Significant Differences In Physical Functioning Research Articles

Exercise intervention in brain injury: a pilot randomized study of Tai Chi Qigong

Objective: To examine the effects of a brief Tai Chi Chuan Qigong (`Qigong') exercise intervention on individuals with traumatic brain injury. Design: A single-centre randomized controlled trial pilot study. Setting: A registered charity day centre in the community. Subjects: Twenty individuals with traumatic brain injury. Intervention: Intervention participants attended a Qigong exercise session for one hour per week over eight weeks. Control participants engaged in non-exercise-based social and leisure activities for the same intervention period. Measures: Outcome was assessed at baseline and post intervention using the General Health Questionnaire-12, the Physical Self-Description Questionnaire and the Social Support for Exercise Habits Scale, to measure perceived mood, self-esteem, flexibility, coordination, physical activity and social support. Results: Groups were comparable at baseline. After the intervention, mood was improved in the exercise group when compared with controls (U = 22.0, P =0.02). Improvements in self-esteem (Z = 2.397, P =0.01) and mood (Z = —2.032, P =0.04) across the study period were also evident in the exercise group only. There were no significant differences in physical functioning between groups. In view of the sample size, these findings are inconclusive. Conclusions: This study provides preliminary evidence that a brief Qigong exercise intervention programme may improve mood and self-esteem for individuals with traumatic brain injury. This needs to be tested in a large-scale randomized trial.

Quality of life in relation to hormonal treatment of postmenopausal women in the Dutch Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial.

Abstract Abstract #21 Background In the last decade, use of adjuvant hormonal treatment increased as well as its duration. Aromatase inhibitors are associated with a minimal increase of disease free survival compared to tamoxifen. Both therapies are associated with different side effects which can affect quality of life (QoL). Therefore, it is necessary to compare the QoL of patients using these therapies. We compared the QoL of women participating in the Dutch Tamoxifen Exemestane Adjuvant Multicentre (TEAM) Trial.
 Patients and Methods The Dutch TEAM trial included 2754 postmenopausal early breast cancer patients who were randomised between five years of exemestane or 2.5-3 years of tamoxifen followed by 2.5-2 years of exemestane. A total of 742 patients were invited onto the QoL subprotocol. At one (T1) and two (T2) years after start of hormonal treatment, patients were ask to fill in questionnaires. This questionnaire contains the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and the EORTC BR23 questionnaires, supplemented with Functional Assessment of Cancer Therapy - Endocrine Subscale (FACT-ES) questions covering endocrine symptoms. The endpoint was the difference in QoL between patients receiving tamoxifen or exemestane.
 Results Questionnaires were completed by 543 patients at T1 and 83% of these returned the questionnaire of T2. There were no significant differences in physical functioning, role functioning, cognitive functioning, emotional functioning, body image, breast symptoms, arm symptoms and endocrine symptoms between both treatment groups at T1 nor at T2. Patients receiving exemestane had significantly less sexual enjoyment (difference of 9 points on a 0-100 scale; p=0.004) and more insomnia (difference of 8 points; p=0.005) compared to patients receiving tamoxifen at T1. At T2, there was no statistically significant difference in sexual enjoyment (difference of 4 points; p=0.287). However, patients receiving exemestane reported significantly worse sexual functioning (difference of 5 points; p=0.020) and still more insomnia (difference of 8 points; p=0.004).
 Conclusion Patients using exemestane reported less sexual enjoyment and more sexual functional problems than patients using tamoxifen. This may be explained by the fact that specific side effects of exemestane (e.g. vaginal dryness) can cause less sexual enjoyment which can result in a decreased sexual functioning. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 21.

Quality of Life with Defibrillator Therapy or Amiodarone in Heart Failure

Implantable cardioverter-defibrillator (ICD) therapy significantly prolongs life in patients at increased risk for sudden death from depressed left ventricular function. However, whether this increased longevity is accompanied by deterioration in the quality of life is unclear. In a randomized trial, we compared ICD therapy or amiodarone with state-of-the-art medical therapy alone in 2521 patients who had stable heart failure with depressed left ventricular function. We prospectively measured quality of life at baseline and at months 3, 12, and 30; data collection was 93 to 98% complete. The Duke Activity Status Index (which measures cardiac physical functioning) and the Medical Outcomes Study 36-Item Short-Form Mental Health Inventory 5 (which measures psychological well-being) were prespecified primary outcomes. Multiple additional quality-of-life outcomes were also examined. Psychological well-being in the ICD group, as compared with medical therapy alone, was significantly improved at 3 months (P=0.01) and at 12 months (P=0.003) but not at 30 months. No clinically or statistically significant differences in physical functioning among the study groups were observed. Additional quality-of-life measures were improved in the ICD group at 3 months, 12 months, or both, but there was no significant difference at 30 months. ICD shocks in the month preceding a scheduled assessment were associated with a decreased quality of life in multiple domains. The use of amiodarone had no significant effects on the primary quality-of-life outcomes. In a large primary-prevention population with moderately symptomatic heart failure, single-lead ICD therapy was not associated with any detectable adverse quality-of-life effects during 30 months of follow-up.

Comparison of quality of life and causes of hospitalization between hemodialysis and peritoneal dialysis patients in China

BackgroundHemodialysis (HD) and peritoneal dialysis (PD) are important renal replacement treatment in end stage renal disease (ESRD), but the comparison of quality of life (QOL) and causes of hospitalisation between the two modalities in China is lacking. In the present study, we compared the two modalities in a multi-center study.Subjects and methodsSix hundred and fifty four HD and 408 PD patients were investigated from 10 hospitals in China from Sept, 2004 to Jan, 2005. Among the HD patients, there were 360 males and 294 females with a mean age of 57.22 ± 12.49 years (18–88 y). Among PD patients, there were 165 males and 243 females, with a mean age of 61.59 ± 12.65 years (22–89 y). Health related 36 items short form questionnaires (SF-36) were used to assess the quality of life. Hospitalisation data were collected and analyzed.ResultsSF-36 domains of Body Pain (BP), General Health (GH), Role-Emotional (RE), Social Functioning (SF), Vitality (VT) and Mental Health (MH) were all significantly higher in the PD patients as compared to the HD patients although there was no significant difference in Physical Functioning (PF) and Role-Physical (RP) between the two groups. The two most common causes of hospitalisation in HD patients were cardiovascular disease (39.8%) and pulmonary infection (21.3%), while they were infectious peritonitis (47.6%) and cardiovascular disease (31.9%) in PD patients. The ever hospitalised patients had lower SF-36 scores in the domains of PF, BP, GH, RE, SF, VT and MH as compared to those of non-hospitalised patients.ConclusionOur study indicated that with the current practice in China, PD patients may enjoy better quality of life than their HD counterparts. Our results also showed that the most common cause of hospitalisation was cardiovascular disease in HD patients and peritonitis in PD patients.

Health‐related quality of life measured by the Short Form 36 in immune thrombocytopenic purpura: a cross‐sectional survey in China

The aim of this study is to assess the quality of life (QoL) of Chinese adults with idiopathic thrombocytopenic purpura (ITP). The Chinese (mainland) version of Medical Outcome Study SF-36 form (SF-36) Health Survey was used to measure health-related QoL of 236 adults with ITP in a cross-sectional study. Comparison of SF-36 subscores of patients with ITP with healthy individuals revealed the reduction of QoL in all of the eight SF-36 dimensions. The difference on statistical significance presented in six of eight dimensions of SF-36 including physical functioning (PF), role limitations due to physical problems, body pain, general health perception (GH), social functioning (SF), and role limitations due to emotional problems (RE) between the patients with ITP and the normal population (P < 0.01). The acute ITP group showed better scores in three dimensions including GH, energy/vitality, and RE than chronic ITP (P < 0.01). Meanwhile through classification with platelet count, three subgroups of patients also experienced significant differences in PF, GH, and SF from the eight dimensions. Age was a significant negative predictor of all eight dimensions other than the SF while current platelet count was a significant negative predictor of GH. Moreover, the treatment cost and family income also influenced the QoL scores. The subjective feeling of fear about bleeding had a detrimental impact on QoL. QoL was impaired in patients with ITP, especially in the acute patients. The platelet count and the feeling of fear about bleeding had a detrimental impact on QoL.

Miniseminar: Vocal Fold Medialization: Injection Versus Thyroplasty?

Medialization laryngoplasty restores voice in patients with unilateral laryngeal paralysis. Of question was whether patients with vocal fold paralysis resulting from cancer or its treatment had as good a post-operative voice result as patients with vocal fold paralysis of benign etiology. The purpose of the present study was to compare post-operative perceptual, acoustic, aerodynamic, and quality of life data in these two patient groups. Twenty-eight patients with vocal fold paralysis secondary to malignancy or its treatment were age and gender-matched with patients with paralysis resulting from benign origin. Pre- and post-operative perceptual judgments of pitch, loudness and quality were rated independently by two speech–language pathologists. A digital audiotape of the patient's voice was analyzed using Soundscope software. Fundamental frequency, conversational intensity and perturbation were evaluated. Glottal flow rates in propositional speech, phonation times and extent of pitch and loudness ranges were also measured. Three quality of life surveys, the Short Form-36 general health survey, the Voice Handicap Index, and the Voice Outcomes Study were administered. Results of voice testing indicated that perceptual, acoustic and aerodynamic data were significantly improved 3 months after thyroplasty in all patients regardless of whether they had a history of cancer. Quality of life data, however, distinguished the two groups. In particular, the general health measure found a significant difference in physical functioning and overall vitality, although satisfaction with improved voice was equally appreciated in both patient groups. Of clinical significance is that though general health may differ, patients with cancer-related laryngeal paralysis can expect to have as good a voice outcome following thyroplasty as patients with paralysis of benign etiology.

Outcomes of treated human granulocytic ehrlichiosis cases.

We conducted a case-control study in Wisconsin to determine whether some patients have long-term adverse health outcomes after antibiotic treatment for human granulocytic ehrlichiosis (HGE). A standardized health status questionnaire was administered to patients and controls matched by age group and sex. Consenting patients provided blood samples for serologic testing. Among the 85 previously treated patients, the median interval since onset of illness was 24 months. Compared with 102 controls, patients were more likely to report recurrent or continuous fevers, chills, fatigue, and sweats. Patients had lower health status scores than controls for bodily pain and health relative to 1 year earlier, but there was no significant difference in physical functioning, role limitations, general health, or vitality measures. The HGE antibody titer remained elevated in one patient; two had elevated aspartate aminotransferase levels. HGE may cause a postinfectious syndrome characterized by constitutional symptoms without functional disability or serologic evidence of persistent infection.

Voice outcome following thyroplasty in patients with cancer-related vocal fold paralysis

Medialization laryngoplasty restores voice in patients with unilateral laryngeal paralysis. Of question was whether patients with vocal fold paralysis resulting from cancer or its treatment had as good a post-operative voice result as patients with vocal fold paralysis of benign etiology. The purpose of the present study was to compare post-operative perceptual, acoustic, aerodynamic, and quality of life data in these two patient groups. Twenty-eight patients with vocal fold paralysis secondary to malignancy or its treatment were age and gender-matched with patients with paralysis resulting from benign origin. Pre- and post-operative perceptual judgments of pitch, loudness and quality were rated independently by two speech–language pathologists. A digital audiotape of the patient's voice was analyzed using Soundscope software. Fundamental frequency, conversational intensity and perturbation were evaluated. Glottal flow rates in propositional speech, phonation times and extent of pitch and loudness ranges were also measured. Three quality of life surveys, the Short Form-36 general health survey, the Voice Handicap Index, and the Voice Outcomes Study were administered. Results of voice testing indicated that perceptual, acoustic and aerodynamic data were significantly improved 3 months after thyroplasty in all patients regardless of whether they had a history of cancer. Quality of life data, however, distinguished the two groups. In particular, the general health measure found a significant difference in physical functioning and overall vitality, although satisfaction with improved voice was equally appreciated in both patient groups. Of clinical significance is that though general health may differ, patients with cancer-related laryngeal paralysis can expect to have as good a voice outcome following thyroplasty as patients with paralysis of benign etiology.

Predictors of physical functioning among geriatric patients with small cell or non-small cell lung cancer 3 months after diagnosis.

This study investigated how treatment options, symptom severity, prediagnosis levels of physical functioning, comorbidity, gender, and age predicted current physical functioning in geriatric patients with small-cell or non-small-cell lung cancer, 12 weeks after their diagnosis. The study involved 146 patients aged 65 years and over with an incident diagnosis of lung cancer. Analysis of covariance revealed no significant differences in physical functioning according to treatment type, small-cell versus non-small-cell classification or gender. Significant predictors of current physical functioning were symptom severity and prior physical functioning. The characteristics of a high-risk profile for disruption in physical functioning of elderly lung cancer patients 12 weeks after their diagnosis would include preexisting physical impairment and high levels of symptomatology.

Evaluación del estado de salud con la Encuesta SF-36: resultados preliminares en México

To establish a multidimensional profile of the health status in a population of southeastern Mexico and analyze the psychometric properties of a translation of the SF-36 survey authorized by the International Quality of Life Assessment Project. The SF-36 was administered to 257 volunteers of a clinic and a control group in a governmental institution. The methodology proposed by the author of the survey to build the health scales was used without modifications. The validity and reliability of the SF-36 adaptation to Mexico was psychometrically analyzed. Eight scales or health concepts related to physical function, physical role, body pain, general health, vitality, social function, emotional role and mental health were constructed. In the health service volunteers, the scale with the lowest mean was general health (63), and that with the highest (89) was physical role. In the control population, the lowest mean was general health (73) and the highest (94.6) was physical function. A comparison of the health scales of both groups showed significant differences in physical function, physical role, body pain, general health and vitality. Based on the psychometric evaluation, the SF-36 shows satisfactory consistency with its supposed validity and reliability, although the translation of certain items will be further analyzed for subsequent modifications.

Comparison of the rehabilitation status of continuous ambulatory peritoneal dialysis and in‐centre haemodialysis in Chinese patients

Summary: In Hong Kong, dialysis treatment has become more accessible in recent years. Due to a shortage of kidney donors patients are required to stay on dialysis for longer periods. the rehabilitation status of 181 end‐stage renal failure (ESRF) patients on dialysis, 34 on in‐centre haemodialysis (ICHD) and 147 on continuous ambulatory peritoneal dialysis (CAPD), at the Prince of Wales Hospital was studied. There was no statistically significant difference in physical functioning due to treatment type; however, CAPD patients were shown to be more socially active and had a better family life than ICHD patients (P &lt; 0.01). There were no statistically significant correlations between physical functioning, social life or family life and the duration of dialysis in both ICHD and CAPD patients. In both groups of patients 52.9% of ICHD and 52.4% of CAPD patients had decreased employment status. All the patients were assessed by doctors‐in‐charge on their physical fitness for employment, 85.7% (n= 6) of the unemployed ICHD patients and 71% (n= 44) of the unemployed CAPD patients were considered to be physically fit to work. Due to the ageing of the general population and greater availability of dialysis treatment and higher survival rate of the chronically ill have led to an increase in the number of elderly patients on dialysis (aged 60 years and over). the proportion of elderly dialysis patients in our renal centre increased from 7–23% in the past 5 years. Continuous ambulatory peritoneal dialysis patients aged less than 60 years were found to be significantly more physically active and socially active than CAPD patients aged over 60 years (P &lt; 0.01). In the aspect of a better family life for these patients, no statistically significant difference was found between the two groups. Rehabilitation of ESRF patients can be achieved by renal replacement therapy. It is concluded that CAPD patients have better adaptation in social life and family life than ICHD patients.