Activity Levels In Patients Research Articles

Comparison of Physical Activity Level and Functional Capacity in Patients with Type 2 Diabetes Mellitus and Healthy Controls.

Background: Physical activity improves glycemic control in T2DM. It may also influence functional capacity and thus improve quality of life. Despite evidence of exercise benefits, majority of people with type 2 diabetes are physically inactive and are less likely to meet the recommendations for physical activity. However, there is no readily available literature demonstrating the functional capacity in Indian subjects diagnosed with T2DM. Purpose: The aim of this study was to compare physical activity level and functional capacity in patients with Type 2 Diabetes Mellitus (T2DM) and healthy controls. Materials and Methods: In this study, 30 patients with T2DM and 30 age, gender and BMI matched healthy controls who met the inclusion criteria were recruited for the study after taking a written consent. The physical activity level was assessed using International Physical Activity Questionnaire (IPAQ) and functional capacity was assessed with 6 Minute Walk Distance (6MWD). The IPAQ score, IPAQ sitting hours and 6MWD were compared between the 2 groups. Data was tested for normality. Unpaired t test was used to compare Age and BMI between groups for matching. Unpaired t test was used to compare 6MWD between both the groups and Mann Whitney U test was used to compare IPAQ score and IPAQ sitting hours between both the groups. Results: The study demonstrates T2DM patients have reduced functional capacity as compared to control group. A difference of 68.4 meters in 6MWD [p=0.000] was observed with no difference in physical activity levels between the two groups. Conclusion: T2DM patients have reduced functional capacity as compared to control group. The mechanism of impaired functional capacity appears to be associated with the disease process. Therefore, early exercise prescription and physical fitness for improving glycemic control and functional capacity in T2DM patients is essential.

Effects of Nutritional Support with a Leucine-Enriched Essential Amino Acid Supplement on Body Composition, Muscle Strength, and Physical Function in Stroke Patients Undergoing Rehabilitation

Background/Objectives: Dietary protein intake can potentially influence renal function. This study aimed to elucidate the association between dietary protein supplementation and a decrease in the estimated glomerular filtration rate (eGFR) in Japanese stroke patients undergoing rehabilitation. Methods: From July 2017 to June 2021, 60 patients undergoing post-stroke rehabilitation were randomly assigned to a rehabilitation alone or rehabilitation nutrition group, which received 120 g Reha-Time Jelly® after each session. Both groups were followed up for 3 months. Serum nutritional markers (prealbumin and retinol-binding protein), muscle strength, body composition, renal function markers (eGFR based on creatinine [eGFR-Cr] and cystatin C [eGFR-Cys]), urinary protein-to-creatinine ratio (UPCR), and motor function (walking speed, 2-min walk distance, and chair stand test) were assessed at baseline and post-intervention. Results: Of the 60 participants (mean age: 70.2 ± 10.0 years), 39 were men (65.0%) and 19 (31.7%) had chronic kidney disease. Initial eGFR-Cr and eGFR-Cys values were 70.5 ± 17.2 and 66.6 ± 14.8 mL/min/1.73 m2, respectively. After the intervention, the rehabilitation nutrition group demonstrated a significantly greater increase in body mass index (BMI) and a smaller decrease in bone mineral content than the rehabilitation alone group. However, no significant between-group differences were noted in serum marker levels or motor function, including grip strength and knee extensor strength, on the paralyzed and non-paralyzed sides. The change in chair stand test performance indicated a trend toward improvement in the rehabilitation nutrition group. No significant differences were observed in the changes in renal function. Conclusions: A 3-month nutritional supplementation intervention may help increase BMI, preserve bone mineral content, and support physical activity levels in patients undergoing post-stroke rehabilitation without negatively affecting renal function.

Mood, Activity, and Instability in Bipolar Disorder and Unipolar Disorder-An Exploratory Post Hoc Study Using Digital Data.

Mood, activity, and instability in symptomatology hold significant roles in bipolar disorder (BD) and unipolar disorder (UD). The objectives were to examine disparities in these symptoms among patients with BD and UD. Data from two studies including patients with BD and UD, respectively, were combined for exploratory analyses. Patients provided daily smartphone-based evaluations of mood and activity/energy for a 6-month period. A total of 47 patients with BD and 59 patients with UD were included in the analyses. The dataset contains more than 13,000 patient-reported evaluations of mood and activity. Daily mood and activity instability measures were calculated using the root squared successive difference method. In linear mixed effect regression models adjusted for age, sex, and work status, there were statistically significant lower levels of activity in patients with BD as compared with patients with UD overall, during euthymic states and during depressive states (B: -0.61, 95% CI: -0.98; -0.24, p = 0.001). There were no statistically significant differences in mood instability and activity instability between patients with BD and patients with UD overall, during euthymic states and during depressive states, when accounting for multiple testing (p > 0.012). Analyses were exploratory and post hoc. Findings should be interpreted with caution. The sample size was modest. Patients with BD presented with lower level of activity as compared with patients with UD. There were no differences in mood and activity instability between these groups. Future studies including larger sample sizes should investigate differences between BD and UD. ClinicalTrials.gov identifier: NCT03033420.

Assessment of Exercise Capacity in Patients Diagnosed with Moderate and Severe Bronchial Asthma: Preliminary Prospective Observational Study.

The main objective of the study was to assess exercise capacity and physical activity levels in patients with bronchial asthma compared to a control group without asthma, as well as to investigate how asthma severity affects the results of the 6MWT and physical activity as measured by the IPAQ questionnaire. A total of 63 individuals were studied, divided into two groups: Group A, consisting of 33 individuals with bronchial asthma, and Group B, consisting of 30 individuals from the general population without bronchial asthma. In both groups, the following assessments were performed: The Six-Minute Walk Test (6MWT), The International Physical Activity Questionnaire (IPAQ) and the Borg rating of perceived exertion scale (the Borg RPE scale) ABB. It was demonstrated that patients with moderate asthma covered more distance during the 6MWT than patients diagnosed with severe asthma. The difference in metres covered between the two groups was statistically significant (p < 0.001), which could be observed during the walk test. The results indicate that a larger proportion of patients with asthma (76%) fall into the insufficient physical activity category compared to those without asthma (24%). Conversely, a higher percentage of non-asthmatic individuals (66.67%) report sufficient physical activity compared to asthmatic patients (33.33%)(P=0.005). This study demonstrated that asthma severity significantly impacts exercise capacity, as shown by shorter distances covered in the 6-minute walk test (6MWT) among patients with severe asthma. While overall physical activity levels (measured by the IPAQ) were not significantly different between asthma and non-asthma groups, asthma patients exhibited significantly more sitting time, suggesting a more sedentary lifestyle.

Comfort and patient activation in patients with myocardial infarction: A cross-sectional study

AimsTo examine comfort and patient activation, affecting factors, and the relationship between comfort and patient activation in patients with myocardial infarction. BackgroundComfort is an important requirement for managing the treatment and patients' well-being and patient activation improves patient engagement. Assessment of comfort, patient activation and associated factors are important to reduce complications and ensure adherence. MethodThis cross-sectional study was conducted between May and August 2023 on 138 patients in the cardiology clinic who met the inclusion criteria. The research data were collected using a Personal Information Form, a General Comfort Scale, and the Patient Activation Measure. ResultsIt was determined that 67.4 % of the patients were male, and the mean age of patients was 55.47 ± 13.59 years. Comfort was found to be moderate and patient activation level was in the first stage in 50.7 % of the patients. A relationship was found between comfort and gender, education status, health perception, hospitalization experience and number, complications, having chronic disease and medication use, source of information and symptoms, while education and employment status, regular exercise, having chronic disease and symptoms affected patient activation. There was a significant, positive correlation between comfort and the patient activation. ConclusionsComfort and patient activation levels of patients with myocardial infarction are related to sociocultural and disease-related factors. Individualized nursing interventions should be planned in line with the affecting factors to increase comfort and patient activation. Also, controlled studies should be conducted in individuals identified as risk groups are important for clinical applications.

Rheumatoid arthritis treatment: Is exercise a game changer?

It is known that physical activity and exercise have many effects on patients with rheumatoid arthritis, such as reducing pain, stiffness, and fatigue and having positive effects on the development of complications related to the disease. However, despite all this information, the level of exercise and physical activity in patients with rheumatoid arthritis is lower than in healthy individuals. This may be due to reasons such as thinking that the disease will worsen, not having enough information about exercises, and not being supported enough by healthcare professionals and family in this regard. This review summarized the basic effects of exercises and recommended exercise programs.

Advancing physical activity management in nursing: a systematic literature review on educational interventions and technology integration

Introduction: This systematic literature review (SLR) aims to critically examine the role of nurses in promoting physical activity through educational interventions and the integration of technology. Method: This systematic review was conducted across multiple databases, including PubMed, CINAHL, Scopus, Cochrane Library, Web of Science, and Google Scholar. Result: The SLR finds that behavior change interventions, such as the use of pedometers and self-liberation techniques, along with simulation-based learning and scenario-based approaches, significantly increase patient activity levels, self-efficacy, and knowledge of lifestyle modification among patients with chronic condition. Conclusion: The review highlights the importance of systemic changes like better resource allocation, streamlined workflows, and supportive policies to empower nurses to prioritize physical activity education in their responsibilities, ultimately enhancing patient care and outcomes.

Physical activity in patients with chronic venous insufficiency: Its relation with disease severity, pain, fatigue, and functionality

Purpose: Chronic venous insufficiency (CVI) is a progressive disease of the venous system caused by a variety of factors that impair the return of venous blood to the heart. The aim of the study was to evaluate the physical activity level in patients with CVI and its relation with disease severity, pain, fatigue, functionality. Methods: In all, 105 CVI patients (28.6% male, 71.4% female, mean age was 44.91±10.74 years) were enrolled in this study. Physical activity was evaluated with the International Physical Activity Questionnaire-Short Form (IPAQ-SF); disease severity, by Venous Clinical Severity Score (VCSS); the intensity of pain was determined by the Visual Analog Scale (VAS); fatigue level with the Fatigue Severity Scale (FSS); functionality was assessed with the Lower Extremity Function Scale (LEFS). Results: There was a significant negative correlation between IPAQ-SF-vigorous and VCSS, VASrest, VASactivity, VASnight (r: -0.818, p

Personality traits and physical activity in patients with gambling disorder attending a rehabilitation center. An observational study.

Problem gambling is associated with various negative health behaviors, such as physical inactivity. However, physical activity may also be used as a coping mechanism to manage stress and anxiety. This study aimed to investigate whether personality traits are associated with physical activity levels in individuals attending a rehabilitation center for gambling disorder (GD). An observational study was conducted in 71 patients belonging to a Gamblers' Recovery Association. All of them completed a socio-demographic questionnaire, the Exploratory Personality Questionnaire-III (CEPER-III) and the International Physical Activity Questionnaire (IPAQ). Comparisons with general population and association between personality traits and physical activity were analyzed. The study sample predominantly consisted of male participants (91.5%), with the majority having an educational attainment of compulsory schooling or less (70.4%). Additionally, a substantial proportion of participants exhibited school-related problems (43.7%) and had a history of mental health issues (33.8%). Compared to the general population, individuals in the CEPER-III cohort demonstrated significantly lower scores in the following personality traits: paranoid (p < 0.05), histrionic (p < 0.001), narcissistic (p < 0.001), passive-aggressive (p < 0.05), and sadistic (p < 0.01). Multivariate logistic regression analysis indicated that the antisocial, borderline, obsessive-compulsive, and self-destructive personality traits were significantly associated (p < 0.05) with the level of physical activity. This study found a link between personality traits and physical activity levels in patients with GD. Gamblers with higher scores on obsessive-compulsive and self-destructive personality traits were more likely to fall into the moderate-high physical activity group. In contrast, those with higher scores on antisocial and borderline personality traits were more likely to be classified in the low physical activity group.

Abstract 4122840: Patient activation improves with a multi-component personalized mHealth intervention in older adults at risk of cardiovascular disease

Background: Patient activation, a person’s level of confidence, comprehension, and autonomy toward their health, is an essential goal of cardiovascular disease therapy. Previous research has shown a link between high levels of patient activation and better patient outcomes and experiences. However, whether individualized interventions such as a text-based mobile health (mHealth), improve patient activation is unclear. Research on patient activation in people at risk for cardiovascular disease and influential factors is minimal. Aims: This study aimed to 1) determine the effect of a multi-component mHealth intervention on patient activation and 2) examine its predictors among older adults at risk for cardiovascular disease. Methods: In this pilot randomized controlled trial, community-dwelling older adults with poor eating behaviors and reduced physical activity (n=54) were randomly assigned to the GetFIT (control) or GetFIT+ (intervention) groups, with three- and six-month follow-up periods. The GetFIT group received healthy lifestyle counseling from a licensed health coach, a free commercial mHealth app with push alerts on physical activity, and an activity tracker for physical activity monitoring. The GetFIT + group received the same components but had personalized text messages instead of push alerts. The 13-item Patient Activation Measure assessed patient activation; higher scores indicate better activation. Linear mixed-effects models were used to investigate between-group changes in outcomes across time. Results: The mean age was 65.4 ± 6.0 years; 61% were females and 61% were married. Baseline characteristics were comparable between groups. Significant improvements were observed in the GetFIT+ group at three months (mean 3.53, 95% CI 0.11, 6.96; p=0.043) and six months (mean 4.37, 95% CI 0.91, 7.83; p=0.014), whereas improvements in the GetFIT group were non-significant. Adjusting for age, gender, education, employment, marital status, social support, smartphone confidence, and self-perceived health did not alter the results. Nevertheless, only social support was associated with higher patient activation overall (B=5.14, 95% CI 1.00, 9.27; p=0.015). Conclusions: People at risk for cardiovascular disease can improve their self-management abilities, knowledge, and confidence through personalized text messaging. Possessing social support is critical for maximizing the benefits of mHealth interventions.

Treatment Tactics in Remission Stage of Episodic Schizophrenia Taking into Account Immunological Parameters

Background: the study of clinical remission in schizophrenia has a significant place at the current stage of development of psychiatric science. Prevention therapy and personalized prophylactic therapy is important to improve the quality of remission, stabilization of the endogenous process and prevention of exacerbation. The aim was to develop apathogenetically grounded method of treatment of episodic schizophrenia at the remission stage using complex assessment of clinical, psychometric and immunological parameters of patients, which allows to control the quality and stability of remission, as well as prediction of exacerbation of the endogenous process. Patients and methods: 91 patients (24 men and 67 women) aged from 18 to 70 years were examined. They were in remission after suffering attacks of an endogenous disease with episodic course (the duration of remissions ranged from 6 months to 12 years). Clinical-psychopathological, psychometric, immunological, clinical and followup, and statistical methods were used. Results: determination of inflammatory and autoimmune markers of blood plasma in the dynamics of the disease and their comparison with the severity of psychopathological symptomatology of patients with schizophrenia, made it possible to form 2 groups of patients with differently directed correlations between the change in clinical state (according to the PANSS scale) and the level of activation of the immune system, assessed in the aggregate immune markers determined. For patients of group 1 (n = 58; 63.74%) the decrease of the intensity of psychopathological symptoms in remission is associated with a decrease in the level of immune system activation («positive» correlations). For the patients of group 2 (n = 33; 36.26%) the level of immune system activation in remission does not decrease and remains at the level of the acute stage of the disease (“negative” correlations). It is shown that the increase in the level of immune system activation in patients of group 1 is a prognostic immunological criterion of possible exacerbation of psychopathological symptoms in remission. Based on the determination of immunological blood parameters in remission, personalized treatment tactics have been developed for these patients, associated with the transition from maintenance doses of drugs to therapeutic ones or additional use of drugs of another group. In most cases, this tactic contributed to relatively favorable dynamics of the existing clinical remission without significant changes in the condition. For patients of group 2, the personalized therapy tactics involves continuation of longterm active therapy. Conclusions: complex assessment of clinical, psychometric and immunological parameters of patients with episodic schizophrenia, which allows to control the quality and stability of remission, can be used to control the quality and stability of remission, as well as to detect preclinical signs of exacerbation of the endogenous process.

β-Hydroxybutyrate and Citrate Synthase as Potential Diagnostic Biomarkers in Aging-Related Atrial Fibrillation.

The incidence of atrial fibrillation (AF) increases with age; however, the precise mechanisms by which aging elevates AF risk and the effective biomarkers for managing AF in elderly patients remain unclear. We analyzed plasma samples from 100 elderly AF patients, 100 young and 100 elderly patients without atrial fibrillation (NAF), along with left atrial tissues obtained from both AF and NAF patients following valve replacement. Our findings indicate reduced levels of β-OHB and citrate synthase (CS) activity in elderly AF patients compared to their NAF counterparts. Statistical analysis revealed a protective association between β-OHB and CS activity concerning the occurrence of elderly AF. Furthermore, atrial tissues from elderly AF patients exhibited mitochondrial dysfunction, structural remodeling, and low-voltage areas. These results suggest that dysregulation of β-OHB levels and CS activity may contribute to aging-related AF by affecting mitochondrial function and atrial remodeling, highlighting their potential as diagnostic biomarkers for this condition.

Physical activity in users with Type 2 Diabetes in Family Health Centres in Copiapó

Physical activity has been demonstrated to be an effective intervention for the prevention and treatment of type 2 diabetes mellitus (DM2)(1,2). However, only 13.3% of the Chilean population are physically active(3,4). To our knowledge, there is no data on the physical activity performed by the diabetic population in Chile. Therefore, this study aimed to describe the level of physical activity in patients with DM2 in the Family Health Centres (CESFAM) of Copiapó (Chile).The study employed a cross-sectional design, utilizing data from 25 participants in the CODIACO cohort. The study population comprised individuals of both sexes, between 30 and 65 years of age, diagnosed with DM2 and users of the CESFAMs of Copiapó, and who also had mobile devices capable of installing the accelerometry application ‘Physics Toolbox Sensor Suite’. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer, and severe inflammatory or infectious diseases were excluded. They were asked to activate and deactivate the application for 7 to 12 days, This mean the device had to be turned on at the beginning of an activity (waking) and off at the end of the day (bedtime), registering all daily activities. The percentages of time spent in each of the four body positions (upright, sitting, crouching, and lying down) were obtained from the total time spent using accelerometry(5). Once the Shapiro-Wilk test was P&gt;0.05, all comparisons were made between times spent in each of the body positions using a one-factor ANOVA, with post-hoc analysis using Tukey’s test. A P-value of less than 0.05 was considered statistically significant. The CODIACO study was approved by the Scientific Research Ethics Committee of the Universidad of Atacama. The project was funded by FONDECYT N° 11180794.There was an average daily activity of 9.6hr (upright = 2.2;sitting = 4.9;crouching = 0.7; supine = 1.6hr) in the sample. The one-factor ANOVA showed significant differences between all positions (P&lt;0.001). The pos-Hoc test revealed a significantly longer time was observed in the sitting position, according to the z-axis position (51.32 ± 12.5% of the total time) compared to the upright (23.5 ± 8.7 %), supine (17.4 ± 3.2 %) or crouching (7.78 ± 0.6 %) positions (P &lt; 0.050). Furthermore, differences were observed in the time spent in the upright position and the time spent in the supine (P&lt;0.05) or crouching (P&lt;0.05) positions, and between sitting and crouching positions (P&lt;0.05).This study demonstrated that patients diagnosed with DM2 at the CESFAM of Copiapó spent a significant portion of their daily activity in a sedentary and low position, with minimal engagement in an upright one. Since upright positions are associated with physical activities such as walking, climbing stairs, toileting, and cooking, obtaining 23.5% in this position suggests a lack of engagement in these activities.

The Role of Body Mass Index on Physical Activity, Symptoms, and Related Outcomes Following Pediatric Concussion

To determine the step count and self-reported activity levels for obese and non-obese pediatric patients following concussion and predict self-reported symptoms, quality of life, and psychological health over time. Participants completed the Post-Concussion Symptom Scale (PCSS), Pediatric Quality of Life (PedsQL), and Behavioral Symptom Inventory-18 (BSI-18) at an initial visit (<72 hours), 3-5 days post-injury, 10-18 days post-injury, and 1 and 2 months post-injury. Physical activity data (eg, step count) were collected via a commercial actigraph. Participants were categorized into obese and non-obese body mass index (BMI) groups based on age- and sex-adjusted growth standards. Mann Whitney U tests compared groups while nonparametric series regression models examined the effect of obese BMI and average daily step count on PCSS, PedsQL, and BSI-18 outcomes at 1- and 2-months post-injury. 194 participants were included: 153 (78.9%; M=14.6 ± 2.4 years; 50% female) in the non-obese group and 41 (21.1%; M=14.2 ± 2.0 years; 44% female) in the obese group. The obese group had a 22.8% lower average daily step count in the week post-injury (p=0.02). At 2-months, there was a significant association between obese BMI and worse PCSS total score (p=0.042), PedsQL (p=0.017), and BSI-18 anxiety (p=0.046). Average daily step count in the first week post-injury was associated with a higher PCSS total score at 2 months (p=0.031). Pediatric patients following concussion with an obese BMI had a lower daily average step count in the week after injury and exhibited worse concussion symptoms, quality of life, and anxiety at 2 months compared with those with a non-obese BMI.

Application of superb microvascular imaging technology in clinical disease activity of rheumatoid arthritis.

Detection of synovitis is essential for assessing the activity and predicting the prognosis of rheumatoid arthritis (RA). The aim of this study was to investigate the diagnostic performance of superb microvascular imaging (SMI) in RA patients with high, moderate, and low activity. One hundred four patients with active RA were selected from the hospital between May 2022 and August 2023. The study observed the correlation between bone erosion of the carpal joint, joint cavity effusion, thickness of synovial hyperplasia of the carpal joint, positivity rate of synovial blood vessels, and their semiquantitative scores with the clinical disease activity of RA using SMI examination. The detection of synovial hyperplasia thickness and joint effusion in the high-activity group was higher than that in the low-activity group, and the difference was statistically significant (P < 0.05). The quantitative SMI test demonstrated that the synovial blood flow grading and semiquantitative grade increased gradually with activity level (P<0.05). During the high, moderate, and low-activity groups, the vascular index (VI) value of the hyperplastic synovial membrane decreased gradually, showing statistical significance both between and within the groups (P<0.05). SMI technology exhibited high sensitivity and accuracy in assessing disease activity in RA. It holds significant clinical application value as a reliable auxiliary tool for assessing disease activity in RA and treatment. Key Points • Super micro-vascular imaging (SMI) demonstrated higher detection rates of microvesselsin RA patients with high disease activity compared to those with low activity, showing statistical significance. • The quantitative SMI test revealed a clear correlation between synovial blood flow grading and disease activity levels in RA patients, highlighting the potential of SMI as a valuable tool for disease activity and treatment of rheumatoid arthritis.

American Rhinologic Society expert practice statement part 2: Postoperative precautions and management principles following endoscopic skull base surgery.

The goal of this American Rhinologic Society expert practice statement (EPS) is to summarize the best available evidence regarding postoperative precautions for patients following endoscopic skull base surgery for intradural pathology. These topics include the administration of postoperative nasal hygiene; patient mobilization and activity level; the resumption of continuous positive airway pressure in patients with obstructive sleep apnea; and the timing and capacity with which a patient may be subjected to barotrauma, such as air travel postoperatively. This EPS was developed following the recommended methodology and approval process as previously outlined. Given the diverse practices and limited agreement on the accepted principles regarding postoperative precautions for patients following skull base surgery, this EPS seeks to summarize the existing literature and provide clinically relevant guidance to bring clarity to these differing practice patterns. Following a modified Delphi approach, four statements were developed, all of which reached consensus. Because of the paucity of literature on these topics, these statements represent a summation of the limited literature and the experts' opinions. These statements and the accompanying evidence are summarized below, along with an assessment of future needs.

Evaluating the Importance of Return to Sports and Hamstring Strength in a Discrete Choice Experiment for Anterior Cruciate Ligament Injury.

With emerging treatments for anterior cruciate ligament (ACL) injury, analysis of patient preferences is lacking to align clinical care and research with patient priorities. To identify patient priorities for outcomes after surgical intervention if they were to sustain an ACL tear, analyze what outcome measures influenced preferences, and determine whether patient demographics influenced preferences. Cross-sectional study. The authors screened patients aged 18 to 30 years who presented for upper extremity complaints to a single institution in 2023. Patients were excluded for current lower extremity injury or history of a knee injury requiring surgical consultation. The authors designed a discrete choice experiment through literature review of outcome measures for bridge-enhanced ACL restoration (BEAR) and ACL reconstruction (ACLR) with hamstring tendon autograft. Measures included return to sports, risk of arthritis, risk of reinjury, and hamstring strength. Patients chose surgery A (ACLR with hamstring tendon autograft) or surgery B (BEAR) and then rated the importance of each outcome measure on their selection. In total, 100 participants (36 female; mean age, 25.1 ± 4.0 years) completed the discrete choice experiment. Overall, 56.0% participated in sports and 80.0% were employed. Based on surgery choice group, there were no significant differences in sex, age, Marx Activity Scale score, sports participation, or employment status between patients who selected BEAR or ACLR with hamstring tendon autograft (all P > .361). Return to sports and hamstring strength were significant priorities for patients in procedure selection (P ≤ .011). Of the patients who selected ACLR with hamstring tendon autograft, 31.6% would not elect to undergo this procedure. In this discrete choice experiment of adults without prior ACL injury, return to sports and hamstring strength were identified as patient priorities when selecting a procedure for ACL injury. Risk of reinjury, however, was not a significant factor in procedure selection. Importantly, these priorities were maintained regardless of patient characteristics, activity level, or employment status.

The potential effect of mobile application-based telerehabilitation on physical activity levels in heart failure patients: insights from the intelliot EU project

Abstract Background Regular physical activity is paramount in heart failure (HF) patients and, due to its well-established benefit in quality of life, functional capacity and prognosis, carries a Class I indication in international guidelines. However, satisfactory compliance rates remain suboptimal, which is largely attributable to unavailability or suboptimal utilization of comprehensive cardiac rehabilitation programs. Digital health application-based telerehabilitation, on the other hand, has emerged as a potentially valuable tools in enhancing risk factor control and lifestyle modification rates in this high-risk patient population. Purpose In this study, we aimed to investigate whether the use of a purpose-designed Internet of Things (IoT)-based e-health system could lead to a clinically relevant increase in physical activity in a cohort of patients with HF across the spectrum of left ventricular ejection fraction (LVEF). Methods Nineteen HF patients were enrolled in the study. Subjects' key clinical characteristics are summarized in Picture 1. All subjects were provided with: a) a set of medical devices with wireless connectivity, b) a state-of-the-art smartwatch and c) a latest-generation smartphone, to which a dedicated patient application was installed. The latter was coupled with a web-based platform designed for physician use, forming the patient-physician interface (PFI). On top of standard-of-care verbal and written exercise recommendations, study physicians also prescribed individualized, guideline-directed exercise regimens for each patient via the PFI, which, in turn, delivered to subjects notifications upon detection of deviations (Picture 2). The first month of participation -during which the smartwatch was used as an activity tracker but exercise notifications had not been activated- served as the baseline period; baseline physical activity level in steps per day was then compared to the respective value measured during each of the 5 following months. Results Mean baseline-to-peak increase in daily step count was calculated at 23.34% (-20.33 - 103.63%). A baseline-to-peak increase in physical activity level of at least 20% was observed in 9/19 patients, with 6 more demonstrating a baseline-to-peak increase in the order of magnitude of 15-19.99%. Only 3 patients failed to achieve any increase in daily step count average. However, after the study month in which the peak physical activity value was observed (typically in the 2nd-4th study month), mean daily step count declined to baseline again in all but 2 patients. Conclusions Despite the study's non-randomized design and small sample size, our results suggest that mobile application-based telerehabilitation constitutes a promising approach in HF patients’ care, as it could aid them achieve a clinically relevant increase in physical activity; this effect, however, can be transient, and this highlights the importance of continued physician oversight.Picture 1: Clinical characteristicsPicture 2: Exercise prescription example

Treatment Options for Plantar Fasciitis: Surgical Release vs. Conservative Therapy

Introduction Plantar fasciitis is one of the most common reasons for visits to orthopedic clinics. This tendinopathy can cause medial heel pain, stiffness, and tenderness on the plantar surface of the foot. Both conservative and surgical methods are employed in its treatment. Aim The aim of this study is to evaluate selected conservative treatment methods, such as stretching, the use of orthotic insoles, splints, injections, extracorporeal shockwave therapy, and taping, as well as surgical treatment options. The study presents a comparison of these methods in terms of their effectiveness, advantages, and disadvantages. State of Knowledge The plantar fascia is a stiff, connective tissue structure extending along the plantar surface of the foot. Biomechanical load on the fascia, which supports the medial longitudinal arch, can lead to degenerative changes that underlie plantar fasciitis. Symptoms include pain, particularly in the mornings and late evenings, which intensifies with palpation of the heel area. Summary (Conclusions) Conservative treatments for plantar fasciitis are effective in 90% of patients. There are no studies that conclusively demonstrate the superiority of one treatment method over another. Thus, the choice of therapy should be tailored to the patient's lifestyle, activity level, and financial capability. Surgical intervention is necessary in cases of chronic plantar fasciitis which remains resistant to conservative treatments.

Self-Efficacy, Patient Activation, and the Burden of Inflammatory Bowel Disease on Patients' Daily Lives.

The effective management of inflammatory bowel disease (IBD) requires complex self-management behaviors. Both patient activation (the degree to which patients are willing and able to engage in care) and self-efficacy (one's confidence in performing certain behaviors) are thought to play an important role in chronic disease self-management, but patient activation is a broad concept that can be more difficult to precisely target than self-efficacy. We aimed to describe the relationship between patient activation, self-efficacy, and the burden of IBD on patients' daily lives. Patients with IBD were recruited from a single center to complete a survey including the Patient Activation Measure (PAM-13®), the IBD Self-Efficacy Scale (IBD-SES), and an IBD-specific patient-reported outcome measure. Using multivariable linear regression, we examined the relationship between IBD burden, self-efficacy, and patient activation, adjusting a priori for age, gender, IBD type, IBD medications, active corticosteroid use, anxiety, and depression. We performed a post-hoc mediation analysis to examine self-efficacy as a potential mediator in the relationship between patient activation and the burden of IBD on patient's daily lives. A total of 132 patients with IBD completed the survey (59% Crohn's disease, 41% ulcerative colitis, 52% female). Higher levels of patient activation and higher levels of self-efficacy were each associated with lower IBD burden (patient activation: ß = -1.9, p < 0.001, self-efficacy: ß = -2.6, p < 0.001). Post hoc mediation analysis confirmed that the relationship between patient activation and daily IBD burden was mediated by self-efficacy (Average Causal Mediation Effect = -1.00, p < 0.001, proportion mediated = 0.62, p < 0.001). The relationship between patient activation and IBD burden is highly mediated by self-efficacy, suggesting that self-efficacy could be a more precise target for intervention. Future studies could focus on targeting self-efficacy to build individuals' confidence in IBD self-management and testing of IBD-tailored self-management programs to ultimately improve disease outcomes.