Fatigue Scores Research Articles

Investigation of the comfort situation and influencing factors of patients with lumbar disc herniation after UBE surgery

[Objective] To explore the first time out of bed comfort of patients after lumbar surgery and its influencing factors. [Methods] A total of 158 patients with lumbar disc herniation and sciatica were selected from March 2023 to August 2023. [Results] Among the 158 patients, 56 cases underwent early inclusion of ambulation, 102 cases did not complete early ambulation. The first ambulation time is 12 hours after operation and concentrated on the second day after operation. Single factor analysis showed that two groups of 24 h postoperatively in patients with early pain, fatigue, upright intolerance, sleep quality, early ambulation will, total protein level, anxiety, depression score, postoperative rehabilitation self-efficacy comparison, the difference was statistically significant (P<0.05).logistic regression analysis showed that postoperative pain score, early fatigue, orthostatic intolerance, sleep quality, anxiety and depression score, and rehabilitation self-efficacy score had great influence on early ambulation. [Conclusion] The current situation of early ambulation comfort of patients with lumbar disc herniation after surgery is not good. Nursing staff should strengthen postoperative pain management, encourage patients to enhance confidence, improve the ambulation mode of patients to reduce upright intolerance and fatigue, so as to promote early ambulation of patients and speed up early rehabilitation of patients.

Optimization system for training efficiency and load balance based on the fusion of heart rate and inertial sensors

ObjectivesTo enhance the daily training quality of athletes without inducing significant physiological fatigue, aiming to achieve a balance between training efficiency and load. Design methodsFirstly, we developed an activity classification training model using the random forest algorithm and introduced the “effective training rate” (the ratio of effective activity time to total time) as a metric for assessing athlete training efficiency. Secondly, a method for rating athlete training load was established, involving qualitative and quantitative analyses of physiological fatigue through subjective fatigue scores and heart rate data. Lastly, an optimization system for training efficiency and load balance, utilizing multiple inertial sensors, was created. Athlete states were categorized into nine types based on the training load and efficiency ratings, with corresponding management recommendations provided. ResultsOverall, this study, combining a sports activity recognition model with a physiological fatigue assessment model, has developed a training efficiency and load balance optimization system with excellent performance. The results indicate that the prediction accuracy of the sports activity recognition model is as high as 94.70%. Additionally, the physiological fatigue assessment model, utilizing average relative heart rate and average RPE score as evaluation metrics, demonstrates a good overall fit, validating the feasibility of this model. ConclusionsThis study, based on relative heart rate and wearable devices to monitor athlete physiological fatigue, has developed a balanced optimization system for training efficiency and load. It provides a reference for athletes’ physical health and fatigue levels, offering corresponding management recommendations for coaches and relevant professionals.

Exploring levels of TSH and FT4 in patients with chronic fatigue syndrome (CFS), fibromyalgia (FM) and healthy controls did not reveal any associations between fatigue score and level of thyroid hormones

Aim The diagnoses of Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM) are highly associated with fatigue and pain, respectively. Physiologically and clinically an effect of thyroid status on fatigue and pain is expected. There may be clinically relevant differences in thyroid hormone axes though within values of reference in both patients with normal thyroid hormones, or in patients with well-regulated thyroid disease. These potential differences are explored in this study. Materials and methods In the present study, female patients with CFS (n = 49) and FM (n = 58) as well as female healthy controls (n = 53) were included. We explored plasma levels of TSH and FT4 between the groups using Kruskall-Wallis, and the relation between fatigue score and levels of TSH and FT4 by means of Spearman’s rho. Results There were no group differences between CFS patients, FM patients, and healthy controls in levels of TSH and FT4. Conclusion As one might clinically and physiologically expect an association between thyroid function and fatigue, which may be associated with clinical disorders such as CFS and FM, we suggest future studies to examine the field further by exploring the influence of thyroid receptors and responses of the thyroid hormone cascade.

Mood Profile Clusters among Greek Exercise Participants and Inactive Adults

Mood profile clusters have previously been identified in several cultural contexts. In the present study, six mood profile clusters referred to as the iceberg, inverse Everest, inverse iceberg, shark fin, submerged, and surface profiles, were investigated in a Greek population. The names of the mood profiles reflect how they appear after raw scores for Tension, Depression, Anger, Vigor, Fatigue, and Confusion (in that order), are converted to T-scores and depicted graphically. A Greek translation of the Brunel Mood Scale (BRUMS-Greek) was completed by 1786 adults, comprising 1417 exercise participants and 369 physically inactive adults (male = 578, female = 1208) aged 18–64 years (M = 34.73 ± 11.81 years). Although the male–female ratio emphasized females, sample sizes of over 500 suggest some degree of representativeness. Seeded k-means cluster analysis clearly identified the six hypothesized mood profiles. Men were over-represented for the iceberg profile. For age, the 18–25 years group were under-represented for the iceberg profile, whereas the 46–55 and 56+ years groups were over-represented. The 56+ years group were under-represented for the inverse Everest, and the 18–25 years group were over-represented for the shark fin profile. For body mass index (BMI), participants in the obese weight category were over-represented for the inverse iceberg and shark fin profiles and under-represented for the submerged profile. Active participants were over-represented for the iceberg and submerged profiles, and under-represented for the inverse Everest, inverse iceberg, and surface profiles. Findings supported the cross-cultural equivalence of the mood profile clusters and confirmed the link between physical inactivity, obesity, and negative mood profiles.

Do Complications After Pancreatoduodenectomy Have an Impact on Long-Term Quality of Life and Functional Outcomes?

Our aim was to assess whether complications after pancreatoduodenectomy (PD) impact long-term quality of life (QoL) and functional outcomes. There is an increasing number of long-term post-PD survivors, but few studies have evaluated long-term QoL outcomes. The EORTC QLQ-C30 and QLQ-PAN26 questionnaires were administered to patients who survived >5 years post-PD. Clinical relevance (CR) was scored as small (5-10), moderate (10-20), or large (>20). Patients were stratified based on whether they experienced a complication during the index hospitalization. Of 305 patients >5 years post-PD survivors, with valid contact information, 248 completed the questionnaires, and 231 had complication data available. Twenty-nine percent of patients experienced a complication, of which 17 (7.4%) were grade 1, 27 (11.7%) were grade 2, and 25 (10.8%) were grade 3. Global health status and functional domain scores were similar between both groups. Patients experiencing complications reported lower fatigue (21.4 vs 28.1, P < 0.05, CR small) and diarrhea (15.9 vs 23.1, P < 0.05, CR small) symptom scores when compared to patients without complications. Patients experiencing complications also reported lower pancreatic pain (38.2 vs 43.4, P < 0.05, CR small) and altered bowel habits (30.1 vs 40.7, P < 0.01, CR moderate) symptom scores. There was a lower prevalence of worrying (36.2% vs 60.5%, P < 0.05) and bloating (42.0% vs 56.2%, P < 0.05) among PD survivors with complications. Post-PD complication rates were not associated with long-term global QoL or functionality, and may be associated with less severe pancreas-specific symptoms.

Association between fatigue and MDS-UPDRS in individuals with Parkinson's disease: cross-sectional study.

Fatigue is significant in the context of Parkinson's disease (PD), considering that one-third of patients classify it as the most restricting symptom in their daily life activities (DLAs). The objective was to verify the relationship (association) between fatigue and non-motor and motor symptoms of PD. A cross-sectional study which included 100 individuals with PD. Initially, demographic and clinical data (modified Hoehn and Yahr scale-HY, anxiety, and depression) were collected. To assess the non-motor and motor symptoms of PD, the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) was applied. Fatigue was evaluated using the Parkinson Fatigue Scale. A higher HY score, greater severity of non-motor aspects of DLAs and motor aspects of DLAs, more motor complications, and higher levels of anxiety as well as depression were observed in the "fatigue" group. Fatigue was associated with a lower daily equivalent levodopa dose (LEDD), a higher body mass index (BMI), anxiety, depression, and the presence of non-motor symptoms. Non-motor symptoms are more determining factors for fatigue than the motor condition itself, with an association between fatigue and higher BMI scores, increased anxiety and depression, lower LEDD, and greater severity of non-motor aspects of DLAs. Individuals in the "fatigue" group had higher HY scores, anxiety, and depression, worse non-motor and motor symptoms related to experiences of daily life, as well as motor complications.

Effects of Smart Glasses on the Binocular Vision and Ocular Fatigue

Purpose: The aim of this study was to investigate binocular visual function and ocular fatigue after the use of smart glasses.Methods: A total of 17 healthy volunteers (age range 13-45 years) were examined for ocular fatigue before and after watching videos for 20 minutes with a binocular smart glasses device. Subjective ocular fatigue was evaluated using a Virtual Reality Symptom Questionnaire (VRSQ). Objective fatigue was measured using the high-frequency component of accommodative microfluctuation. Accommodation amplitude was measured using the push-up method. Changes in the spherical equivalent were also measured using an autorefractometer. Strabismus angles were measured at distant (6 m) and near fixation (33 cm) in primary. Contrast sensitivity tests using the Pelli-Robson chart was performed. Accommodative convergence/accommodation (AC/A) ratio was measured by gradient methods.Results: Subjective ocular fatigue, as indicated by the VRSQ scores, significantly increased after using the smart glasses (&lt;i&gt;p&lt;/i&gt; = 0.001). The high-frequency component of accommodative microfluctuation increased in both eyes (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Accommodation amplitude was decreased, and temporary myopia was observed in both eyes (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, there was no significant increase in general fatigue according to the VRSQ. Parameters including strabismus angle, AC/A ratio, and contrast sensitivity showed no significant differences before and after smart glasses usage (&lt;i&gt;p&lt;/i&gt; &gt; 0.05).Conclusions: The increased high-frequency component of accommodative microfluctuation, decreased accommodation amplitude, and elevated ocular fatigue scores measured by the VRSQ indicate a potential association between the use of smart glasses and ocular fatigue. Further investigations are warranted to explore methodologies for mitigating ocular fatigue and elucidating the potential risk of temporary myopic shifts arising from the utilization of smart glasses.

Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort

Background: Respiratory disorders remain incompletely described in multiple sclerosis (MS), even though they are a frequent cause of death. Methods: The objective was to describe respiratory disorders in MS patients with Expanded Disability Status Score (EDSS) ⩾ 6.5. Diaphragm dysfunction was defined by at least two of the seven criteria: clinical signs, inspiratory recruitment of neck muscles during wakefulness, reduced upright vital capacity (VC) < 80%, upright-to-supine VC ⩾ 15% of upright VC, decrease in Maximal Inspiratory Pressure < 60%, phasic activation of inspiratory neck muscles during sleep, and opposition of thoracic and abdominal movements during sleep. Cough weakness was defined by a peak cough flow < 270 L/min and/or need for cough assist. Sleep apnea syndrome was defined by an apnea–hypopnea index ⩾ 15. Results: Notably, 71 MS patients were included: median age 54 [48, 61] years; median disease duration 21.4 [16.0, 31.4] years. Of these, 52 patients had one or more respiratory disorders; diaphragm dysfunction was the most frequent (n = 34). Patients with diaphragm dysfunction and cough weakness were more disabled. The fatigue score and the cognitive evaluations did not differ between the groups. Five patients required non-invasive ventilation. Conclusion: Respiratory disorders are frequent in severe MS, mostly diaphragm dysfunction. Of interest, instrumental interventions are available to address these disorders.

Abstract P352: Association of General and Exertional Fatigue Subtype With Pre-Clinical Heart Failure Stage in Community Dwelling Older Adults in the Atherosclerosis Risk in Communities Study

Background: General and exertional fatigue are prevalent in heart failure (HF), can co-occur, and are associated with adverse outcomes. However, little is known about general and exertional fatigue in pre-clinical HF stages (stage A or B HF). Methods: In this cross-sectional analysis, we included participants at ARIC study visit 5 with stage A HF (risk factors for HF) or B HF (echocardiographic abnormalities or cardiac biomarker elevations). Using general fatigue (Patient Reported Outcomes Measurement Information System (PROMIS) fatigue scale) and exertional fatigue (Medical Research Council breathlessness scale) scores, we cross-categorized individuals into 4 fatigue subtypes: fatigue-free; high general fatigue only; high exertional fatigue only; high general/high exertional fatigue. The absence of a fatigue type was defined as a score of “none-mild”, and high severity as a score of “moderate-severe”. We examined the independent association of HF stage with fatigue subtype using multinomial logistic regression. Results: Our sample (N=4,269) was 59% female, 80% White, with a mean age of 75 years. Prevalence of any type of fatigue was 28% (n=1,179). Those with stage B had a higher prevalence of all fatigue types compared to stage A: high general fatigue only (10.2% vs 8.1%), high exertional fatigue only (12.6% vs 9.1%) and high general/high exertional fatigue (6.9% vs 4.7%). Compared to those with stage A, those with stage B had higher odds of having high general fatigue only (adjusted Odds Ratio (aOR) = 1.3 (95%CI = 1.0, 1.7)), high exertional fatigue only (aOR = 1.4 (1.1, 1.8)), and high general/high exertional fatigue (aOR = 1.6 (1.1, 2.2)) compared to being fatigue-free. Further adjustment for cardiometabolic risk factors attenuated these associations (Table). Conclusions: General and exertional fatigue are more prevalent in those with subclinical HF and these associations may be linked to cardiometabolic profiles. Prevention and management of risk factors may reduce the burden of fatigue in this population.

Effectiveness of Yoga in Reducing Fatigue Among Cancer Patients at HCG Cancer Centre, Gulbarga

Cancer, a global health challenge, demands holistic care, especially for enduring issues like fatigue. Yoga emerges as a key intervention, notably in breast cancer cases. This study, conducted at HCG Cancer Centre, Gulbarga, with 50 participants, evaluates yoga's effectiveness in reducing fatigue using a randomized control design. Demographics and fatigue levels, measured by the BFI scale, are gathered. Results spotlight a significant reduction in fatigue post-yoga intervention for the experimental group, in contrast to the control. This research pioneers’ evidence-based nursing practices, showcasing yoga's potential in alleviating cancer-related fatigue for enhanced patient well-being. In simpler terms, the data strongly indicates a substantial decrease in fatigue levels for the experimental group post-yoga intervention. The mean pre-test fatigue score of 3.6 significantly dropped to 2.04 in the post-test, with a highly significant p-value of 2.8250. This underscores yoga's effectiveness in reducing fatigue among experimental subjects. In the control group, minimal changes in fatigue levels were noted without yoga intervention, as evident from the post-test data. Statistical analysis, with a p-value of 0.432, confirms nonsignificant changes in fatigue scores for the control group. This emphasizes the potential positive impact of yoga in mitigating fatigue levels, distinct from the minimal changes observed in the control group. The findings stress the need for critical interpretation of fatigue score changes and highlight yoga's positive role in addressing cancer-related fatigue, evident through significant outcomes in the experimental group. Keywords: Cancer, Yoga, Fatigue

Synergy of de-walled Ganoderma Lucidum spore powder (GLSP) on targeted therapy in advanced non-squamous non-small cell lung cancer with epidermal growth factor receptor (EGFR) mutant: protocol for a randomized, double-blind, placebo-controlled study

BackgroundOsimertinib is regarded as a promising third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for advanced non-squamous non-small cell lung cancer (NSCLC) patients who developed T790M. However the adverse effects, primarily fatigue, remain an overwhelming deficiency of Osimertinib, hindering it from achieving adequate clinical efficacy for such NSCLC. Ganoderma lucidum has been used for thousands of years in China to combat fatigue, while Ganoderma Lucidum spores powder (GLSP) is the main active ingredient. The aim of this study is to investigate whether GLSP is sufficiently effective and safe in improving fatigue and synergizing with Osimertinib in non-squamous NSCLC patients with EGFR mutant.Method/designA total of 140 participants will be randomly assigned to receive either de-walled GSLP or placebo for a duration of 56 days. The primary outcome measure is the fatigue score associated with EGFR-TKI adverse reactions at week 8, evaluated by the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire for Cancer Patients (QLQ-C30). Secondary outcomes include evaluation of treatment effectiveness, assessment of quality of life (QoL), and exploration of immune indicators and gut microbiota relationships. Following enrollment, visits are scheduled biweekly until week 12.Trial registrationChina Clinical Trial Registry ChiCTR2300072786. Registrated on June 25, 2023.

Influence of transcatheter arterial embolization on symptom distress and fatigue in liver cancer patients.

Hepatocellular carcinoma (HCC) is a prevalent malignancy, and transcatheter arterial embolization (TAE) has emerged as a pivotal therapeutic modality. However, TAE may induce symptom distress and fatigue, adversely affecting the quality of life of patients. To investigate symptom distress, fatigue, and associated factors in HCC patients undergoing TAE. We used a cross-sectional design and purposive sampling to enroll HCC patients who underwent TAE at our institution from January to December 2022. Questionnaires were utilized to collect data on symptom distress and fatigue scores from the first to the third day after TAE. Our study revealed a significant reduction in fatigue and symptom distress among patients after TAE. Pain, fatigue, insomnia, fever and abdominal distension were the most common symptoms troubling patients during the first 3 d post-TAE. Marital status, presence of family support, physical functional status, age, and symptom distress were identified as predictors of fatigue in patients. Healthcare professionals should educate HCC patients on symptom distress and fatigue, offering personalized relief strategies to lessen their psychological burden.

Fatigue, depression, and sleep disorders are more prevalent in patients with metabolic-associated fatty liver diseases.

To determine the prevalence and risk factors for depression, sleep disturbances, and exhaustion in MAFLD patients. Two hundred twenty-four consecutive patients with MAFLD attending the outpatient clinic from April to October 2023; were subjected to clinical evaluation, laboratory testing including non-invasive laboratory markers, fibroscan (measuring steatosis and fibrosis), and different quantitative and qualitative fatigue scores. A control group including 342 patients without MAFLD was taken. The prevalence of fatigue, depression, and sleeping disorders in the MAFLD group was 67.8%, 75%, 62.5% vs 21%, 16.4%, and 19.5% in the control group respectively ( P = <0.001, P = <0.001 and P = <0.001). MAFLD with fatigue was significantly associated with the presence and severity of steatosis and fibrosis by fibroscan ( P = <0.0001). By univariate and multivariate analysis: age, BMI, waist circumference, T2DM, hypertension, steatosis, fibrosis, and Fib-4 were considered risk factors for fatigue in the MAFLD group. The age, high social level, diabetes, hypertension, steatosis, fibrosis, and fib-4 were considered, by univariate and multivariate analysis, independent risk factors for depression in the MAFLD group. age, BMI, waist circumference, diabetes, hypertension, steatosis, fibrosis, and fib-4 were independent risk factors for sleep disorders in MAFLD. Fatigue, sleeping disorders, and depression are more prevalent in MAFLD patients than in the general population. The lower health utility scores in patients with MAFLD are associated with more advanced stages of the disease.

Open-label, single-center, clinical study evaluating the safety, tolerability and clinical effects of pentosan polysulfate sodium in subjects with mucopolysaccharidosis I.

Lysosomal enzyme deficiency in mucopolysaccharidosis (MPS) I results in glycosaminoglycan (GAG) accumulation leading to pain and limited physical function. Disease-modifying treatments for MPS I, enzyme replacement, and hematopoietic stem cell therapy (HSCT), do not completely resolve MPS I symptoms, particularly skeletal manifestations. The GAG reduction, anti-inflammatory, analgesic, and tissue remodeling properties of pentosan polysulfate sodium (PPS) may provide disease-modifying treatment for musculoskeletal symptoms and joint inflammation in MPS I following ERT and/or HSCT. The safety and efficacy of PPS were evaluated in four subjects with MPS I aged 14-19 years, previously treated with ERT and/or HSCT. Subjects received doses of 0.75 mg/kg or 1.5 mg/kg PPS via subcutaneous injections weekly for 12 weeks, then every 2 weeks for up to 72 weeks. PPS was well tolerated at both doses with no serious adverse events. MPS I GAG fragment (UA-HNAc [1S]) levels decreased at 73 weeks. Cartilage degradation biomarkers serum C-telopeptide of crosslinked collagen (CTX) type I (CTX-I) and type II (CTX-II) and urine CTX-II decreased in all subjects through 73 weeks. PROMIS scores for pain interference, pain behavior, and fatigue decreased in all subjects through 73 weeks. Physical function, measured by walking distance and dominant hand function, improved at 49 and 73 weeks. Decreased GAG fragments and cartilage degradation biomarkers, and positive PROMIS outcomes support continued study of PPS as a potential disease-modifying treatment for MPS I with improved pain and function outcomes.

Statistical analysis plan for the PRO B study: open-label, superiority randomised controlled trial of alarm-based patient-reported outcome monitoring in patients with metastatic breast cancer

BackgroundWith an increasing collection of patient-reported outcomes (PROs) to measure health-related quality of life (HRQoL) in oncological patients, there is still a lack of standardised strategies on how to interpret and use these data in patient care. Prior research has shown support for the use of digital PRO monitoring together with alarm systems to notify clinicians when the PRO values are deteriorating. This system has demonstrated advantages in improving HRQoL and increasing survival rates among oncology patients. Hence, we designed the PRO B study, a superiority multi-centre randomised controlled trial, to investigate the effects of alarm-based monitoring in metastatic breast cancer patients in Germany. The study protocol for the PRO B study was published in September 2021, and this manuscript describes a formal statistical analysis plan (SAP) for the PRO B study to improve the transparency and quality of this trial.Methods and designThe trial aimed to recruit 1000 patients with metastatic breast cancer. However, as of the completion of recruitment on June 15, 2023, we have successfully enrolled 924 patients from 52 breast cancer centres. Patients were 1:1 stratified randomised to the intervention and control groups. App-based PRO questionnaires are sent weekly to the intervention group and every 3 months to the control group. Only patients in the intervention group trigger an alarm if their PRO scores deteriorate, and they are subsequently contacted by the local care team within 48 h. The primary outcome is the fatigue score at 6 months, and secondary outcomes are other HRQoL and overall survival. Evaluation of the superiority of the intervention will be done using a linear mixed model with random intercepts for study centres.ConclusionThis detailed SAP defines the main components of the statistical analysis for the PRO B study to assist the statistician and prevent bias in selecting analysis and reporting findings. Version 1 of the SAP was finalised on January 18, 2024.Trial registrationDRKS (German Clinical Trials Register) DRKS00024015. Registered on February 15, 2021.

Fatigue is associated with disease severity in adult patients with hidradenitis suppurativa

AbstractBackgroundPatients with hidradenitis suppurativa (HS) experience fatigue, but no studies have yet examined the association between HS severity and fatigue intensity.ObjectivesTo examine the possible association between HS severity and fatigue and identify fatigue subtypes present in patients with HS.MethodsAdult patients with HS participated in a survey assessing fatigue using the Multidimensional Fatigue Inventory‐20. Disease severity was determined by self‐report.ResultsData from 654 adult patients with HS were analysed and compared with 3,788 reference individuals from the general population. Total and subtype fatigue scores for patients with HS were significantly higher compared with the general population reference individuals and increased with higher HS severity, itch, pain, sleep, dermatology life quality index scores and lower socioeconomic status. The association between HS severity and increased fatigue scores remained statistically significant after adjustment for age, sex, and socioeconomic status.ConclusionsPatients with HS had a significantly higher fatigue score compared with the general population reference individuals in a severity‐dependent manner. A higher awareness of fatigue as a symptom in patients with HS is warranted.

Global health status and fatigue score in isocitrate dehydrogenase-mutant diffuse glioma grades 2 and 3: A longitudinal population-based study from surgery to 12-month follow-up.

At the group level, health-related quality of life (HRQoL) in patients with IDH-mutant diffuse glioma grades 2 and 3 seems to remain stable over time. However, clinical experience indicates that there are patients with unfavorable outcomes on key HRQoL subdomains. The aim of this longitudinal population-based study, following patients over a period of 12 months from surgery, was to describe individual-level data on global health status and fatigue score and explore possible predictors of deterioration. All patients undergoing surgery for presumed glioma grades 2 or 3 at the Sahlgrenska University Hospital during 2017-2022, were screened for the study. Patients were invited to complete the European Organization of Research and Treatment of Cancer core questionnaires and brain module at baseline, 3 and 12 months postoperatively. Data is reported with respect to minimal clinical important difference (MCID). We included 51 patients with IDH-mutant diffuse glioma grades 2 or 3. There was no difference in group-level data of either global health status or fatigue score from baseline to the 12-month follow-up (P-value > .05). Unfavorable individual changes (beyond MCID) in global health status and fatigue score were observed in 12 and in 17 patients, respectively (23.5% and 33.3%). A lower proportion of proton radiotherapy was found in patients with unfavorable changes in fatigue (10/15, 66.7%) compared to all other patients undergoing radiotherapy (22/23, 95.7%, P-value .03). Deterioration beyond MCID was seen in approximately one-third of patients. Changes in global health status could not be predicted, but changes in fatigue may be influenced by tumor-targeted and symptomatic treatment.

Feasibility Study of Exergaming Combined with High-Intensity Interval Training for Different Ages: Investigation of Aerobic Capacity and Mood State

&lt;p&gt;目的：探討體感式電玩結合高強度間歇運動對不同年齡層之血乳酸、心跳率、運動負荷量與運動情緒之效果。方法：本研究以有規律運動習慣之8位成年人與8位高齡者為研究對象，採橫斷面研究設計，並執行以任天堂switch健身環大冒險遊戲所設計之運動，進行8組20秒，強度為盡最大努力，每組間隔休息30秒，總時間為380秒。於運動前、運動中與運動後5分鐘、10分鐘檢測血乳酸、心跳率、運動自覺量表與運動情緒，計算運動負荷量，並以二因子混合設計分析收集數據，並計算效果量。結果：1. 血乳酸：兩組的血乳酸皆超過4 mmol/L，顯示運動強度達高強度，且成年人在運動中第4、8趟與運動後5、10分鐘皆顯著高於高齡者；2. 心跳率：運動期間，兩組的心跳率皆超過85%最大心跳率推估值，而成年人顯著高於高齡者；3. 運動負荷量：兩組間客觀與主觀的運動負荷量皆無顯著差異；4. 運動情緒：兩組在運動情緒之活力與疲勞分數上皆無顯著差異。結論：成年人和高齡者皆可利用體感式電玩搭配高強度間歇運動達到預期的高強度運動負荷，故可作為運動課程編排參考，以達到運動多元化。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Purpose: This study aimed to investigate the effects of combining exergaming with high-intensity interval exercise (HIIE) on blood lactate levels, heart rate, exercise load, and mood state in different age groups. Methods: A cross-sectional study design was employed, and 8 young adults and 8 older adults, all with regular exercise habits, were recruited. The participants executed a HIIE program using the Nintendo Switch fitness ring adventure, comprising 8 sets of 20-second maximum-effort intervals followed by 30 second of rest, totaling 380 seconds of exercise. Blood lactate levels, heart rate, rating of perceived exertion (RPE) scale, and profile of mood states (POMS) were assessed before, during, and 5 and 10 minutes after the exercise. Exercise load was calculated based on the collected data. The data were analyzed using a two-way mixed-design analysis of variance. Results: 1. Blood lactate levels: The concentration of blood lactate in both groups showed an increase over 4 mmol/L during HIIE program, indicating the high exercise intensity. The young adult group exhibited significantly higher blood lactate levels than the older adult group at the 4th, 8th exercise bouts, and 5 and 10 minutes after exercise. 2. Heart rate: During the exercise, heart rates of both groups exceeded 85% of the estimated maximum heart rate (HRmax), with significantly higher rates observed in the young adult group compared to the older adult group. 3. Exercise load: There were no significant differences in objective (%HRmax) and subjective (RPE scores) exercise load between the groups. 4. Mood state: Both groups showed no significant differences in vigor and fatigue scores on the POMS. Conclusion: To diversify exercise options, combining exergaming with HIIE when designing an exercise program could be an option in both young and older individuals.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Assessment of functional outcomes, level of fatigue, and risk of sarcopenia in COVID-19 patients at discharge: A cross sectional study

Background: There is emerging evidence with regards to reduced physical performance in patients recovering from COVID- 19 at time of hospital discharge. Assessing various functional parameters at discharge would shed light on the multi-system affection that could be helpful in formulating rehabilitation goals for the patient. Objectives of the study were to assess the physical performance, functional capacity, muscular strength, level of fatigue, and risk of sarcopenia in COVID-19 patients at discharge using short physical performance battery test, 1 minute sit to stand test, grip strength, fatigue assessment scale, SARC-CalF Scale respectively. Methods: This cross-sectional study comprised of 42 patients diagnosed with COVID-19 recruited from a tertiary care hospital. Demographic details and clinical variables were documented. Participants were assessed for physical performance, muscular strength, level of fatigue, functional capacity, and risk of sarcopenia. Data was analyzed using SPSS version 24. Results: The study comprised of 42 participants including 71.43% males (N=30) and 28.57% females (N=12) having mean age of 49.86±15.83 years. Findings of the assessed parameters were as follows: SPPB=7.57±2.84, 1 MSST=13.17±5.79 repetitions, grip strength=19.44±8.38 kg, FAS=19.79±10.83, SARC-CalF score=5.19±4.83. There was a weak positive correlation found between CT severity score and level of fatigue (r=0.325, p=0.036). Conclusions: This study provides a descriptive information about the functional outcomes of COVID -19 patients at discharge which can further be utilized for development of a tailor-made exercise program.

Expression of β1- and β2-adrenergic receptors in oral squamous cell carcinoma and their association with psychological and clinical factors

BackgroundPsychological stressors have been related to tumor progression through the activation of beta-adrenergic receptors (β-AR) in several types of cancer. Purpose: This study aimed to investigate the expressions of β1- and β2-AR and their association with psychological and clinicopathological variables in patients with oral squamous cell carcinoma. Methods: Tumor samples from 99 patients diagnosed with OSCC were subjected to immunohistochemical reaction to detect the expression of β1-AR and β2-AR. Anxiety and depression symptoms were assessed using the Beck Anxiety Inventory and Beck Depression Inventory (BDI), respectively. The Brunel Mood Scale was used for measuring affective mood states. Results: Univariate analyzes revealed that higher expression of β1-AR was associated with increased alcohol consumption (p = 0.032), higher education (p = 0.042), worse sleep quality (p = 0.044) and increased levels of pain related to the primary tumor (p < 0.001). Higher expression of β2-AR was related with regional metastasis (p = 0.014), increased levels of pain related to the primary tumor (p = 0.044), anxiety (p < 0.001) and depressive (p = 0.010) symptoms and higher mood scores of angry (p = 0.010) and fatigue (p = 0.010). Multivariate analysis identified that patients with advanced clinical stage had lower β1-AR expression (OR=0.145, 95% CI=0.025–0.828, p = 0.003). Higher anxiety symptoms and higher mood fatigue are independent factors for increased β2-AR expression (OR=4256, 95% CI=1439–12606, p = 0.009; OR=3816, 95% CI=1258–11,573, p = 0.018, respectively). Conclusion: This study reveal that anxiety, fatigue symptoms, and clinical staging are associated with tumor expression of beta-adrenergic receptors in patients with oral cancer.