Physical Component Of Quality Of Life Research Articles

Effectiveness of hybrid comprehensive telerehabilitation in women with heart failure - subanalysis of the TELEREH-HF RCT

Abstract Background Despite the known benefits of cardiac rehabilitation, it remains underutilized among women. In particular, little is known about the effectiveness of hybrid comprehensive telerehabilitation (HCTR) in women with heart failure (HF). Purpose: The purpose of this study was to assess effectiveness and safety of HCTR in women with HF. Methods: The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO2 peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were made before and after intervention/observation. Results: Women constituted 11.5 % of population in the TELEREH-HF study. Forty women in HCTR group and 44 women in UC group completed HCTR and observation respectively. HCTR resulted in significant improvement in VO2peak, workload duration and QoL. We did not observe these favorable results in the UC group except for an increase workload duration. In the HCTR group, there was a significantly greater improvement in physical component of QoL than in the UC group. All results are presented in Table 1. In neither group were there deaths nor major adverse events related to exercise training. Conclusion In women with HF, hybrid comprehensive telerehabilitation is safe and resulted in a significant improvement in physical capacity and QoL.

The association between osteoporosis and quality of life among older adults in Southern Iran: findings from the Bushehr Elderly Health Program

Background & objectiveOsteoporosis is a growing public health concern, particularly among the aging population. This study aimed to evaluate the association between osteoporosis and quality of life (QoL) in a sample of older adults.MethodsThis cross-sectional study utilized data from all the participants of Bushehr Elderly Health program (BEHP), phase 2. QoL was assessed using the 12-Item Short Form Survey (SF-12 Questionnaire), and participants were classified as having osteoporosis or not based on the WHO diagnostic criteria. The physical (PCS) and mental (MCS) component summaries of QoL were estimated. The association between osteoporosis and QoL was evaluated separately for men and women, considering various health and lifestyle factors using linear regression analysis.ResultsThe study included 2,399 participants (average age 71.27 ± 7.36 years). 1,246 were women and 1,153 were men. Osteoporosis was present in 59% of women and 23% of men. Participants with osteoporosis had significantly lower PCS scores compared to those without osteoporosis (women: 38.1 vs. 40.2, p < 0.001; men: 44.3 vs. 45.8, p: 0.002). However, there was no statistically significant difference in MCS scores. Stratified by sex, osteoporosis was significantly associated with PCS in women [β = -2.14 (-3.13, -1.15)] and men [β = -1.53 (-2.52, -0.54)]. After accounting for relevant variables, the association remained significant in women [β=-0.95 (-1.87, -0.03)], but not in men [β=-0.63 (-1.55,0.28)].ConclusionThis study highlights the significant association between osteoporosis and the physical component of QoL in both older men and women, particularly among women. Further research and interventions focusing on enhancing physical QoL in individuals with osteoporosis are warranted to promote healthier aging.

Medium- and Long-Term Effects of COVID-19 in a Population of Patients Admitted to the Intensive Care Unit: Cognitive and Psychological Sequelae and Quality of Life Six Months and One Year after Discharge.

Most researchers have assessed cognitive functions in post-COVID-19 patients by means of screening tools and found cognitive sequelae in addition to anxiety, stress, depression, and a reduced quality of life (QoL). This study was aimed at investigating cognitive and psychological sequelae in patients admitted to the intensive care unit (ICU) six months (t6) and one year (t12) after discharge from the hospital, the impact of critical illness on well-being and QoL, and the protective role of cognitive reserve (CR). Twenty-three ICU patients underwent an extensive neuropsychological test battery at t6 and t12; a healthy control group underwent the same evaluation. Patient scores were compared with control scores: patients reported significantly lower scores in visual-spatial functions, both at t6 (U = 122; p = 0.033) and at t12 (U = 70; p = 0.003), and higher levels of anxiety (U = 126; p = 0.043) and depression (U = 97; p = 0.005) at t6; the levels of anxiety decreased at t12, while only depression symptoms persisted (U = 99.5; p = 0.025). Regarding the QoL, patients obtained lower scores in the physical component of QoL, both at t6 (U = 72; p = 0.008) and at t12 (U = 56.5; p = 0.005). Few and moderate correlations emerged between isolated cognitive functions and CR and the length of hospital stay. The results suggest a prevalent visual-spatial involvement, the medium- and long-term persistence of psychological sequelae, and a reduced QoL in ICU patients.

Combined Effects of Physical Activity and Diet on Cancer Patients: A Systematic Review and Meta-Analysis.

The purpose of our systematic review was to examine the effects of any physical activity/exercise intervention combined with any diet/nutrition intervention on any biological/biochemical index, quality of life (QoL), and depression in breast, lung, colon and rectum, prostate, stomach, and liver cancer patients and/or cancer survivors. A systematic review and meta-analysis were undertaken, using PRISMA guidelines and the Cochrane Handbook. The systematic review protocol can be found in the PROSPERO database; registration number: CRD42023481429. We found moderate-quality evidence that a combined intervention of physical activity/exercise and nutrition/diet reduced body mass index, body weight, fat mass, insulin, homeostatic model assessment for insulin resistance, C-reactive protein, triglycerides, and depression, while it increased high-density lipoprotein, the physical component of QoL, and general functional assessment of cancer therapy. We conclude that a combined intervention of physical activity/exercise and diet/nutrition may decrease body weight, fat mass, insulin levels, and inflammation, and improve lipidemic profile, the physical component of QoL, and depression in cancer patients and survivors. These outcomes indicate a lower risk for carcinogenesis; however, their applicability depends on the heterogeneity of the population and interventions, as well as the potential medical treatment of cancer patients and survivors.

Delayed Antibody Response in the Acute Phase of Infection Is Associated with a Lower Mental Component of Quality of Life in Survivors of Severe and Critical COVID-19.

Background: The long-term sequelae of coronavirus disease 2019 (COVID-19) significantly affects quality of life (QoL) in disease survivors. Delayed development of the adaptive immune response is associated with more severe disease and a worse prognosis in COVID-19. The effects of delayed immune response on COVID-19 sequelae and QoL are unknown. Methods: We conducted a prospective study to assess the relationship between the delayed antibody response in the acute phase of infection in naïve unvaccinated patients suffering from severe or critical COVID-19 and their QoL 12 months after hospital discharge. The 12-item Short Form Survey (SF-12) questionnaire was used for assessment of QoL. The SF-12 evaluates both mental and physical components of QoL, incorporating a mental component score (MCS-12) and a physical component score (PCS-12). A delayed antibody response was defined as testing negative for anti-spike SARS-CoV-2 antibodies at the time of hospital admission. Results: The study included 274 patients (154 men and 120 women). Of the enrolled patients, 144 had a delayed immune response. These patients had a significantly lower MCS-12 (p = 0.002), but PCS-12 (p = 0.397) was not significantly different at the 12-month follow-up compared to patients with positive anti-spike SARS-CoV-2 antibodies. The MCS-12 at the time of follow-up was negatively associated with delayed antibody response irrespective of possible confounders (p = 0.006; B = 3.609; ηp2 = 0.035; 95% CI = 1.069-6.150). An MSC-12 below 50 points at the time of follow-up was positively associated with delayed antibody response (p = 0.001; B = 1.092; OR = 2.979; 95% CI = 1.554-5.711). Conclusions: This study confirmed that, in patients with severe and critical COVID-19, a negative result for anti-spike SARS-CoV-2 antibodies at the time of hospital admission is associated with a lower mental component of QoL in unvaccinated patients naïve to COVID-19 one year after hospital discharge.

The association between quality of life and diabetes: the Bushehr Elderly Health Program

Background and objectiveConsidering the importance of diabetes and its increased prevalence with aging, this study aimed to evaluate the association between diabetes status and quality of life (QOL) and the determining factors in individuals over 60.MethodsTwo thousand three hundred seventy-five individuals including 819 (34.5%) with diabetes, aged 69.4 ± 6.4, from Bushehr Elderly Health Program (BEHP) were enrolled. We categorized the participants as non-diabetic, controlled diabetic, and poorly controlled diabetic. The QOL was assessed using the SF-12 questionnaire. The physical (PCS) and mental (MCS) component summaries of QOL were estimated. We compared the SF-12 domains and components between the categories using ANOVA. Further, the association of diabetes status with PCS and MCS was assessed after adjustment for possible confounders including age, sex, depression, cognitive impairment, physical activity, and other relevant factors using linear regression analysis.ResultsIndividuals with diabetes had lower PCS (40.9 ± 8.8 vs. 42.7 ± 8.6, p-value < 0.001), and MCS scores (45.0 ± 10.2 vs. 46.4 ± 9.4, p-value < 0.001) compared to participants without diabetes. No significant differences were observed in PCS or MCS scores between controlled or poorly controlled individuals with diabetes. Diabetes status was associated with PCS and MCS scores in univariable analysis. Regarding physical component of QOL, after adjusting for other confounders, poorly controlled diabetes was significantly associated with PCS [beta: -1.27 (-2.02, -0.52)]; some other determinants include depression [-7.66 (-8.51, -6.80)], male sex [3.90 (3.24,4.57)], and good physical activity [1.87 (1.17,2.57)]. As for the mental component, controlled diabetes was significantly associated with MCS [-1.17 (-2.13, -0.22)]; other contributing factors include depression [-14.35 (-15.34, -13.37)], male sex [1.97 (1.20,2.73)], good physical activity [-1.55 (-2.35, -0.75)], and smoking [-1.42 (-2.24, -0.59)]. BMI had an inverse association with PCS [-0.19 (-0.26, -0.13)] and a direct association with MCS [0.14 (0.07,0.21)].ConclusionIndividuals with diabetes exhibited reduced QOL scores. Upon adjusting for other variables, it was found that uncontrolled diabetes correlated with decreased PCS scores, whereas controlled diabetes was linked to lower MCS scores. Factors such as depression and being female were identified as contributors to diminished QOL in both physical and mental aspects. These results have the potential to guide healthcare decision-making, facilitating the creation of tailored interventions aimed at improving the QOL for individuals with diabetes, with a specific focus on women and depression.

Effectiveness of hybrid comprehensive telerehabilitation in heart failure patients with permanent atrial fibrillation - subanalysis of the TELEREH-HF RCT

Abstract Background Atrial fibrillation (AF) negatively impacts physical fitness and quality of life (QoL). Little is known about efficacy of hybrid comprehensive telerehabilitation (HCTR) in heart failure (HF) patients with AF. Purpose The purpose of this study was to assess safety and effectiveness of HCTR in HF patients with permanent AF. Methods The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO2 peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were made before and after intervention/observation. Results There were 73 patients with permanent AF in HCTR group and 72 patients with permanent AF in UC group. HCTR resulted in a significant improvement in VO2peak and workload duration. We did not observe these favorable results in the UC group. In the HCTR group, there was a significantly greater improvement in physical component of QoL than in the UC group. All results are presented in Table 1. In neither group were there deaths nor major adverse events. Conclusion In HF patients with permanent AF, hybrid comprehensive telerehabilitation is safe and resulted in a significant improvement in physical capacity and physical component of QoL.

Association of CORADS Classification and Cardiorespiratory Fitness Profile among Symptomatic and Asymptomatic Post-Coronavirus Disease 2019 Individuals

ABSTRACT Background: Physiotherapy treatment is focused for coronavirus disease 2019 (COVID-19) patients in critical, acute, and postacute phases, and the physiotherapists have the responsibility of recovering COVID-19 individuals back to their usual quality of life (QOL). Hence, evaluating the COVID-19 survivor’s QOL is important to improve their independence. Objective: This study aims to assess the patient’s cardiorespiratory fitness in association with their CORADS classification and QOL in post-COVID-19 individuals is essential during this pandemic. Methodology: A retrospective study was conducted with 60 post-COVID-19 individuals who were recruited by convenience. Result: P value of symptomatic and asymptomatic is 0.001, which is considered significant based on their VO2, and that the mean difference, standard error difference, and 95% confidence interval of the difference for both are −6.68, 0.73, and −8.14, respectively. The physical component of QOL is significant in symptomatic individuals (0.005), but all other components are nonsignificant. Conclusion: The impact of COVID-19 on health-related QOL and cardiorespiratory fitness is higher in symptomatic individuals than symptomatic individuals.

Physical Activity and Quality of Life in Persons Newly Diagnosed With Multiple Sclerosis: A Cross-sectional Study

ObjectiveTo examine the association between physical activity (PA) and quality of life (QOL) in persons newly diagnosed with multiple sclerosis (MS) who have been under-represented in MS research. DesignCross-sectional study with secondary data analysis. SettingGeneral community. ParticipantsThe study included 152 persons newly diagnosed with MS (ie, diagnosed with MS within the past 2 years) aged 18 and older (N=152). Main Outcome MeasuresParticipants completed the Godin Leisure-Time Exercise Questionnaire to measure PA. QOL, disability status, fatigue, mood, and comorbidity were assessed using the 12-Item Short Form Survey (SF-12), Patient Determined Disease Steps, Hamburg Quality of Life Questionnaire Multiple Sclerosis, and comorbidity questionnaire. ResultsThe bivariate correlations indicated that PA was significantly and positively associated with the physical component of QOL (ie, SF-12 PCS) (r=0.46). The stepwise multiple linear regression analysis indicated PA as associated with SF-12 PCS (β=0.43, R2=0.17) when solely included in the model. After controlling for fatigue, mood, disability status, and comorbidity as covariates (R2=0.63), the association between PA and SF-12 PCS was still statistically significant, but attenuated in magnitude (β=0.11). ConclusionsThis study observed that PA was significantly associated with the physical component of QOL in persons newly diagnosed with MS, even after controlling for covariates. The findings underscore the importance of developing behavior change interventions targeting PA while addressing the roles of fatigue and disability status for enhancing the physical component of QOL of this MS subpopulation.

Physical and cognitive function to explain the quality of life among older adults with cognitive impairment: exploring cognitive function as a mediator

BackgroundPhysical and cognitive function are both indicators of aging, characterized by a loss of adaptive response to life challenges and functional limitations, subsequently affecting their quality of life. This study aimed to identify the direct effect of physical function and the indirect effect of cognitive function on the quality of life in older adults with mild cognitive impairment.MethodsThe study participants were 79 older adults recruited from community centers in four urban districts of Korea. All participants completed a self-reported questionnaire for demographic characteristics and outcome variables. Outcome measures included physical function (grip strength, balance, and mobility), cognitive function, and mental and physical components of quality of life (QOL). Statistical analyses were conducted using hierarchical multiple linear regression and the PROCESS macro for mediation analysis.ResultsThe mean age of participants was 77.46 years old with an elementary or lower education level (53.2%). The mean score of cognitive function was 16.39 (SD = 6.5). Physical function (grip strength, balance, mobility) and cognitive function explained 25% of the variance in physical (p = 0.004) and 29% in mental (p < 0.001) components of QOL after controlling for age, sex, and education level. Mobility was associated with both physical (β=-0.27, p = 0.024) and mental (β=-0.36, p = 0.002) components of QOL. The cognitive function partially mediated the relationship between balance and the physical component of QOL; the proportion of mediation was 55%.ConclusionIn conclusion, physical and cognitive function were significant predictors of QOL in older adults with cognitive impairment. Specifically, balance has significant indirect effects on the physical component of QOL through cognitive function as a mediator. Health-promoting strategies could be more effective when focusing on the direct effect of physical function as well as the mediating effect of cognitive function to promote the quality of life in this population.

Interventions for improving health literacy in people with chronic kidney disease.

Low health literacy affects 25% of people with chronic kidney disease (CKD) and is associated with increased morbidity and death. Improving health literacy is a recognised priority, but effective interventions are not clear. This review looked the benefits and harms of interventions for improving health literacy in people with CKD. We searched the Cochrane Kidney and Transplant Register of Studies up to 12 July 2022 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. We also searched MEDLINE (OVID) and EMBASE (OVID) for non-randomised studies. We included randomised controlled trials (RCTs) and non-randomised studies that assessed interventions aimed at improving health literacy in people with CKD. Two authors independently assessed studies for eligibility and performed risk of bias analysis. We classified studies as either interventions aimed at improving aspects of health literacy or interventions targeting a population of people with poor health literacy. The interventions were further sub-classified in terms of the type of intervention (educational, self-management training, or educational with self-management training). Results were expressed as mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals (CI) for continuous outcomes and risk ratios (RR) with 95% CI for dichotomous outcomes. We identified 120 studies (21,149 participants) which aimed to improve health literacy. There were 107 RCTs and 13 non-randomised studies. No studies targeted low literacy populations. For the RCTs, selection bias was low or unclear in 94% of studies, performance bias was high in 86% of studies, detection bias was high in 86% of studies reporting subjective outcomes and low in 93% of studies reporting objective outcomes. Attrition and other biases were low or unclear in 86% and 78% of studies, respectively. Compared to usual care, low certainty evidence showed educational interventions may increase kidney-related knowledge (14 RCTs, 2632 participants: SMD 0.99, 95% CI 0.69 to 1.32; I² = 94%). Data for self-care, self-efficacy, quality of life (QoL), death, estimated glomerular filtration rate (eGFR) and hospitalisations could not be pooled or was not reported. Compared to usual care, low-certainty evidence showed self-management interventions may improve self-efficacy (5 RCTs, 417 participants: SMD 0.58, 95% CI 0.13 to 1.03; I² = 74%) and QoL physical component score (3 RCTs, 131 participants: MD 4.02, 95% CI 1.09 to 6.94; I² = 0%). There was moderate-certainty evidence that self-management interventions probably did not slow the decline in eGFR after one year (3 RCTs, 855 participants: MD 1.53 mL/min/1.73 m², 95% CI -1.41 to 4.46; I² = 33%). Data for knowledge, self-care behaviour, death and hospitalisations could not be pooled or was not reported. Compared to usual care, low-certainty evidence showed educational with self-management interventions may increase knowledge (15 RCTs, 2185 participants: SMD 0.65, 95% CI 0.36 to 0.93; I² = 90%), improve self-care behaviour scores (4 RCTs, 913 participants: SMD 0.91, 95% CI 0.00 to 1.82; I² =97%), self-efficacy (8 RCTs, 687 participants: SMD 0.50, 95% CI 0.10 to 0.89; I² = 82%), improve QoL physical component score (3 RCTs, 2771 participants: MD 2.56, 95% CI 1.73 to 3.38; I² = 0%) and may make little or no difference to slowing the decline of eGFR (4 RCTs, 618 participants: MD 4.28 mL/min/1.73 m², 95% CI -0.03 to 8.85; I² = 43%). Moderate-certainty evidence shows educational with self-management interventions probably decreases the risk of death (any cause) (4 RCTs, 2801 participants: RR 0.73, 95% CI 0.53 to 1.02; I² = 0%). Data for hospitalisation could not be pooled. Interventions to improve aspects of health literacy are a very broad category, including educational interventions, self-management interventions and educational with self-management interventions. Overall, this type of health literacy intervention is probably beneficial in this cohort however, due to methodological limitations and high heterogeneity in interventions and outcomes, the evidence is of low certainty.

From Court to Couch: Exercise and Quality of Life after Acute Type A Aortic Dissection.

Background Acute Type A aortic dissection can be physically and mentally stressful with little known about survivors' postrepair activity levels, exercise habits, and quality of life (QOL). This study was aimed to describe pre- and postdissection changes regarding exercise, understand physician recommendations, quantify use of cardiac rehabilitation, and assess QOL in dissection survivors. Methods A total of 295 acute Type A aortic dissection survivors were surveyed about exercise, cardiac rehabilitation, QOL, sexual activity, and posttraumatic stress disorder (PTSD) with 137 (46%) respondents. Results Respondents were less likely to participate in competitive athletics after than before dissection (1/131 [0.76%] vs. 26/131 [20%], p [McNemar test] < 0.0001) or lift heavy objects (11/111 [9.9%] vs. 41/111 [37%], p < 0.0001). Forty-eight of 132 respondents (36%) did not participate in cardiac rehabilitation. Compared with general population norms, respondents reported lower median QOL physical component scores (40 [26, 51; 15th, 85th percentile], p < 0.0001); these were lower in respondents who did not exercise (Hodges–Lehmann [HL; 95% confidence interval (CI)]: –6.8 [–11, –2.4], p = 0.002), limited sexual activity (–8.0 [–13, –4.3], p = 0.0002), or screened positive for PTSD (–10 [–14, –5.3], p = 0.0002). Median mental component scores were similar to general population norms (HL [95% CI]: 55 [34, 61], p = 0.24) but were lower among respondents who did not exercise (–4.2 [–7.8, –1.0], p = 0.01), limited sexual activity (–5.5 [–10, –1.8], p = 0.003), or screened positive for PTSD (–16 [–22, –10], p < 0.0001). Conclusion Physicians should prescribe cardiac rehabilitation, encourage appropriate exercise, promote resumption of sexual activity, and identify and treat PTSD after surgery for acute Type A aortic dissection.

English

Data on physical activity (PA) and sleep duration (SD) as important correlates of quality of life (QoL) among diabetic patients are scarce. This study investigated the pattern of self-reported PA, SD and QoL in purposively selected diabetes patients (N = 124, mean age: 54.61) at two major hospitals in Kano, Nigeria. Respondents&rsquo; PA level, SD and QoL were estimated using the International PA Questionnaire, a single-item measure of sleep and the Short Form-36 Health Survey respectively. Nighttime SD was estimated in hours and the mean for the previous seven days was recorded. Respondents&rsquo; socio-demographic characteristics were also obtained while weight and height were measured. Data were analysed using descriptive and inferential statistics (Spearman correlation) at p &le;0.05. 56.5%, 37.9% and 5.6% of them had low, moderate and high PA levels respectively. 57 (46%) slept for &lt;6 hours and 67 (54%) for 6-8 hours. While 86% had QoL physical component summary of &lt;50, 13% had &ge;50. Those with mental component summary &lt;50 (57.3%) were also more than those with values &ge;50 (42.7%). There was no significant correlation between PA and either of the two clinical variables (sleep duration [p = 0.075, r = 0.160] and QoL [SF-36 PSC, p = 0.435, r = 0.071; SF-36 MSC, p = 0.379, r = -0.080]). Furthermore, SD did not significantly correlate with QoL (p &gt; 0.05).&nbsp; In conclusion, the majority of the respondents were not meeting any of the criteria for either moderate or high levels of PA with SD being poor for significant proportion of them for optimal QoL and general wellbeing. Key words: Physical activity; Sleep duration; Quality of life; Diabetes mellitus; Northwestern Nigeria.

Art therapy possibilities in the complex treatment of patients with multiple sclerosis

Objective: to study the effectiveness of art therapy methods in the complex treatment of neuropsychological disorders and quality of life improvement in patients with relapsing-remitting and secondary-progressive multiple sclerosis (MS).Patients and methods. A group of 42 patients (5 men and 37 women, mean age 32.9 years, mean EDSS severity 3.8 points) with MS underwent outpatient continuous active art therapy cycle. The mean group training cycle duration was six months. The comparison group included 15 age- and sex-adjusted individuals without neurological disorders. Tests on various drawing topics were carried out before and after a three-month therapy course. We used Hospital Anxiety and Depression Scale (HADS) to assess the severity of anxiety and depression and the SF-36 scale to evaluate the quality of life (QoL).Results and discussion. Before the art therapy start, light blue, yellow, pink, blue, and green colors prevailed in the drawings. There was no predominance of any color depending on MS severity or course. The green color predominated in this test in the control group, and the light blue color was significantly less represented. The art therapy course did not lead to a significant change in the severity of MS according to the Expanded Disability Status Scale (EDSS). After the art therapy course, the color scheme of the drawings was mainly represented by red, light blue, green, yellow, and blue colors. In addition, a red-orange color appeared in the drawings, which was completely absent before the course. Positive trends were noted according to HADS: a decrease in anxiety by 23% and depression by 19%. The physical component of QoL assessed by the SF-36 scale did not change substantially, but the psychological component significantly improved by 11%.Conclusion. The predominance of light blue color observed in MS is associated with damage to the nervous and musculoskeletal systems, and blue color – with psychological problems and depression. However, after a course of art therapy for MS, red, red-orange, yellow, and green colors representation increased significantly, which indicates an increase in positive attitude, a decrease in the level of depression, and an improvement in QoL.

Functional gait measures correlate to fear of falling, and quality of life in patients with Hereditary Spastic Paraplegia: A cross-sectional study

ObjectiveGait impairment is the cardinal motor symptom in hereditary spastic paraplegias (HSPs) possibly linked to increased fear of falling and reduced quality of life (QoL). Disease specific symptoms in HSP are rated using the Spastic Paraplegia Rating Scale (SPRS). However, limited studies evaluated more objectively easy-to-apply gait measures by comparing these standardized assessments with patients’ self-perceived impairment and clinically established scores. Therefore, the aim of this study was to correlate functional gait measures with self-rating questionnaires for fear of falling and QoL, and with the SPRS as clinical gold standard. MethodsHSP patients (“pure” phenotype, n = 22) fulfilling the clinical diagnostic criteria for HSP and age-and gender-matched healthy subjects (n = 22) were included in this study. Motor impairment was evaluated using the SPRS, fear of falling by the Falls Efficacy Scale-International (FES-I), and QoL by SF-12. Functional gait measures included gait speed and step length (10-meter-walk-test), the Timed up and go test (TUG), and maximum walking distance (2-min-walking-test). ResultsFunctional gait measures correlated to fear of falling (gait speed: r = −0.726; step length: r = −0.689; TUG: r = 0.721; 2-min: r = −0.709) and the physical component of QoL (gait speed: r = 0.541; step length: r = 0.531; TUG: r = −0.512; 2-min: r = 0.548). Furthermore, FES-I (r = 0.767) and QoL (r = -0.728) correlated with the clinical gold standard (SPRS). Gait measures strongly correlated with SPRS (gait speed: r = −0.787; step length: r = −0.821; TUG: r = 0.756; 2-min: r = −0.791). ConclusionFunctional gait measures reflect fear of falling, QoL, and mobility in HSP. The metric, semi-quantitative gait measures complement the clinician’s evaluation and support the clinical workup by more objective parameters.

Fears, beliefs, and quality of life of patients with cancer vs the general population during the coronavirus disease 2019 (COVID-19) pandemic in Lombardy.

To understand how patients with cancer reacted to the coronavirus disease 2019 (COVID-19) pandemic and whether their quality of life (QoL) was affected. In June 2020, 111 patients with cancer treated in the supportive care unit of a Comprehensive Cancer Center in Milan and 201 healthy controls from the general population were enrolled and assessed both quantitatively and qualitatively for fears and COVID-19-related beliefs as well as for QoL. Fear of COVID-19 was significantly lower among patients (41% vs 57.6%; p = 0.007), as was fear of cancer (61.5% vs 85.6%; p < 0.001) and other diseases. The perceived risk of getting COVID-19 was lower among patients (25.2% vs 52.7%; p < 0.001), as was the belief of having been exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (18.1% vs 40.8%; p < 0.001). The physical component of QoL was better among the population (54.5 vs 43.8; p < 0.001); the reverse was true for patients' psychological well-being (44.6 vs 39.6; p < 0.001). The qualitative data supported such results, showing a reduced psychological effect on the patients with cancer compared to the controls. Various reasons explain this result, including the awareness of being treated for cancer and nevertheless protected against getting infected in a cancer center of public health reorganized to continue treating patients by protecting them and personnel from the risk of infection. The experience of a cancer diagnosis, together with proper hospital reorganization, may act as protective factors from fears and psychological consequences of the COVID-19 outbreak.

Yoga-An Alternative Form of Therapy in Patients with Blunt Chest Trauma: A Randomized Controlled Trial.

BackgroundYoga as alternative form of therapy has shown positive impact on pulmonary functions, exercise capacity, behavioral changes, and inflammation in non-trauma patients. However, the efficacy of Yoga has not been studied in chest trauma patients. MethodsThis randomized controlled trial was conducted at level-1 Trauma Centre. Isolated chest injury patients were randomized into either standard physiotherapy or Yogatherapy groups. Patients in physiotherapy group received conventional chest physiotherapy and Yogatherapy group received a set of Yogic exercises in addition to conventional chest physiotherapy. Primary outcome measure was changes in pulmonary function tests (PFT) at 4 weeks of discharge. Secondary outcomes were changes in quality of life (QoL), respiratory muscle strength and endurance, chest wall mobility, and levels of cytokines at 4 weeks. Data were analyzed using STATA v14.0.ResultsA total of 89 eligible patients were randomized to physiotherapy (n = 46) and Yoga therapy (n = 43) groups. Demographic characteristics were comparable in both the groups. There were statistically significant improvements in PFT in the Yogatherapy group compared with physiotherapy with an increase in Forced vital capacity (p = 0.02) and Forced expiratory volume (p = 0.01) at 4 weeks. In addition, there were significant improvement in physical component of QoL, respiratory muscle endurance (p = 0.003) and axillary cirtometry (p = 0.009) in the Yogatherapy group. However, no statistically significant difference in the trends of cytokine markers seen between the groups.ConclusionYoga was found to be effective in improving pulmonary functions and QoL in patients with chest trauma. (Trial registered at ctri.nic.in/clinicaltrials/login.php, numberREF/2016/05/011,287).

ASSESSMENT OF HEALTH-RELATED QUALITY OF LIFE AND RISK FACTORS ASSOCIATED WITH PANCREATITIS IN A TERTIARY CARE HOSPITAL

Objective: The objective of the study was to measure the health-related quality of life (HRQoL) in pancreatitis and to appraise the risk factors associated with the pancreatitis.&#x0D; Methods: A prospective observational study was performed with admitted cases of pancreatitis over 6 month’s period. A total of 150 patients were selected for the study. All data concerning risk factors were recorded and Short-Form-36 (SF-36) questionnaire was applied and quality of life (QOL) was analyzed in all patients with in study group.&#x0D; Results: All domains of (HRQoL) were assessed; it shows highest effect on role limitations due to physical health (36%), role limitations due to emotional problems (29%), role limitations due to physical health, and role limitations due to emotional problems (10%). Finally, our study revealed that there is a profound deterioration in physical components of QOL. The risk factors that majorly influence the QOL in association with disease were found to be alcohol consumption and smoking (70%).&#x0D; Conclusion: Pancreatitis remarkably diminishes the patient’s HRQoL which predominantly shows negative impact on physical health.

Patient-reported outcomes in chronic kidney disease

The review provides a definition of the concept of «patient-reported outcomes (PRO)». The main components of PRO include health-related quality of life (QoL), symptoms assessed by the patient, functional status, satisfaction with treatment. The review presents a description of the most frequently used questionnaires for assessing QoL in patients with chronic kidney disease (CKD). It has been shown that the physical component of QoL decreases in predialysis stages of CKD. As CKD progresses, the Physical Component Summary (PCS) of the SF-36 questionnaire deteriorates, as well as the scale scores of Physical functioning, Pain, General health, and Role limitations caused by Physical problems (RP). Among the CKD-specific QoL scales, a deterioration in the scores of Symptoms/Problems, Burden of Kidney Disease, Effects of kidney disease on daily life is observed. There are no convincing data in the literature in favor of a decrease in psychosocial aspects of QoL in patients with CKD. The review presents the definition of «comprehensive conservative care» proposed by the experts convened at the 2013 KDIGO Controversies Conference on Supportive Care. It has been shown that comprehensive conservative care can be a fairly effective method of choice for elderly patients with Stage 5 CKD. It has been demonstrated that a decrease in PCS is independently associated with CKD progression and an increased risk of death. However, the information on QoL in predialysis CKD is insufficient. The use of different questionnaires for QoL assessment complicates data comparison. Randomized clinical trials are practically absent, which reduces the value of the results obtained.

Effects of Pomegranate Peel Extract and Vitamin E on Quality of Life in Hemodialysis Patients: A Randomized Placebo-Controlled Clinical Trial

Background and aims: Quality of life (QOL) is poor in hemodialysis (HD) patients. High oxidative stress and inflammatory conditions disturb their normal physiological, emotional, and physical functions. This study aimed to assess the effects of pomegranate peel extract (PPE) alone and in combination with vitamin E (Vit E) as anti-oxidant and anti-inflammatory substances on QOL of HD patients using Short-form 36 (SF-36) QOL questionnaire. Methods: This study was a double-blinded, placebo-controlled randomized clinical trial on HD patients. A total of 100 HD patients were randomly divided into 4 equal groups as follows: Pom+Vit E group, which received 2 PPE tablets + 1 Vit E soft gel daily, Pom group, which received 2 PPE tablets+1 Vit E placebo soft gel daily, Vit E group, which received 1 Vit E soft gel+2 PPE placebo tablets daily, and Placebo group, which received 2 PPE placebo tablets + 1 Vit E placebo soft gel daily. The intervention duration was 8 weeks. The stratified block randomization method based on sex, age, HD duration, and employment status was used for randomization. Results: The mean age of participants ranged between 51 and 57 years with an HD duration of 9-11.2 months. Bodily pain score and general health score significantly increased in the Pom group and Pom+ Vit E group. The emotional role functioning score of the Pom+Vit E group was significantly higher than that of the placebo group (P&lt;0.05). Conclusion: The consumption of PPE and Vit E had beneficial effects on mental components but not the physical components of QOL. Moreover, combination therapy was more effective than single therapy.