Post Measures Research Articles

A COMPARATIVE STUDY ON THE IMMEDIATE EFFECTIVENESS OF MULLIGAN BENT LEG RAISE TECHNIQUE VS PNF HOLD-RELAX WITH AGONIST CONTRACTION IN IMPROVING HAMSTRING RANGE OF MOTION AND MUSCLE PERFORMANCE: A LITERATURE REVIEW.

Background: Hamstring tightness is a common issue that can hinder athletic performance and increase the risk of injury. Effective interventions are needed to enhance hamstring range of motion (ROM) and muscle performance. This study aims to compare two manual therapy techniques: the Mulligan Bent Leg Raise technique and the PNF Hold-Relax with Agonist Contraction technique. Objective: The primary objective is to compare the immediate effects of these two techniques on hamstring ROM and muscle performance. Secondary objectives include evaluating participants’ perceived comfort during the interventions and exploring the practical application of both techniques in clinical settings. Methods: A review of literature, focusing on randomized controlled trials involving participants aged 18–35 years, was conducted. Participants were divided into two groups: one receiving the Mulligan Bent Leg Raise technique and the other undergoing PNF Hold-Relax with Agonist Contraction. Pre- and post-intervention measurements of hamstring ROM and muscle performance were collected. Immediate effects were recorded and analyzed to compare outcomes between the two techniques. Results: Preliminary results indicate significant immediate improvements in hamstring flexibility and muscle performance for both techniques. Literature supports the effectiveness of both the Mulligan and PNF techniques in enhancing hamstring function. Conclusion: Evidence suggests that both the Mulligan Bent Leg Raise and PNF Hold-Relax with Agonist Contraction techniques effectively improve hamstring flexibility and muscle performance. Implications: This study provides valuable insights for physiotherapy practice, equipping clinicians with evidence-based strategies to address hamstring tightness and dysfunction. By integrating these techniques, physiotherapists can achieve rapid improvements and enhance overall treatment outcomes.

Effects of various laser applications on surface roughness and bond strength to veneering composites of polyether ether ketone (PEEK) and polyether ketone ketone (PEKK) materials.

The aim of this study was to investigate the bond strength between PEEK/PEKK and composite resins after various laser treatments and to compare the effectiveness of lasers on these polymers. 130 disc-shaped PEEK and PEKK blocks were obtained (10mm diameter-4mm height). One sample from each group (10 in total) was selected for scanning electron microscopy (SEM) analysis. The samples were randomly divided into 5 different surface treatment groups for each material (PEEK and PEKK): Er: YAG laser, Nd: YAG laser, diode laser, femtosecond laser and control (no surface treatment) (n = 12). Baseline and post-treatment surface roughness measurements were performed using a profilometer. The composite resin was bonded and SBS was measured. Comparisons among the groups were conducted via Kruskal-Wallis, one-way ANOVA; Tukey and Dunn tests were used as a post hoc test (p ≤ 0.05). All lasers significantly increased the roughness values of the PEEK and PEKK samples. In terms of shear bond strength; the Er: YAG and femtosecond laser groups had the highest values and the Nd: YAG, diode and control groups had the lowest values of the PEEK samples (p ≤ 0.05). The control group had the highest bond strength values and the femtosecond group had the lowest values for PEKK samples (p ≤ 0.05). All laser treatments increased the surface roughness of the PEEK and PEKK. Lasers increased the bond strength of PEEK to the veneering composite resin and decreased the bond strength values of PEKK. This shows that lasers behave differently in PEEK and PEKK materials.

Comparative efficacy of interpersonal psychotherapy and antidepressant medication for adult depression: a systematic review and individual participant data meta-analysis.

Interpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses. This IPD meta-analysis compared the efficacy of IPT and antidepressants on various outcomes at post-treatment and follow-up (PROSPERO: CRD42020219891). A systematic literature search conducted May 1st, 2023 identified randomized trials comparing IPT and antidepressants in acute-phase treatment of adults with depression. Anonymized IPD were requested and analyzed using mixed-effects models. The prespecified primary outcome was post-treatment depression symptom severity. Secondary outcomes were all post-treatment and follow-up measures assessed in at least two studies. IPD were obtained from 9 of 15 studies identified (N = 1536/1948, 78.9%). No significant comparative treatment effects were found on post-treatment measures of depression (d = 0.088, p = 0.103, N = 1530) and social functioning (d = 0.026, p = 0.624, N = 1213). In smaller samples, antidepressants performed slightly better than IPT on post-treatment measures of general psychopathology (d = 0.276, p = 0.023, N = 307) and dysfunctional attitudes (d = 0.249, p = 0.029, N = 231), but not on any other secondary outcomes, nor at follow-up. This IPD meta-analysis is the first to examine the acute and longer-term efficacy of IPT v. antidepressants on a broad range of outcomes. Depression treatment trials should routinely include multiple outcome measures and follow-up assessments.

Mindfulness improves psychological health and supports health behaviour cognitions: Evidence from a pragmatic RCT of a digital mindfulness-based intervention.

Mindfulness-based interventions can improve psychological health; yet the mechanisms of change are underexplored. This pre-registered remote RCT evaluated a freely accessible digital mindfulness programme aiming to improve well-being, mental health and sleep quality. Health behaviour cognitions were explored as possible mediators. Participants from 91 countries (N = 1247, Mage = 27.03 [9.04]) were randomized to 30 days of mindfulness practice or attention-matched control condition. Measures of well-being, depression, anxiety, stress, sleep quality, barriers self-efficacy, self-regulation and behavioural predictors (e.g., attitudes and behavioural intentions) were taken at baseline, 1-month (post-intervention) and 2-months (follow-up). Linear regression examined intervention effects between and within groups. Longitudinal mediation analyses explored indirect effects through health behaviour cognitions. Three hundred participants completed post-intervention measures. Those receiving mindfulness training reported significantly better well-being (Mdifference = 2.34, 95%CIs .45-4.24, p = .016), lower depression (Mdifference = -1.47, 95%CIs -2.38 to -.56, p = .002) and anxiety symptoms (Mdifference = -.77, 95%CIs -1.51 to -.02, p = .045) than controls. Improvements in well-being and depression were maintained at follow-up. Intervention effects on primary outcomes were mediated by attitudes towards health maintenance and behavioural intentions. Mediating effects of attitudes remained when controlling for prior scores in models of depression and well-being. Digital, self-administered mindfulness practice for 30 days meaningfully improved psychological health, at least partially due to improved attitudes towards health behaviours and stronger behavioural intentions. This trial found that digital mindfulness is a promising and scalable well-being tool for the general population, and highlighted its role in supporting health behaviours.

Effects of adding core stability training to conventional rehabilitation protocol on shoulder function after rotator cuff repair

Background. Rotator cuff tear (RCT) is a prevalent cause leading to shoulder disability and is widely recognized as one of the primary causes of pain as well as dysfunction in the shoulder. The core stabilization exercise program improved the strength of the shoulder muscles. The core stability training (CST) may be utilized during the early phases of shoulder rehabilitation. Purpose. To assess the impacts of adding CST to the conventional rehabilitation protocol on function, proprioception, as well as range of motion (ROM) of shoulder joint following rotator cuff repair (RCR). Methods. Fifty-two participants after RCR were assigned to two groups in a random manner; group I (n = 26) and group II (n = 26). Participants in groups I and II were engaged in a conventional rehabilitation protocol for 12 weeks after RCR. Group II additionally performed CST after the 8th week until the 12th week of RCR. Outcome measures were shoulder function using the Arabic shoulder pain and disability index (SPADI), shoulder joint position sense (JPS) (proprioception accuracy through detecting absolute angle of error) using digital inclinometer, ROM in shoulder flexion, abduction, internal rotation, as well as external rotation using the digital inclinometer. Unpaired t-test, chi square, and MANOVA test were implemented for data analysis. Results. Compared to the pre-treatment condition, the post treatment results revealed that there were statistical substantial improvements (p < 0.05) in SPADI score, absolute angle of error, and ROM flexion, abduction, external rotation and internal rotation) in both groups, even though there were substantial differences among both groups at all post-treatment measures (p < 0.05) in favor of group II. Conclusion. Incorporating CST into the conventional rehabilitation protocol after RCR leads to notable enhancements in shoulder joint function, proprioception, and ROM for flexion, abduction, internal rotation, as well as external rotation.

Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial

Background: Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, muscle imbalance is the most important cause of sacroiliac joint dysfunction. The hamstring and gluteus medius are the primary muscles involved in postural dysfunction-related muscle imbalance; however, the quadratus lumborum’s role in the compensatory mechanism is becoming more apparent, and its potential for treatment in conjunction with gluteus medius strengthening has not yet been investigated. Gluteus medius exercises, along with conventional treatment, are routinely given to patients with sacroiliac joint dysfunction; however, the aim of this study is to explore the additional effects of the muscle energy technique (MET) on the quadratus lumborum along with strengthening of the gluteus medius on pain, disability and quality of life of patients with sacroiliac joint dysfunction. Methods: Using a computer-generated random number table, seventy patients with unilateral sacroiliac joint pain were divided equally and randomly into two groups. Prior to initiating treatment, baseline measurements were taken using a hand-held dynamometer, visual analog scale (VAS), Oswestry Disability Index (ODI-U) and short form 36-item survey (SF-36v2) to assess strength, pain, functional disability and quality of life, respectively. Over the course of four weeks, all patients received twelve sessions, and both the pre- and post-intervention outcome measures were documented. Results: After 4 weeks of treatment, both groups showed statistically significant (p < 0.005) mean improvements in muscle strength, pain, disability and quality of life before and after intervention. However, the mean improvements in post-intervention on a dynamometer, VAS, ODI and SF-36 were better in the MET with exercise group (METGME) as compared to the conventional group with exercise (CTGME), with a larger effect size. Conclusions: The muscle energy technique, applied to the quadratus lumborum in combination with gluteus medius strengthening, is more effective clinically and significantly in improving pain, disability and quality of life in comparison to conventional treatment of sacroiliac joints with gluteus medius exercises.

Defibrillator shocks and their effect on objective asian patient outcomes: results of the painfree SST clinical trial

Abstract Background The implantable cardioverter defibrillator (ICD) reduces mortality in patients at risk of sudden cardiac death. However, the effect of ICD shock on device-measured activity is unknown. The aim of this analysis was to analyze the acute and long-term effects of ICD shock on objective behavioral data. Methods The PainFree SST study was a prospective, multicenter, global study that enrolled 2770 patients including 225 from from Asia (181 from Japan, 25 from India, and 19 from Malaysia). Patient physical activity was determined from the device built-in accelerometer. The device translates the accelerometer output into a count of active minutes, which is stored as a daily total value in device memory for a rolling window of 425 days. Obviously, activity is measured only after device implantation. Early after implant, activity is reduced due to the procedure and thus not representative. Therefore, no baseline can be reported for activity. The follow-up activity data was analyzed with a linear mixed model, with a random effect for patient and an auto-regressive correlation matrix for subsequent measurements of individual patients. Results Figure 1 shows average daily activity between 90 days before and 90 days after a shock. The dashed vertical line indicates the day of shock. Both patients from Asia and from other countries show a drop in activity after a shock with recovery in the subsequent 30-60 days. The curve for Asian patients is more variable than the curve for other countries due to the lower number of patients (there were 33 Asian patients with shocks contributing data). Figure 2 shows average daily activity before and after ATP therapy. Any post shock measurement is excluded. Contrary to the temporary reduction in activity around a shock (Figure 1), ATP therapies do not seem to have an impact on activity. In patients from the other countries, activity is significantly reduced when patients are hospitalized (-66.3 minutes/day, p<0.0001), but not in Asian patients (-5.1 minutes/day, p=0.71). Both in Asian and other countries, activity is significantly reduced after an ICD shock (Asian: -47.5 minutes/day, p=0.0002; Other countries: -21.5 minutes/day, p<0.0001). The effect of shock for Asian is greater than the other countries (p=0.054). In the month after the shock there is a significant recovery, +34.8 minutes/day in Asian patients (p=0.0077) and +7.7 minutes/day in patients from other countries (p=0.031). The recovery is trended to be bigger in Asian patients (p=0.058). Conclusions ICD shocks have a lasting adverse impact on objective, device-measured physical activity, particularly among Asian individuals. Successful management of patients with an ICD necessitates specific attention to clinically relevant behavioral outcomes, aiming to expedite recovery and facilitate a return to activities of daily living, with a particular focus on the Asian population.

Effects of electroconvulsive therapy on inflammatory markers and depressive symptoms in adolescents with major depressive disorder

ObjectiveLimited research exists on the use of electroconvulsive therapy (ECT) for adolescents with major depressive disorder (MDD). This study investigates the effects of ECT on inflammatory markers in adolescents aged 13-18 suffering from severe MDD, evaluating its efficacy in modulating cellular inflammatory markers and ameliorating depressive symptoms.MethodsA cohort of 38 adolescents with severe MDD received standard antidepressant therapy along with 6-8 ECT sessions spanning two weeks. A control group of 29 age-matched, healthy individuals was also assessed for comparative purposes. The investigation measured variations in depressive symptomatology and inflammatory marker levels (IL-1β, IL-6, IL-10) pre- and post-intervention.ResultsPost-ECT, a substantial decrease in pro-inflammatory cytokines (IL-1β and IL-6) and an increase in the anti-inflammatory cytokine (IL-10) were noted. Participants who responded to the treatment showed a significant decline in HAMD-17 scores, which accentuates ECT’s therapeutic potential. Comparative analysis indicated a significant correlation between post-treatment inflammatory marker alterations and clinical improvement, implying that shifts in inflammatory state might serve as predictors of treatment response. Moreover, the mitigation of depressive symptoms exhibited a moderate correlation with post-treatment decrements in IL-1β and IL-6 levels, underscoring MDD’s intricacy and ECT’s comprehensive impact.ConclusionWhile initial inflammatory marker levels did not predict the response to ECT, the post-treatment measures appeared to be linked to clinical improvement. These findings suggest ECT’s potential effectiveness in treating severe MDD in adolescents and point to the possible predictive value of inflammatory markers in therapeutic outcomes. The study contributes to our understanding of the biopsychosocial framework of MDD and indicates that ECT may be a viable treatment option for this population.

Generalized tetanus complicated with Takotsubo-cardiomyopathy in a septuagenarian following a laceration injury with soil contamination – a case report

BackgroundTetanus is a clinical rarity due to the successful globally adopted childhood vaccination programme. The rising elderly population in the United Kingdom creates a subset of individuals whom are prone to develop Tetanus as they preceded this vaccination drive.Case summaryA 76 year old Caucasian lady presented with a soil contaminated laceration injury on her knee following a fall. Though she received urgent assessment and wound care, the relevance of the injury in the backdrop of her age was not appreciated and her tetanus post exposure prophylaxis was overlooked. She readmitted seeking further management 1 week later with an infected wound with Trismus and clinical features favoring Generalized tetanus. During her stay she developed Takotsubo-cardiomyopathy with congestive cardiac failure and required prolonged care in the intensive unit with mechanical ventilation and rehabilitation before being discharged home.ConclusionFirst contact physicians should have a greater appreciation of the types of injuries and at-risk individuals who are more prone to develop tetanus upon exposure to ensure early and appropriate identification. There should be greater situational awareness with regard to the elderly in view of their heightened risk of development of tetanus specially those born before the vaccination drive. Knowledge regarding post exposure prophylaxis measures for tetanus should be regularly updated using local guidance to ensure awareness, so as to despite its rarity Tetanus remains an adequately appreciated disease.

Implementation and Evaluation of a Virtual Skills-Based Dementia Caregiver Group Intervention within a VA Setting: A Pilot Study.

This study sought to design, implement, and evaluate a 6-week skills-based telehealth group for dementia caregivers within a VA setting. The protocol was designed based on a CBT skill-building approach and was evaluated using the four levels of evaluation developed by Kirkpatrick (1998). Eight spousal caregivers of individuals with MCI or dementia participated in the pilot group within a VA geriatric clinic. Methods included comparison of pre- and post-intervention outcome measures (caregiver burden, depression, anxiety, flourishing) and inductive narrative analysis of qualitative feedback from participants. Qualitatively, the intervention was well received and participants identified several areas of subjective learning and skill implementation including increased behavioral and communication skills, knowledge, and connection with resources. However, paired-sample t-tests of group outcomes revealed no significant differences on measures of caregiver burden, depression, anxiety, and flourishing pre- and post-intervention. Based on Kirkpatrick's levels of evaluation, this study revealed positive reception of a group-based intervention for dementia caregivers within a VA setting, but further investigation of intervention effectiveness is needed given the lack of significant change found on outcome measures. A virtual skills-based group may be a feasible option for dementia caregiver intervention within VA settings that warrants further investigation.

Music and Sleep Hygiene Interventions for Pregnancy-Related Insomnia: An Online Randomized Controlled Trial.

Approximately 50% to 60% of all pregnant women suffer from insomnia during pregnancy. Pregnancy-related insomnia has been associated with severe outcomes for both mother and child postnatally. Currently, the treatment of pregnancy-related insomnia is often neglected due to a lack of suitable treatments. This online assessor-masked randomized controlled trial aimed to evaluate the effectiveness of music listening and sleep hygiene for treating pregnancy-related insomnia. We recruited first-time pregnant women at the end of the second trimester with a report of poor sleep. Participants in the music and sleep hygiene (MSH) group received standard sleep hygiene advice and were instructed to listen to music daily at bedtime for 4 weeks. They could choose from 6 sleep playlists of different genres. Participants randomized to the sleep hygiene alone (SH) group received standard sleep hygiene only. Primary outcomes were sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI) and insomnia severity measured with the Insomnia Severity Index. gov Identifier: NCT04633395. Among the 98 participants receiving the online intervention, 31 participants in the MSH group (62%) and 40 participants in the SH group (80%) completed the postintervention measurements. Both groups experienced improved sleep quality during the intervention period (PSQI change, -2.10; 95% CI, -3.27 to -0.93; P <.001), with no significant difference between the groups. Similarly, insomnia symptoms were reduced (Insomnia Severity Index change, -3.42; 95% CI, -5.02 to -1.83; P <.001) with no significant difference in the effect between groups. There was a significant difference in adherence to sleep hygiene between the MSH and SH groups (42% vs 8%; P =.007). Sleep quality and insomnia severity can be improved in pregnant women with relatively simple interventions like music listening and sleep hygiene advice. These results align with previous research, but larger trials are recommended to support introduction into clinical practice.

The Effect of Implementation of Skin Care Guidelines on Nurses’ Knowledge Regarding Skin Care and Incidence of Skin Injuries Among Neonates at a Private Tertiary Care Hospital

Background: Skin care of sick newborns is important because skin acts as a barrier to prevent neonates from infections which may lead to neonatal morbidity and mortality. The highly technological environment of the neonatal intensive care unit (NICU) makes them vulnerable to loss of skin integrity. In acute care setting maintenance of skin integrity is considered as an established quality indicator representing nursing care. Aim of Study: The study aimed to determine the effect of skin care guidelines on nurses’ knowledge related to skincare and the incidence of skin injuries among neonates. Methodology: Pre-post quasi-experimental study was conducted in the NICU of a private tertiary care hospital. A consecutive sampling technique was used. The intervention comprised educational sessions and demonstrations of skin care practices from AWHONN skin care guidelines. The data on the nurses’ knowledge were collected through self-developed and self-administered questionnaires. Skin injuries were recorded on a checklist through observation for 1 month before and after the intervention. A paired sample t-test was used for comparing knowledge and continuous demographical variables. While the incidence density ratio was calculated for skin injuries. Results: There was a statistically significant improvement in the nurses’ knowledge of skin care from pre (mean 15.06 ± 5.16) to post (mean19.40 ± 5.17) measurement P-value .001. Incidence density rate of skin injuries reduced from 19% to 3% after the implementation of skin care guidelines. Conclusion: Through the implementation guidelines nurses’ knowledge and practices regarding skin care improved while skin injuries among neonates were reduced.

Reducción del miedo al entorno sanitario en niños usando espacios simulados: un ensayo controlado aleatorizado

PurposeThis study aimed to evaluate the effectiveness of an intervention that involved interactions within a simulated health care space to reduce medical fear among children in infant classes. MethodsAn experimental study involving 86 children divided into an intervention group and a control group with pre- and postintervention measurements was undertaken. The intervention, known as the Health-Friendly Program, consisted of showing children various scenarios that simulated different medical contexts so that they could interact in them, experiment with the materials and ask questions. Medical fear was evaluated using the Spanish version of the revised «Child Medical Fear Scale», which provides a score of the medical fear level ranging between 0 and 34 points. The pretest and posttest levels of medical fear in the intervention and control groups were compared with Student's t test. ResultsThe children in the intervention group experienced a significant reduction in fear by 3.21 points (SD: 6.50) compared to the children in the control group. This reduction in fear was shown in all four dimensions of the scale: intrapersonal fears, procedural fears, environmental fears and interpersonal fears. ConclusionThe Health-Friendly Program provides an innovative intervention to reduce medical fear among children based on information, confrontation strategies and simulation scenarios. This study suggests the potential benefit of incorporating educational interventions in schools in collaboration with university and health care simulation centers.

Immediate Effects of Kinesio Tape and Instrument-Assisted Soft Tissue Mobilization on Pain and Proprioception in Chronic Neck Pain: A Randomized Controlled Trial

ObjectiveThe purpose of this study was to compare the immediate effects of single-session Kinesio Tape (KT) and instrument-assisted soft tissue mobilization (IASTM) interventions on pain and proprioception in patients with chronic neck pain (CNP). MethodsForty patients with CNP aged 21 to 44 years were included in this study. The participants were divided into 2 groups as the IASTM and KT groups. The participants in the KT group took part in one session of KT application to the trapezius and sternocleidomastoid muscles, while those in the IASTM group took part in one session of IASTM application to the same muscles. The pain levels of the participants during activity were recorded using the Visual Analog Scale (VAS), and their cervical region proprioception levels were assessed using the Cervical Range of Motion device. Pain severity and proprioception were assessed before and after the interventions. ResultsNo statistically significant difference was found between the pretreatment pain and proprioception values of the 2 groups (P > .05). After the treatments, there was a significant improvement in proprioception in both groups (P ≤ .001). Similarly, there was a significant improvement in VAS values in both groups after the treatments (P ≤ .001). The VAS and proprioception values of the 2 groups were not significantly different in the post-treatment measurements (P > .05). ConclusionIt was concluded that the IASTM and KT interventions had an immediate effect on pain and proprioception in the participants who had CNP, while neither intervention was superior to the other.

Baseline-dependent improvement in CF studies, plausibility of bias

Background:It has been commonly reported that therapeutic treatments in cystic fibrosis (CF) have ceiling effects, such that their efficacy is diminished for persons with high pre-treatment health (Montgomery et al., 2012 and Newsome et al., 2019). Floor effects have also been reported where decline is of lower magnitude in those with below-average pre-treatment health (Harun et al., 2016; Konstan et al., 2012 and Szczesniak et al., 2017). When measurement error is present, the statistical literature has warned of exaggerated or spurious associations between pre-treatment measures and subsequent change (Chambless and Davis, 2003 and Yanez et al., 1998). Measurement error, equivalently described as day-to-day variation, has been described to occur in CF outcome measurements such as forced expiratory volume in 1 s taken by spirometry (FEV1pp) (Magaret et al., 2024; Stanojevic et al., 2020 and Thornton et al., 2023). Methods:We conducted a simulation study to assess the potential for spurious floor or ceiling effects in studies of CF therapeutics. We considered uncontrolled or single-arm studies, and evaluated estimated association between pre-treatment FEV1pp and treatment-induced change: post- versus pre-treatment. Results:When day-to-day variation was present in FEV1pp, at levels equivalent to those reported in large studies measuring spirometry both at home and in clinic, naive analytic approaches found spurious associations of change with baseline (Paynter et al., 2022 and Saiman et al., 2003). Type I error ranged from 31.9% to 98.3% for day-to-day variation as high as 3% to 15% relative to biological variation. Incorporating known day-to-day variation, the regression calibration approach corrected bias and controlled type I error (Chambless and Davis, 2003). Conclusion:Exaggerated ceiling effects are possible. Further studies could provide meaningful confirmation of ceiling effects in CF, perhaps reducing day-to-day variation by incorporating multiple pre- and post-treatment measurements.

A routine within a routine: Can bedtime yoga improve sleep for the whole family?

Parents often point to bedtime as a source of frustration, yet early bedtimes and sufficient sleep are important for children's development, learning, and behavior. ObjectivesThis pilot study aimed to assess the feasibility and preliminary effectiveness of a yoga-based bedtime routine in a sample of parent-child dyads from a rural community. MethodsUsing a waitlist control study design, children aged 2–5 years and their parent were randomized to either intervention (yoga) or control (bedtime story) groups. Pre- and post-intervention measures included the CHAOS, CSHQ, and FNPA scales. Height, weight, and waist circumference were measured by trained staff, while sleep and physical activity were tracked using accelerometry. ResultsOf the 15 dyads that completed all assessments, 13 (81.2%) completed at least 16 yoga sessions. CSHQ scores improved in both groups (Cohen's d 0.42 vs. 0.52 for intervention and control, respectively), and FNPA scores improved in the intervention group (Cohen's d = 0.4). The number of sessions completed was inversely correlated with changes in CHAOS score (r = −0.74, p = 0.003). DiscussionThese findings suggest that a yoga-based bedtime routine is feasible for families with 2-5-year-old children, with good adoption and adherence. Improvements in sleep and household chaos measures indicate that a yoga routine may be slightly more effective than a story-based one. This study provides preliminary support for further research on a yoga-based bedtime routine in a larger sample.

A Self-led Self-management Intervention Supporting Teens with IBD (ASSIST-IBD): protocol for a feasibility study of a novel digital treatment adherence intervention

IntroductionTreatment non-adherence is common in young people with inflammatory bowel disease (IBD), yet support is lacking. A self-led self-management intervention supporting teens with IBD (ASSIST-IBD) is a new theory-based digital...

Efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease and obstructive sleep apnea; a randomized controlled trial.

To evaluate the efficacy of pulmonary rehabilitation in the outcomes of patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome patients who used positive airway pressure. Prospective randomized controlled single- blind trial. A total of 79 patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome were randomly assigned to either the intervention group (n = 40) or control group (n = 39). All patients consistently adhered to positive airway pressure therapy every night from enrolment in the study, while intervention group patients received additional moderate-intensity aerobic exercise for 20 weeks. Pre- and post-intervention measurements included the 6-Minute Walk Test, Barthel Index, body mass index, fat mass, free fat mass, forced expiratory volume in 1 s (FEV1), FEV1%predicted, modified Medical Research Council, and polysomnography parameters. After 20 weeks, the intervention group exhibited statistically significant improvements in 6MWD, Barthel Index, body mass index, fat mass, and modified Medical Research Council compared with control group (all p < 0.01). In addition, the intervention group showed a significantly lower percentage of total sleep time with oxygen saturation < 90% (p = 0.013) and higher lowest nocturnal oxygen saturation (p = 0.008) than the control group. However, there was no significant difference in FEV1 %predicted between the 2 groups. Pulmonary rehabilitation incorporating moderate-intensity aerobic exercise could improve physical endurance and motor abilities in individuals with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome, while also improving anamnestic dyspnoea, body composition, and sleep-disordered breathing.

Effects of 4 weeks of device-induced normobaric intermittent hypoxia/hyperoxia training on the performance of elite cyclists: A pilot study

Introduction &amp; Purpose Classic altitude training and other forms of hypoxia are regularly used in endurance training (Mujika et al., 2019). Due to corona exit restrictions in 2019-2020, device-induced normobaric hypoxia/hyperoxia was suggested as an alternative to classic altitude training. Intermittent hypoxia/hyperoxia training (IHHT) has been studied and used in various forms since the 1940s (Serebrovskaya, 2002) with the advantage to be used at the athlete’s training site (Burtscher, 2005). The aim of this pilot study was to test the effects of a IHHT intervention on aerobic performance, hematological parameters and hypoxia-induced factor-1α (HIF-1α). Method A total of 11 athletes (2 women) from the U23 and elite national squads of the Austrian Cycling Federation completed 16 IHHT units in addition to their normal training program over a period of 4 weeks as part of a randomized cross over intervention study (control – IHHT, IHHT – control). The IHHT units were carried out on a Cellgym CellAir® Gecko Plus device at rest without exercise following a predetermined protocol (Sessions 1-8: 5 min of hypoxia (12.0% oxygen) followed by 3 min of hyperoxia (34.0% oxygen) repeated five times. Sessions 9-16): 6 min of hypoxia (11.0% oxygen) followed by 3 min of hyperoxia (34.0% oxygen). During the 4 weeks of control period, participants should maintain their training schedule. Aerobic performance was determined before and after the intervention by spiroergometry. As secondary outcomes, changes in hematological parameters and protein levels of HIF-1α were determined from venous blood which was processed immediately after collection. Serum was stored at -80 °C until HIF-1 α determination by ELISA technique. Results Eleven out of 13 athletes took part in the pre – post IHHT measurements, but only three of them managed to participate in the measurements planned for the control period, making it impossible to compare the two conditions. Replacement was not possible due to the availability of candidates and the ongoing preparation for the season. After 4 weeks of intervention with 16 IHHT training sessions, no significant changes were observed in performance parameters such as VO2peak, relative VO2max, maximum power (watts) or threshold values (p &gt; 0.05). There were also no significant changes in blood enzymes, lipid and iron metabolism (p &gt; 0.05). However, a tendency towards increased values of haemoglobin (z = 1.738; p = 0.082) and a significant increase of erythrocyte counts (z = 2.193; p = 0.028) were detected. Other haematological parameters and HIF-1α did not change significantly (p &gt; 0.05). Discussion &amp; Conclusion In summary, four weeks of device-induced normobaric IHHT had a modest effect on haematological parameters, but with no detectable transfer to maximal or submaximal endurance performance in highly trained athletes. Although various studies have shown that the difference between normobaric and hypobaric hypoxia exposure is not limited to the partial pressure of oxygen, but Mounier and Brugniaux state that the physiological responses are in fact equivalent (Mounier &amp; Brugniaux, 2012). However, due to the limitations of the competitive setting and the low sample size, the final interpretation of the study remains difficult. References Burtscher, M. (2005). Intermittierende Hypoxie: Höhenvorbereitung, Training, Therapie [Intermittent hypoxia: altitude preparation, training, therapy]. Schweizerische Zeitschrift für Sportmedizin und Sporttraumatologie, 53(2), 61-67. Serebrovskaya, T. V. (2002). Intermittent hypoxia research in the former Soviet Union and the commonwealth of independent states: History and review of the concept and selected applications. High Altitude Medicine &amp; Biology, 3(2), 205-221. https://doi.org/10.1089/15270290260131939 Mounier, R., &amp; Brugniaux, J. V. (2012). Counterpoint: Hypobaric hypoxia does not induce different responses from normobaric hypoxia. Journal of Applied Physiology, 112(10), 1784-1786. https://doi.org/10.1152/japplphysiol.00067.2012a Mujika, I., Sharma, A. P., &amp; Stellingwerff, T. (2019). Contemporary periodization of altitude training for elite endurance athletes: A narrative review. Sports Medicine, 49, 1651-1669. https://doi.org/10.1007/s40279-019-01165-y

Personalized sleep and nutritional strategies to combat adverse effects of night shift work: a controlled intervention protocol

Abstract Background Working during the night interferes with the timing of normal daily activities and is associated with an increased risk of chronic diseases. Under controlled experimental conditions, interventions focusing on sleep and nutrition can mitigate the short-term adverse effects of shift work. However, it is unclear how these results translate to real-life, how they can be targeted to individual conditions, and how they relate to long-term health. Therefore, the current study aims to implement a personalized sleep and nutritional intervention among night shift workers in the field. Methods A non-blinded controlled intervention study is used, consisting of a run-in period, an intervention of 3 months, post-intervention measurements, and a follow-up after 12 months. Three study arms are included: sleep intervention, nutritional intervention, and control group (n = 25 each). Participants are healthy 18–60-year male night shift workers, with at least one year of experience in night shift work. Information from the run-in period will be used to personalize the interventions. The main outcomes are sleep measurements and continuous interstitial glucose levels. Furthermore, general health biomarkers and parameters will be determined to further evaluate effects on long-term health. Discussion This study aims to mitigate negative health consequences associated with night shift work by introducing two personalized preventive interventions. If proven effective, the personalized interventions may serve as practical solutions that can have a meaningful impact on the sustainable health and employability of night shift workers. This study will thereby contribute to the current need for high–quality data on preventative strategies for night shift work in a real-life context. Trial registration This trial has been registered under ClinicalTrials.gov Identifier NCT06147089. Registered 27 November 2023.