent endoscopic and 54 (30%) underwent open approaches. Patients undergoing endoscopic approaches were more likely to have sellar or clival pathology (68 vs. 15%, p < 0.001). Those undergoing endoscopic approaches had better disease-specific quality of life at one year using the SBI and ASB (mean change from baseline = 7.2 vs. 0.69, p = 0.004; 5.8 vs. -1.1, p = 0.002), respectively. On multivariable analysis, endoscopic approach was associated with greater improvement in overall quality of life (mean difference in change scores from baseline = 6.5, p = 0.009), as well as endocrine (mean difference = 8.3, p = 0.011), neurologic (mean difference = 8.3, p = 0.012), visual (mean difference = 7.9; p = 0.032), financial (mean difference = 9.7, p = 0.03), and spiritual domain scores (mean difference = 4.0, p = 0.035). Subgroup analyses of pituitary and non-pituitary histopathologies demonstrated trends towards greater quality of life at 1-year compared to baseline in the endoscopic approach compared to the open group. Endoscopic approaches are associated with better quality of life compared to open approaches. However, baseline differences in histopathology between the group limit the direct comparison of the open and endoscopic approaches. Future studies with larger and more homogenous samples are required. Level IV evidence.

Abstract 22: Implementation of increased physical therapy intensity for improving walking across inpatient stroke rehabilitation units: Primary results of the Walk ‘n Watch multi-site stepped-wedge cluster randomized controlled trial

Introduction: Though clinical practice guidelines support high repetitions of walking after stroke, practice is slow to change with low levels of walking activity in stroke rehabilitation units. We undertook an implementation trial to change practice; we enabled entire stroke units to use the Walk ‘n Watch protocol and determined the effect of implementation on the 6 Minute Walk Test (6MWT) at hospital discharge. Methods: This 12-site clinical trial across 7 Canadian provinces used a stepped-wedge cluster design to randomize when each site switched from Usual Care to the Walk ‘n Watch protocol. At the start of the Walk ‘n Watch phase, we trained all front-line physical therapists on the unit with training workshops, manuals, hands-on practice, and videos. Each site was provided onboarding materials to address staff changes so therapists who did not attend the initial training could adopt the protocol. Each site also identified a ‘protocol champion’ to facilitate initial weekly huddles with therapists to discuss barriers to implementation. Therapists were trained to complete safety screening and to determine eligibility. The Walk ‘n Watch protocol focused on completing a minimum of 30-minutes of daily weight-bearing, walking-related activities that progressively increased in intensity informed by activity trackers measuring heart rate and step number. Blinded assessors completed the outcomes at baseline and 4-weeks later (near discharge). Primary analysis used a linear mixed-effects model adjusted for stratum, date of enrollment, age, sex and baseline 6MWT. Results: The total number of participants was 306 (162 Usual Care, 144 Walk ‘n Watch, 188 males/118 females) with a mean(SD) age of 68(13), 29(17) days since stroke, and a baseline 6MWT of 152(106) m. The improvement on the 6MWT was 43.6m (95%CI 12.7, 76.1) greater in the Walk ‘n Watch group compared to the Usual Care group. Further, the Walk ‘n Watch group improved quality of life (EQ5D), balance and mobility (Short Physical Performance Battery) and gait speed. Conclusions: The implementation trial design enabled the protocol to be tested under real-world conditions, involving all therapists on each unit to deliver the protocol. The trial had a deliberate aim to facilitate changes in practice that resulted in clinically meaningful improvements in walking and quality of life.

USO DE OMALIZUMABE NO TRATAMENTO DE ASMA: REVISÃO DE LITERATURA

Abstract To describe the effectiveness of using omalizumab in asthma, evaluating the quality of life of patients using this biological therapy. This work's methodological approach was a compilation of bibliographic and descriptive research through a literature review in the Virtual Health Library (VHL) and PubMed databases. The descriptors “asthma” and “omalizumab” were used. Furthermore, the criteria used were controlled clinical trial articles, from 2018 to 2023 and published in English, excluding articles that deviated from the topic covered. Omalizumab aims in these studies to show an improvement in the quality of life in asthmatic patients and its benefits in asthmatics not controlled with conventional therapy, assessed through the reduction in exacerbations and improvement in lung function. Therefore, through the analysis of the articles used as a basis for this literature review, using omalizumab in asthmatic patients, especially critical cases, can result in a considerable improvement in quality of life and significantly reduce the risk of mortality from this pathology. Key words: omalizumab, asthma.

The effect of muscle energy technique on pain, kinesiophobia, and quality of life in patients with COPD with chronic pain

Patients with Chronic Obstructive Pulmonary Disease (COPD) experience pain both as a symptom and comorbid condition. This study aimed to investigate the effect of the Muscle Energy Technique (MET) on pain, kinesiophobia, and quality of life in patients with chronic pain and COPD. 52 patients with moderate COPD and pain complaints were included in this randomized controlled trial and longitudinal study and were divided into two groups. The intervention group received MET 3 times a week for 4 weeks, while the control group was given a home exercise program. Both groups participated in a home-based exercise program. Pain, fear of movement, and health-related quality of life were assessed at baseline, the end of the 4-week intervention, and at the 6-week follow-up. Significant improvements were observed in both groups; however, the intervention group showed more pronounced reductions in pain and kinesiophobia as well as improvements in quality of life (p < 0.05), and the effectiveness decreased over time. This study highlights the potential benefits of MET for pain, kinesiophobia, and quality of life in patients with chronic pain and COPD. Therefore, MET interventions should be considered in the treatment of chronic pain in patients with COPD.Trial registration: NCT04874571.

Long-term safety and sustained efficacy of bimekizumab in patients with ankylosing spondylitis (radiographic axial spondyloarthritis): 5-year results from BE AGILE (phase 2b) and its open-label extension

ObjectiveAssess long-term safety, tolerability and efficacy of bimekizumab in ankylosing spondylitis (radiographic axial spondyloarthritis (r-axSpA)).MethodsPatients with active r-axSpA completing the dose-ranging 48-week randomised controlled trial could enrol in the open-label...

Patient-Reported Quality of Life Outcomes with Mandibular Advancement versus CPAP: Insights from the CRESCENT Trial.

We compared mandibular advancement device (MAD) versus CPAP on quality-of-life (QoL) in a prespecified analysis of the CRESCENT trial. 220 participants over age 40 with OSA, hypertension, and increased cardiovascular risk from three public hospitals were randomly assigned to MAD or CPAP (1:1). Multi-dimensional QoL questionnaires were administered at baseline, 6 months, and 12 months. Three sleep-related QoL questionnaires: Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), and Sleep Apnea Quality of Life Index (SAQLI). Two generic QoL questionnaires: EuroQoL 5-D (EQ-5D) and Short Form 36 Health Survey (SF36). MAD adherence was 5.5 (3.9-6.9) hours at 6 months and 5.0 (3.3-6.1) hours at 12 months. CPAP adherence was 4.9 (3.3-6.1) hours at 6 months and 4.8 (3.3-5.7) hours at 12 months. Both groups showed improvements in sleep-related QoL. ESS improved at 6 and 12 months (p<0.001), with a between-group difference favoring CPAP at 6 months (Δ 1.45 [0.44 to 2.46], p=0.005). FOSQ improved at 6 and 12 months (p<0.001), with a between-group difference favoring CPAP at 12 months (Δ -0.91 [-1.77 to -0.05], p=0.038). SAQLI improved at 6 and 12 months (p<0.001) without between-group difference. For generic QoL questionnaires, SF-36 improved in most domains at 6 and 12 months, with Social Functioning section favoring CPAP at 12 months (p=0.013). EQ-5D improved at 12 months, with a trend favoring CPAP (p=0.053). MAD and CPAP effectively improved sleep-related QoL and some aspects of generic QoL. CPAP improved sleep-related QoL to a greater extent than MAD.