Nottingham Health Profile Research Articles

A comparison of different psychosocial questionnaires in patients with myocardial infarction

In a consecutive study of 140 patients investigated one month after myocardial infarction (MI), a battery of American and English questionnaires was used to measure depression, anxiety, sleep problems, health locus of control and perceived health. These measures were compared with a well-documented generic questionnaire, the Nottingham Health Profile (NHP), and a similarly well-documented mood scale, the Mood Adjective Check List (MACL). There was close agreement among all measures depicting anxiety and tension. The concordance between the measures of anxiety states and depression was lower. Depression and sleep problems seem to constitute separate concepts, since they are not as highly related to the other measures of anxiety. Because psychosocial factors are important measures for the outcome after an infarction, accurate assessments of these variables are required. Further research is clearly warranted to clarify the complicated interaction between psychosocial constructs and to improve the methods used for their evaluation.

The effect of balneotherapy on body mass index, adipokine levels, sleep disturbances, and quality of life of women with morbid obesity.

To investigate the effect of balneotherapy on body mass index, adipokine levels, sleep disturbances, and quality of life in women with morbid obesity. Fifty-four women with morbid obesity were included in the study. The body mass indexes (BMI) and waist/hip ratios (WHR) of the women were calculated. Subcutaneous fat thickness was measured using a *skinfold meter, and the percentage of adipose tissue was calculated. The *Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and the Nottingham Health Profile (NHP) was used to assess quality of life. In addition to routine biochemical tests, leptin, adipokine, visfatin from blood, and cortisol from saliva samples were studied. Participants were given 15 sessions of balneotherapy for 20 min each. After treatment, the laboratory and clinical parameters of the participants were *reevaluated. There was no statistically significant difference of BMI, WHR, and percentage of adipose tissue between before and after treatment measurements (p ˃ 0.05).There was a statistically significant improvement in PSQI and NSP scores (p ˂ 0.001). The levels of blood glucose, leptin, and visfatin were significantly decreased, and adiponectin was significantly increased after treatment (p = 0.047, p ˂ 0.001, p ˂ 0.001, and p ˂ 0.001, respectively).There was no statistically significant changes in salivary cortisol levels (p = 0.848). Patients with diabetes showed a statistically significant decrease in glucose levels after treatment (p = 0.017).There was a statistically significant decrease in low-density lipoprotein cholesterol levels in patients with dyslipidemia compared with pre-treatment (p = 0.018). Balneotherapy improves sleep and quality of life of women with morbid obesity. After balneotherapy, glucose, leptin, adiponectin, and visfatin levels may change positively.

Comparison of Spinal Sagittal Curvatures, Functional Status and Quality of Life of Medical Secretaries with or without Upper or Low Back Pain

Amaç: Tıbbi sekreterlerde sırt ve/veya bel ağrısı sık görülmektedir. Bu çalışmanın amacı, sırt veya bel ağrısı olan sekreterler ile olmayan sekreterlerin omurga eğriliği, omurga hareketliliği, disabilite ve yaşam kalitesi düzeylerini karşılaştırmaktır. Materyal ve Metod: Çalışmaya aynı hastanede çalışan 111 tıbbi sekreter dahil edildi. Tıbbi sekreterler sırt ağrısı olan ve olmayan olarak iki gruba; bel ağrısı olan ve olmayan olarak diğer iki gruba ayrıldılar. Omurganın sagittal düzlemdeki şekli ve hareketliliği “Spinal Mouse™” isimli non-invaziv bir alet kullanılarak ölçüldü. Ölçümler ayakta dururken ve oturma pozisyonunda ayrı ayrı tekrarlandı. Ağrı şiddeti Vizüel Analog Skala (VAS) ile; fonksiyonel durum Oswestry Disabilite Ölçeği (ODÖ) ile; yaşam kalitesi ise Notthigham Sağlık Profili (NSP) kullanılarak değerlendirildi. Bulgular: Çalışmaya dahil edilen tıbbi sekreterlerin (75 kadın/36 erkek) yaş ortalaması 30.73±5.74 yıl idi. Sırt ağrısı olan 51 sekreterin VAS ortalaması 5.47±2.67; bel ağrısı olan 63 sekreterin VAS ortalaması 5.52±2.66 idi. Sırt ağrısı olan sekreterlerin oturur pozisyonda ve ayakta iken ölçülen torakal kifoz açısı, sırt ağrısı olmayan sekreterlere göre daha yüksekti (p˂0.032, p˂0.001). Her iki grup arasında oturur pozisyonda ve ayakta iken ölçülen torakal vertebra hareketliliği açısından anlamlı fark yoktu. İki grup arasında NSP-total, NSP-enerji, NSP-ağrı, NSP-duygusal reaksiyonlar ve NSP-fiziksel hareketlilik alt grupları arasında anlamlı fark vardı (p˂0.001, p=0.001, p˂0.001, p=0.001, p=0.001). Bel ağrısı olan sekreterlerin ayakta duruşta ölçülen lomber lordoz açısı, bel ağrısı olmayanlara göre daha düşüktü (p˂0.001). Her iki grup arasında oturur pozisyonda iken ölçülen lomber lordoz açısı ile oturur pozisyonda ve ayakta iken ölçülen lomber vertebra hareketliliği açısından anlamlı fark yoktu. İki grup arasında ODÖ, NSP-total, NSP-enerji, NSP-ağrı ve NSP-fiziksel hareketlilik alt grupları arasında anlamlı fark vardı (p˂0.001, p=0.025, p=0.042, p=0.039, p=0.019). Sonuç: Spinal Mouse™ kullanılarak yapılan ölçümlerde omurga hareketliliğinde fark olmamasına rağmen; sırt ağrısı olan sekretelerde torakal omurgada kifoz artışı, bel ağrısı olanlarda da lomber omurgada lordoz azalması olduğu görülmüştür. Sırt ve bel ağrısının varlığı fonksiyonel durumu ve yaşam kalitesini olumsuz etkilemektedir.

The assessment of pain, flexibility and daily activity level in the patients who had facet tropism

<p class="abstract"><strong>Background:</strong> The aim of this study to investigate the relationship between asymmetric angular value in lumbar facet joints and pain, flexibility and daily activity level.</p><p class="abstract"><strong>Methods:</strong> The study included 51 patients with complaint of low back pain (LBP) and underwent lumbar magnetic resonance imaging. Facet joint angle measurements of L4-L5 and L5-S1 were measured. Visual analogue scale (VAS) was used for severity of pain. Joint range of motions (ROM) was measured via goniometry. Body extensibility measurements were performed via body hyperextension test. The Nottingham health profile scale was used to assess daily activity level of individuals. </p><p class="abstract"><strong>Results:</strong> The VAS values of patients with tropism were significantly higher (p=0.016). There wasn’t significance difference in ROM and flexibility (p=0.784). In patient group with facet tropism, there was limit of lateral flexion towards the side where the facet joint angle was larger than the control group (p=0.002). There was no significant difference between daily activity levels of both groups (p=0.755).</p><p class="abstract"><strong>Conclusions:</strong> Pain severity of facet tropism patients is higher. Patients with facet tropism had lateral flexion restriction. In the light of these findings, when the lateral flexion limitation is detected in individuals with complaints of pain without discopathy, it’s necessary to make MR measurements in differential diagnosis by considering facet joint tropism, and to plan physiotherapy and rehabilitation programs. As a result, tropism should be questioned in patients suffering from LBP and limited lateral flexion. There is need for studies in which different evaluation and treatment methods are applied for tropism.</p><p class="abstract"> </p>

Polikliniğe Başvuran Hastaların Sağlık Hizmet Algısına Yaşam Kalitesi Ve Sosyodemografik Özelliklerinin Etkisi

Aim: To determine the effect of quality of life and sociodemographic characteristics of patients admitted to the outpatient clinic of a Physical Therapy and Rehabilitation Hospital on Health Service Perceptions. Methods: This cross-sectional study was conducted on a total of 367 patients (236 female, 131 male) who met the criteria of participation in the study and applied to the policlinic at a Physical Therapy and Rehabilitation Hospital between June 15 and September 15, 2019. Data were collected using a structured form measuring the socio-demographic characteristics and satisfaction levels of the patient and Nottingham Health Profile Scale (NHP) to measure the general perceived quality of life of the patient. Results: A statistically significant correlation was found between age values and total satisfaction mean scores (r = 0.215 p = 0.0001). Total satisfaction average scores of the literate group were found to be significantly higher than the other groups (p = 0.032, p = 0.005).The total satisfaction mean scores of the Hospital Advise (+) group were found to be statistically higher than the Hospital Advise (-) group (p = 0.0001). There was a statistically significant correlation between NHP Pain average scores and total satisfaction mean scores (p = 0.001). Conclusion: Health service perception may be affected by many different factors in patient-hospital communication. Age, education, hospital referral status and presence of pain are important parameters that we defined in our study. In the development of the health service provided, it will be guided to examine and define all factors in detail.

Validity and Reliability of the Turkish Version of the London Chest Activity of Daily Living Scale in Obstructive Lung Diseases.

The London Chest Activity of Daily Living Scale (LCADL) is a simple, useful, and comprehensive measure of dyspnea perception in activities of daily living. This study was conducted to determine the validity and reliability of the Turkish version of the LCADL. A total of 64 patients with obstructive lung disease (24 chronic obstructive pulmonary disease, 20 asthma, and 20 bronchiectasis patients) were included. The Turkish LCADL was evaluated for interobserver reliability, test-retest reliability, and criterion validity. Two different observers applied the scale with an interval of 10 minutes to assess interobserver reliability. The second observer applied the scale twice at an interval of 10-15 days to assess test-retest reliability. Criterion validity was assessed using the 6-minute walk test (6MWT), Nottingham Health Profile (NHP), and Saint George Respiratory Questionnaire (SGRQ). The interobserver reliability of the scale was very high (rs=0.985, p<0.050). Cronbach's alpha coefficient for total score was 0.976 and intraclass correlation coefficient was 0.953. These results indicate that the Turkish LCADL has high reliability. The correlation between LCADL and 6MWT was moderate 0.503 (p=0.002). The LCADL total score was weakly correlated with NHP total score (rs=0.370, p=0.040) and SGRQ total score (rs=0.367, p=0.004). The Turkish version of the LCADL scale is reliable and valid in obstructive lung disease. The LCADL scale will be beneficial in existing pulmonary rehabilitation programs aiming to improve functional status. We believe that using the Turkish LCADL scale as an outcome measure in pulmonary rehabilitation programs will serve as an indicator of rehabilitation efficacy for individual patients.

Type D Personality is Associated With Disease Severity and Poor Quality of Life in Turkish Patients With Fibromyalgia Syndrome: A Cross-Sectional Study.

This study aims to investigate the rate of type D personality in Turkish patients with fibromyalgia (FM) and evaluate its associations with clinical parameters of FM as well as its effects on health-related quality of life (HRQoL). The study included 100 patients with FM (14 males, 86 females; mean age 34.6±7.4 years; range, 22 to 49 years) fulfilling 1990 American College of Rheumatology diagnostic criteria and 50 healthy controls (9 males, 41 females; mean age 32.6±6.5 years; range, 21 to 50 years). Type D personality was assessed using the type D scale-14 (DS-14). FM disease severity was determined by Fibromyalgia Impact Questionnaire (FIQ), functional status by Stanford Health Assessment Questionnaire (HAQ), and HRQoL by Nottingham Health Profile (NHP). Severity of pain and fatigue were measured by visual analog scale (VAS). The frequency of type D personality was 33% in FM patients and 12% in controls (odds ratio=3.612, 95% confidence interval 1.398-9.333) (p=0.006). Type D FM patients scored higher in tender point count (TPC), FIQ, HAQ, VAS-pain and all NHP subgroups except energy (p<0.01). Type D personality was found to be correlated with FIQ, TPC, HAQ, VAS-pain and NHP subgroups except energy (p<0.01). Based on our findings, assessment of personality characteristics of patients with FM may hold the key for the treatment of the disease. Besides, a better understanding of personality-related pain in FM patients may provide a more targeted approach to pain treatment.

Health-related quality of life after heart surgery – Identification of high-risk patients: A cohort study

This cohort study evaluated factors, which have been shown to be relevant for Health-Related Quality of Live (HRQL) after cardiac surgery and investigated the combinatory impact on HRQL. Additionally, the aim was to introduce a first attempt to developing a risk estimation model which could identify patients at risk for impaired HRQL. For this single-centre cohort study, 6099 cardiac surgical patients (60% isolated coronary bypass surgery) filled in the Nottingham Health Profile (NHP) for the evaluation of HRQL six months after surgery and provided information regarding their medical and socio-demographic status. For the NHP scores the deviation to the matched normative data of a healthy sample was calculated. A robust linear regression examined factors that influence HRQL. As a next step, based on the regression model, a risk estimation model was developed which is a first attempt to classify patients into risk categories. Male gender, age below 60 or between 60 and 74 years, living alone, no occupation, bypass surgery, NYHA status II, III or IV and chest pain were identified as risk factors to determine impaired HRQL. The model explains 29.13% of the variance. Based on the risk estimation model 27.4% were classified as medium or high risk. For the first time a multilevel method was applied to evaluate HRQL after heart surgery showing that socio-demographic variables are important co-factors to dyspnea and chest pain. We take a first attempt in developing a new approach that should encourage further research in this field to frame a screening tool that may help identifying patients at risk in the future.

Health-related quality of life after vascular surgery and endovascular treatment in subjects with critical limb ischemia.

Background & Objective:Revascularization of the target vessel and restoration of distal flow is critical not only to reduce mortality and morbidity but also improve health-related quality of life (HRQoL) in patients with critical limb ischemia. However, data concerning the impact of surgical bypass and percutaneous transluminal angioplasty (PTA) on HRQoL is limited. This study aimed to compare the impact of surgical bypass and PTA on HRQoL in subjects undergoing superficial femoral artery (SFA) or popliteal artery revascularization.Methods:Seventy-one subjects who underwent successful revascularization of the SFA or popliteal artery either with surgical revascularization or PTA were enrolled in this study. Three months after revascularization, all subjects underwent ankle-brachial index (ABI) measurement, 6-minute walking test and completed the Nottingham Health Profile (NHP) questionnaire. The NHP score differences (measured at the post-procedural 3rd month) between subjects undergoing surgical or endovascular (PTA) revascularization subjects was the primary outcome measure of the study.Results:Both groups experienced significant improvements in ABI and 6-minute walking distance at post-procedure three months. NHP total scores of Part I and Part II at post-procedural six months were similar in the two groups. However, social isolation [77.98 (0 - 85) vs. 22.53 (0 - 100), p=0.002] and physical abilities [78.7 (30.31 - 87.7) vs. 54.47 (0 - 100), P=0.014] domain scores of the surgical revascularization group were significantly higher than that of the endovascular treatment group.Conclusion:This study shows that total scores obtained from the NHP questionnaire applied three months after revascularization of SFA stenosis are similar in subjects undergoing surgical revascularization or PTA. However, the social isolation and physical abilities domains of the NHP are significantly higher in subjects receiving surgical revascularization compared to those receiving PTA.

Clinical correlation and determination of Dkk-1 and sclerostin levels in patients with rheumatoid arthritis

The aim of this study is to compare serum Sclerostin and Dickkopf-1 (Dkk-1) levels in patients with rheumatoid artrithis (RA) and healty controls to determine their clinical significance in patients with RA. Sixty with RA according to American Collage of Rhematology criteria and at least one year follow up, enrolled in this study and compared thýrty healty controls. To evaluate disease activity score 28 (DAS28) was calculated. Physical function capasity (disability) was asssessed with Health Assesment Quastionnarie (HAQ) and Nottingham Health Profile (NHP). Erythrocyte Sedimentation Rate, C Reactive Protein, Rheumatoid Factor and anticyclic citrullinated peptide levels were determined by routine laboratory methods. Serum sclerostin and Dkk-1 levels of the patients with RA and healty controls were measured by ELISA. Radiographic assesment of hands joints was evaluated according to the modified Larsen score. Between patients with RA and healty controls, there was significant difference with respect to the age (respectively p=0.00) and significant difference with respect to gender (p=0.033). Serum sclerostin and dickkopf-1 levels were significantly higher (p=0.002, p=0.049) in patients with RA compared to healty controls. Serum sclerostin and dickkopf-1 levels were doesnt correlated with clinical and laboratory parameters of disease activity. There was no significant correlation between radiological scoring of joint damage and serum sclerostin and dickkopf-1levels (p 0.05). This study shows that Serum sclerostin and dickkopf-1 levels were increased in RA patients in comparison to control group but there was no significant correlation with the disease activity and joint damage. The sample of our study can be enlarged and further studies are required.

The effects of clinical pilates exercises on functional disability, pain, quality of life and lumbopelvic stabilization in pregnant women with low back pain: A randomized controlled study.

Although the Pilates method has been reported to be effective in women with low back pain (LBP), the efficacy of Pilates exercises in pregnant women with LBP has not been evaluated widely. The purpose of this study was to determine the effects of clinical Pilates exercises on lumbopelvic stabilization, pain, disability and quality of life in pregnant women with LBP. Fourty pregnant women were randomized into either a Pilates exercise group (n= 20) or control group (n= 20). Subjects in the Pilates exercise group performed the exercises two times a week for eight weeks. Subjects in the control group followed regular prenatal care. Lumbopelvic stabilization was assessed with a pressure biofeedback unit, pain with the Visual Analog Scale, disability with the Oswestry Low Back Pain Questionnaire and quality of life with the Nottingham Health Profile (NHP). Pain and disability were significantly improved in the Pilates exercise group after intervention (p= 0.03, p< 0.001, respectively). There were also significant improvements in sleep, physical mobility sub-parameters of NHP and lumbopelvic stabilization after Pilates exercises (p= 0.048, p= 0.007, respectively). However, there were no statistically significant changes in all outcome measures in the control group (p> 0.05). Pilates exercises can be recommended as an effective and safe method for increasing lumbopelvic stabilization, reducing pain and disability, improving physical mobility and sleep problems in pregnant women with LBP.

The validity and reliability of the Turkish version of the Seattle Angina Questionnaire.

The purpose of this study was to assess the validity and reliability of a Turkish version of the Seattle Angina Questionnaire (SAQ) in patients with coronary heart disease (CHD) and angina. The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant. Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale. The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.

International Development of the Alzheimer's Patient Partners Life Impact Questionnaire (APPLIQue).

Informal caregivers play a vital role in the care of people with Alzheimer's Disease (AD), yet caregiving is associated with caregivers' burden. The initial objective of the study was to develop a new outcome measure to assess quality of life (QoL) in AD caregivers. Informal (non-professional) caregivers providing 75% or more of the care activities for, and living in the same household as, a person with AD were invited to take part in the study. Qualitative interviews (N = 40) were conducted with AD caregivers in the UK and thematic analyses were applied to generate a pool of potential items. A draft questionnaire was produced and adapted for use in Italy, Spain, Germany and the US. In each of the 5 countries, cognitive debriefing interviews (N = 76) were conducted to determine the questionnaire's face and content validity, followed by a postal validation survey (N = 268). The data from these surveys were combined to reduce the number of items and assess the new questionnaire's psychometric properties. Thematic analysis of the UK interview transcripts generated a draft questionnaire, which was successfully translated into each additional language. The items were well accepted and easy to complete. However, reanalysis of the qualitative interview data revealed that spousal and non-spousal caregivers identified different experiences of caregiving. A review of the item pool indicated that items were primarily targeted at spousal caregivers. Therefore, further analyses of the postal survey data included spousal caregivers only (n = 116). The results supported scaling assumptions (e.g., corrected item-total correlations ≥0.32), targeting (e.g., floor/ceiling effects <2.5%), internal consistency (α ≥0.93) and test-retest reliability (rs = 0.88) of the new questionnaire, according to classical test theory. Assessment of external construct validity yielded results in accordance with a priori expectations. QoL scores were most strongly related to scores on the emotional reactions sections of the Nottingham Health Profile and the General Well-Being Index. The new questionnaire was found to be capable of detecting meaningful differences between respondents; spousal caregivers had worse QoL when the person with AD was confused (p < .001), could not be left alone (p < .001), did not recognize the caregiver (p < .001), was incontinent (p < .05), and wandered around the house (p = .01). The Alzheimer's Disease Patient Partners Life Impact Questionnaire (APPLIQue) is a questionnaire specific to spousal caregivers of people with AD. Data support its scaling assumptions and it exhibits excellent psychometric properties according to classical test theory. The questionnaire is recommended for use in intervention studies where the QoL of spousal caregivers is of interest.

Quality of life of older adults admitted to a Medical Clinic Unit of a Public Hospital in Brazil.

To evaluate the quality of life of older adults admitted to the Medical Clinic Unit of a public hospital in Belo Horizonte, Brazil, to correlate the quality of life with the functionality proposed by the Katz index, and to characterize the clinical and epidemiological profile of the studied population. This is a descriptive cross-sectional study with a quantitative approach. Data collection was performed through applying the Nottingham Health Profile instrument and the Katz Index instrument. 116 older adults participated. The quality of life found in the study was considered good. It correlated with the Katz index (the more dependent, the worse the quality of life), the number of comorbidities (the higher the number of comorbidities, the worse the quality of life) and the family structure who lived with the older adults (there was worse quality of life for older adults who lived with their children). In this study it was found that the quality of life in the evaluated sample was good and that it is related to functionality, the number of comorbidities and with whom the older adult lives. Thus, poor quality of life cannot be associated with hospitalization in this sample.

Reliability and Validity of the Turkish Version of the ABILHAND Questionnaire in Rheumatoid Arthritis Individuals, Based on Rasch Analysis.

This study aims to assess the reliability and validity of the Turkish version of the ABILHAND questionnaire in individuals with rheumatoid arthritis (RA) [ABILHAND-RA (TR)] using the Rasch analysis. A total 90 individuals (15 males, 75 females; mean age 51.8±10.9 years; range, 20 to 65 years) diagnosed as RA according to the criteria of the American College of Rheumatology were included. The ABILHAND-RA (TR) was used to determine manual ability, while disease activity was evaluated by the use of Disease Activity Score 28 (DAS28). Jamar hand dynamometer and pinch-meter were used to examine grip and pinch strength of the participants. Nine Hole Peg Test (NHPT) and Duruoz Hand Index (DHI) measured hand disability level. Nottingham Health Profile (NHP) was used to assess quality of life. ABILHAND-RA (TR) results were analyzed using the Rasch analysis method. Item 20 was excluded from the 27-item ABILHAND-RA (TR) as 96% of the individuals rated this item as "easy". The new set of 18 items (7 subtests and 11 items) were found to sustain item invariance and fit to the Rasch model. Significant relationships were found between ABILHAND-RA (TR) and DAS28, bilateral grip strength, NHPT dominant side results, DHI, and NHP. Turkish version of the ABILHAND-RA was found to be clinically valid, reliable, and sensitive enough to be used in clinical evaluations, rehabilitation interventions, and for progression follow-up in individuals with RA.

The comparison of efficacy of single intraarticular steroid injection versus the combination of genicular nerve block and intraarticular steroid injection in patients with knee osteoarthritis: a randomised study.

The aim of this study is to evaluate the efficacy of genicular nerve block (GNB) and intraarticular corticosteroid injection (IACSI) in patients with knee osteoarthritis (OA). Forty patients with Kellgren-Lawrence grade 2-4 knee OA were included for the study. Patients were divided into two groups randomly as IACS and IACS + GNB groups. All patients were evaluated with ultrasound for cartilage thickness, patellar tendon thickness, quadriceps tendon thickness and quadriceps muscle cross-sectional area (QMA). Pain intensity of the patients was evaluated with visual analogue scale and the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Functional status of the patients was evaluated with Western Ontario and Mc Master Universities Osteoarthritis Index. Quality of life of the patients was assessed with Nottingham Health Profile (NHP). All assessments were measured and compared at baseline, 1st month and 3rd month after treatment. All evaluation parameters were significantly improved in IACSI and IACSI + GNB groups. However, the improvement was better in IACSI + GNB group compared to those in IACSI group in terms of all evaluation parameters except QMA (0.10 ± 0.18 and 0.11 ± 0.22, respectively) and NHP scores in 1st month evaluation (- 3.11 ± 6.99 and - 3.54 ± 1.74, respectively). When combined with IACSI, GNB yields better analgesic effect and improves function in patients with knee OA compared to only IACSI.

Comparison of the effects of stabilization exercise plus kinesio taping and stabilization exercise alone on pain and well-being in fibromyalgia

PurposeTo compare the effects of spinal stabilization exercise (SSE) plus kinesio taping (KT) and SSE alone on pain and well-being in women with fibromyalgia (FM). Material and methodsPatients with FM were randomly allocated into SSE (n:19) and SSE + KT (n:17) groups. Pain and fatigue with Visual Analog Scale, health status with Fibromyalgia Impact Questionnaire, quality of life (QoL) with Nottingham Health Profile, depression with Beck Depression Inventory, sleep quality with Jenkins Sleep Scale were assessed. SSE and KT with fascial correction technique were carried out 2 days a week for 6 weeks. ResultsSSE + KT was more effective in decreasing pain and fatigue, and improving some parameters related to health status and the QoL compared to SSE alone (p < 0.05). After treatment, pain, depression, health status, QoL, and sleep quality improved in both groups (p < 0.05). ConclusionsSSE with KT was superior for improving pain and general well-being compared to SSE alone.

The bidirectional association between sleep problems and anxiety symptoms in adolescents: a TRAILS report

BackgroundPrevious studies have suggested a bidirectional association between sleep problems and anxiety symptoms in adolescents. These studies used methods that do not separate between-person effects from within-person effects, and therefore their conclusions may not pertain to within-person mutual influences of sleep and anxiety. We examined bidirectional associations between sleep problems and anxiety during adolescence and young adulthood while differentiating between person effects from within-person effects. MethodsData came from the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study including six waves of data spanning 15 years. Young adolescents (N = 2230, mean age at baseline 11.1 years) were followed every 2–3 years until young adulthood (mean age 25.6 years). Sleep problems and anxiety symptoms were measured by the Youth Self-Report, Adult Self-Report and Nottingham Health Profile. Temporal associations between sleep and anxiety were investigated using the random intercept cross-lagged panel model. ResultsAcross individuals, sleep problems were significantly associated with (β = 0.60, p < 0.001). At the within-person level, there were significant cross–sectional associations between sleep problems and anxiety symptoms at all waves (β = 0.12–0.34, p < 0.001). In addition, poor sleep predicted greater anxiety symptoms between the first and second, and between the third and fourth assessment wave. The reverse association was not statistically significant. ConclusionsWithin-person associations between sleep problems and anxiety are considerably weaker than between-person associations. Yet, our findings tentatively suggest that poor sleep, especially during early and mid-adolescence, may precede anxiety symptoms, and that anxiety might be prevented by alleviating sleep problems in young adolescents.

Acupuncture plus night splint for quality of life and disability in patients with carpal tunnel syndrome: a randomized controlled trial

BackgroundCarpal tunnel syndrome (CTS) is a common condition caused by pressure on a nerve in the wrist. This study aimed to evaluate the effects of acupuncture plus night splinting on quality of life, function and pain in patients with CTS. MethodsThis research is a prospective randomized, single-center trial. Acupuncture and night splinting was applied two times a week for five weeks, while the control group received night splinting only. Outcomes measured were Quality of life (Nottingham Health Profile, NHP), function (Boston Carpal Tunnel Questionnaire) and pain (visual analogue scale, VAS). ResultsAt the end of the treatment, the acupuncture plus splinting group showed more reduction in the pain level than the splinting group (p=0.007). The change in the pain subscale of the NHP was significantly reduced in the acupuncture plus night splinting group than the night splinting group (p=0.001). The change in sleep and physical activity subscale of the NHP score failed to show significant differences between the two groups. The functional scores also failed to show the signficant differences between the two groups. ConclusionThe effect of acupuncture plus night splinting may show significant reduction on pain but failed to show significant differences on the other outcomes compared to the night splinting group. Further studies with larger sample size may confirm the findings.

WHEN AND HOW I WANT: FEASIBILITY AND EFFECTS OF EMBEDDING PHYSICAL ACTIVITY INTO NURSING HOME CARE

Physical activity (PA) is essential to maintaining health into older age. However, older adults living in nursing homes (NHs) remain highly inactive. This study tested the feasibility of a PA programme embedded into NH care and its potential effects on older adults’ function and quality of life (QOL). A cluster-randomised controlled pilot feasibility study, including qualitative and economic components, was conducted. Intervention participants (n=18) performed Morning Movement (morning-time walking and sit-to-stand exercises) and Activity Bursts (bouts of activity throughout the day in standing), 3 times weekly for 12-weeks. Participants in the control NH (n=16) received usual care. At baseline and 12-weeks, feasibility and economic data were collected, function was measured using the Timed Up and Go (TUG) and 10-Metre Walk Test (10MWT) and QOL was measured with the Nottingham Health Profile (NHP) and Investigating Choice Experiments for the Preferences of Older People-CAPability (ICECAP-O). Semi-structured interviews were conducted with staff and participants at mid- and post-intervention and analysed thematically. The PA programme was acceptable to staff and participants and study procedures were feasible. Mean TUG improved by 10.2 (±21.6) seconds in the intervention group and was unchanged -0.2 (9.5) seconds in the control group (95% confidence interval of between-group difference in improvement -2.5 to 23.3 seconds). 10MWT scores stayed stable in the intervention group and disimproved in the control group. ICECAP-O and NHP scores were unchanged. While this study contained a small sample, it demonstrated a feasible, acceptable and potentially effective NH PA intervention and provides guidance for a definitive trial.