Significant Improvements In Outcome Measures Research Articles

Ultrasound-guided electrocoagulation of neovascularisation for persistent patellar tendinopathy in athletes: a cohort study of 25 patients with a mean follow-up of 5 years from the SANTI Study Group

BackgroundPatellar tendinopathy (PT) is a common condition characterised by persistent patellar tendon pain and dysfunction, particularly in athletes. Neovascularisation is frequently observed in the PT and is associated with increased...

EFFECTIVENESS OF ULTRASOUND GUIDED DEXTROSE PROLOTHERAPY INJECTION IN COMPARISON WITH EXTRACORPOREAL SHOCK WAVE THERAPY ON IMPROVING PAIN AND FUNCTION AMONG ATHLETES WITH ACHILLES TENDINOPATHY: A RANDOMIZED CONTROLLED TRIAL

Background: Achilles tendinosis is a chronic, degenerative condition affecting both sedentary individuals and athletes of all abilities, with prevalence in running-based sports particularly high. Pain is considered to be the primary symptom of Achilles tendinosis, to the extent that it is suggested that a patients symptoms can reflect the severity of the condition. Several treatment modalities such as activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading are known as standard treatment mostly without proven evidence. Objectives: To determine the effectiveness of ultrasound guided Dextrose prolotherapy injection in comparison with extracorporeal wave therapy on improving pain and function among athletes with Achilles tendinopathy Study Design: A Randomized controlled trial Methods: Fifty eight athletes with achilles tendinopathy meeting the inclusion and exclusion criteria were selected for this study and randomized into 2 treatment groups: dextrose prolotherapy injection under ultrasound guidance (prolotherapy group n = 29), and 3 sessions of focused extracorporeal shock wave therapy (ESWT group n = 29). The outcome measures were Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire and pain visual analog scale (VAS). Both the groups underwent rehabilitation programs. For descriptive statistics mean, standard deviation and frequency were used. Continuous variables were analysed by students t-test. Categorical variables were analysed using Chi-square test. Within the group comparison (baseline and follow-up data of each group) was done by Repeated measures ANOVA. Between the groups comparison was analysed using students t-test. A p-value < 0.05 was taken as significant. Results: The 2 groups were homogeneous in terms of their baseline characteristics like age, gender, duration of symptoms and side of affection (p > 0.05). Within the group comparison showed significant improvement in outcome measures in both the groups at all follow ups (p = 0.00). Between the groups analysis found improvement in the VAS and VISA-A scores at all follow ups but the improvement was significantly more in the Prolotherapy group in comparison with the ESWT group (p = 0.00). Conclusion: Ultrasound guided injection of dextrose prolotherapy in combination with eccentric strengthening exercises lead to significant improvement in pain and function over the long term in comparison with focused ESWT among athletes with Achilles tendinosis and thereby enabling faster return to sports.

Long term effects of continuous positive airway pressure treatment of obstructive sleep apnea-hypopnea syndrome in multiple sclerosis patients

BackgroundObstructive sleep apnea-hypopnea (OSAH) is common in MS patients and is associated with fatigue. We recently published a randomized, controlled trial (RCT) of active vs sham continuous positive airway pressure (CPAP) treatment in MS patients with fatigue, poor sleep quality, and (OSAH) (Mult Scl J 2022;28:82–92). Our aim was to evaluate the long-term effects of CPAP treatment on fatigue (Fatigue Severity Scale, FSS, primary outcome) and other clinical outcomes in MS patients with OSAH. MethodsFollowing the RCT, participants were offered treatment with CPAP and participation in an open label study. Patients were re-evaluated with RCT outcome measures at least 6 months after completion of the RCT. ResultsTwenty-eight of 34 (82 %) RCT-completers participated in this study a mean of 2.7 years after the RCT. Sixteen (57 %) patients were treated with CPAP (mean use 5.4 ± 1.0 h/night during the 6 months prior to follow-up visit), while the other 12 patients declined CPAP use and received no other OSAH treatments. Baseline clinical characteristics, including MS related disability and sleep outcomes, were not significantly different between CPAP-treated vs non-CPAP treated patients. Patients using CPAP at follow-up (n = 16) demonstrated significant improvements from RCT baseline in FSS (p = 0.005), Fatigue Scale for Motor and Cognitive Functions (p = 0.008, p = 0.012), Pittsburgh Sleep Quality Index (p = 0.016), Center of Epidemiological Studies-Depression Scale (p = 0.05), and Multiple Sclerosis Quality of Life-54 (MSQOL-54) physical and mental component scores (p = 0.012, p = 0.023), but no improvements in Epworth Sleepiness Scale, Pain Visual Analog Scale, or Expanded Disability Status Scale. Patients not using CPAP (n = 12) had no significant improvements in outcome measures. Using a linear mixed model, FSS (p = 0.03), morning fatigue (p = 0.048), and MSQOL-54 physical component score (p = 0.02) improved significantly in CPAP treated patients compared with non-CPAP treated patients from RCT baseline. ConclusionIn this post-RCT open label study, long-term CPAP use was associated with improved fatigue (FSS, our primary outcome) and physical quality of life in MS patients with OSAH.

Does the Role of Family Assisted Cognitive Remediation Therapy Still Exists in Modern Era of Artificial Intelligence: A Randomized Case-control Study for Schizophrenia Patients from Rural Background

Background: Last decade showed promising evidences of computer based therapies, incorporating either an in-patient or home-based computer model for training the family members. The crux of all these studies focuses on the role of “family”. The compliance and perception, from a patient perspective, especially in a developing country, is still unproven. Purpose and Design: The aim of our randomized case-control study, was to analyze the impact of add-on FACT in stable patients of Schizophrenia and assess and the level of functioning and quality of life (QoL) among two groups. The primary outcome measures (PANSS and SCoRS) and secondary outcome measure (GAF and WHODAS) were compared among two groups. Material and methods: 96 patients of stable Schizophrenia, were randomized in two groups, Group A (study group, n=48) included patients, who receive add-on FACT and Group B (control group, n=48) includes the patients on our standard protocol (pharmacotherapy and brief counselling). Both the groups received single session of psycho-education with, Group A receiving an additional four training sessions. We targeted prospective memory, conversational and task vigilance, verbal learning and memory, cognitive flexibility and problem solving in our sessions. Assessments were done at baseline, 8 and 16 weeks and domains were compared. Results: There was significant improvement in outcome measures of psychopathology, level of functioning, quality of life and disability among patients of Group A. Of the cognitive domains, trend of an improvements was seen inattention/vigilance, working memory, processing speed, household responsibility and social cognition. Conclusion: The collaborative efforts of treating physician and family involvement showed significant clinical outcome. FACT holds promise in the rehabilitation for stable patients of schizophrenia. The therapy modifies family dynamics, retaining the roots of psycho-education and tailored cognitive therapy model; irreplaceable for any artificial intelligence model.

The effectiveness of robotic-assisted upper limb rehabilitation to improve upper limb function in patients with cervical spinal cord injuries: a systematic literature review.

Spinal Cord Injury (SCI) damages corticospinal tracts and descending motor pathways responsible for transmitting signals from the brain to the spinal cord, leading to temporary or permanent changes in sensation, motor function, strength, and body function below the site of injury. Cervical SCI (cSCI), which leads to tetraplegia, causes severe functional upper limb (UL) impairments that increase falls risk, limits independence, and leads to difficulties with activities of daily living (ADLs). Robotic therapy (RT) has been developed in recent decades as a new treatment approach for people with cervical spinal cord injuries (cSCI). The present review aimed to explore current available evidence and studies regarding the effectiveness of RT for individuals with cSCI in improving UL function, identify current research gaps and future research directions. This review was conducted by searching PubMed, CINAHL, Medline, Embase, and APA PsycInfo for relevant studies published from January 2010 to January 2022. Selected studies were analyzed with a focus on the patients' self-perception of limited UL function and level of independence in activities of daily living. In addition, the JBI Critical Appraisal checklist was used to assess study quality. A total of 7 articles involving 87 patients (74 males and 13 females) were included in the analysis, with four studies utilizing exoskeleton and three studies utilizing end-effector robotic devices, respectively. The quality of these studies varied between JBI Critical Appraisal scores of 4 to 8. Several studies lacked blinding and a control group which affected internal validity. Nevertheless, four out of seven studies demonstrated statistically significant improvements in outcome measurements on UL function and strength after RT. This review provided mixed evidence regarding the effectiveness of RT as a promising intervention approach to improve upper limb function in participants with cSCI. Although RT was shown to be safe, feasible, and reduces active therapist time, further research on the long-term effects of UL RT is still needed. Nevertheless, this review serves as a useful reference for researchers to further develop exoskeletons with practical and plausible applications toward geriatric orthopaedics.

Early Initiated Multimodal Postoperative Physical Therapy Program for Anterior Cervical Discectomy and Fusion: A Case Report With 2-Year Outcomes

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a common surgical procedure for cervical radiculopathy. While postoperative physical therapy (PT) has been shown to be effective after many orthopaedic surgeries, there is limited evidence available regarding postoperative PT after ACDF for cervical radiculopathy. CASE PRESENTATION: A 61-year-old male initiated early in-person PT 2 weeks following 2-level ACDF, which utilized a multimodal PT program (manual therapy, patient education, therapeutic exercise, self-management, HEP, modalities) guided by tissue healing, achievement of clinical objective milestones, and clinical reasoning. OUTCOME AND FOLLOW-UP: Significant improvement in outcome measures (numeric pain-rating scale, neck disability index, 36-item short-form health survey, global rating of change, fear avoidance beliefs questionnaire, cervical active range of motion) was achieved 12 weeks postoperatively and maintained up to 2 years with no adverse events. DISCUSSION: Early initiated in-person multimodal postoperative PT may be safe and effective for patients at all stages of healing after ACDF. Further research is needed to address the benefits to larger patient populations. JOSPT Cases 2023;3(3):163-173. Epub: 20 June 2023. doi:10.2519/josptcases.2023.11608

The efficacy of glyceryl trinitrate for acute intracerebral hemorrhage: A systematic review and meta-analysis.

Current research on the effects of glyceryl trinitrate (GTN) on the lowering of elevated blood pressure (BP) among patients with acute intracerebral hemorrhage (AIH) has not been highly emphasized. The aim of this meta-analysis is to examine the effects of GTN in patients with acute stroke. The lowering of BP was the primary outcome measure in patients treated with GTN compared to no-GTN treatment. A meta-analysis was performed to evaluate the efficacy of GTN in lowering BPs and analyze the outcomes of GTN treatment. Appropriate articles were searched using PubMed, Taylor & Francis Online, Cochrane, Scopus, ScienceDirect, Wiley Online Library, and Springer, with the use of appropriate keywords as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Out of 13 articles eligible for this study, 7 studies qualified for the meta-analysis by meeting the inclusion criteria. The PRISMA guidelines and the recommendations of Cochrane Collaboration were followed when conducting this meta-analysis. After subgroup analysis, differences between patients treated with GTN and without GTN were analyzed. The lowering of BP resulted in improved functional outcomes in patients treated with GTN. This meta-analysis showed differences between the 2 groups, with a risk ratio (RR) of 1.01 (95% confidence interval (95% CI): 0.92-10.07, p = 0.30, I2 = 18%). There was a significant improvement in outcome measures in patients treated with GTN by lowering elevated BP after acute stroke.

Pandemic Phase-Adjusted Analysis of COVID-19 Outcomes Reveals Reduced Intrinsic Vulnerability and Substantial Vaccine Protection From Severe Acute Respiratory Syndrome Coronavirus 2 in Patients With Breast Cancer.

Although representing the majority of newly diagnosed cancers, patients with breast cancer appear less vulnerable to COVID-19 mortality compared with other malignancies. In the absence of patients on active cancer therapy included in vaccination trials, a contemporary real-world evaluation of outcomes during the various pandemic phases, as well as of the impact of vaccination, is needed to better inform clinical practice. We compared COVID-19 morbidity and mortality among patients with breast cancer across prevaccination (February 27, 2020-November 30, 2020), Alpha-Delta (December 1, 2020-December 14, 2021), and Omicron (December 15, 2021-January 31, 2022) phases using OnCovid registry participants (ClinicalTrials.gov identifier: NCT04393974). Twenty-eight-day case fatality rate (CFR28) and COVID-19 severity were compared in unvaccinated versus double-dosed/boosted patients (vaccinated) with inverse probability of treatment weighting models adjusted for country of origin, age, number of comorbidities, tumor stage, and receipt of systemic anticancer therapy within 1 month of COVID-19 diagnosis. By the data lock of February 4, 2022, the registry counted 613 eligible patients with breast cancer: 60.1% (n = 312) hormone receptor-positive, 25.2% (n = 131) human epidermal growth factor receptor 2-positive, and 14.6% (n = 76) triple-negative. The majority (61%; n = 374) had localized/locally advanced disease. Median age was 62 years (interquartile range, 51-74 years). A total of 193 patients (31.5%) presented ≥ 2 comorbidities and 69% (n = 330) were never smokers. In total, 392 (63.9%), 164 (26.8%), and 57 (9.3%) were diagnosed during the prevaccination, Alpha-Delta, and Omicron phases, respectively. Analysis of CFR28 demonstrates comparable estimates of mortality across the three pandemic phases (13.9%, 12.2%, 5.3%, respectively; P = .182). Nevertheless, a significant improvement in outcome measures of COVID-19 severity across the three pandemic time periods was observed. Importantly, when reported separately, unvaccinated patients from the Alpha-Delta and Omicron phases achieved comparable outcomes to those from the prevaccination phase. Of 566 patients eligible for the vaccination analysis, 72 (12.7%) were fully vaccinated and 494 (87.3%) were unvaccinated. We confirmed with inverse probability of treatment weighting multivariable analysis and following a clustered robust correction for participating center that vaccinated patients achieved improved CFR28 (odds ratio [OR], 0.19; 95% CI, 0.09 to 0.40), hospitalization (OR, 0.28; 95% CI, 0.11 to 0.69), COVID-19 complications (OR, 0.16; 95% CI, 0.06 to 0.45), and reduced requirement of COVID-19-specific therapy (OR, 0.24; 95% CI, 0.09 to 0.63) and oxygen therapy (OR, 0.24; 95% CI, 0.09 to 0.67) compared with unvaccinated controls. Our findings highlight a consistent reduction of COVID-19 severity in patients with breast cancer during the Omicron outbreak in Europe. We also demonstrate that even in this population, a complete severe acute respiratory syndrome coronavirus 2 vaccination course is a strong determinant of improved morbidity and mortality from COVID-19.

Effect of exergames by using Xbox 360 Kinect on cognition of older adults with mild cognitive impairment

Objective: To determine the effects of exergames by using Xbox 360 Kinect on cognition in older adults with mild cognitive impairment (MCI). Methodology: This randomized control trial included 56 MCI older adults who were randomly divided into experimental group (n=28) and control group (n=28), using coin and toss method. The experimental group performed X-box 360 Kinect games while the control group received stretching and strength training exercises of upper and lower extremity. The intervention was of 30 min per day/5 days per week for six weeks. Mini-mental state examination, Montreal Cognitive Assessment, Trail making Test A and B, Verbal fluency (Semantic/ Phenomic) were used as outcome measures at baseline and after six weeks of intervention. Data were analyzed by SPSS 26. Results: Final analysis included 51 subjects, out of which 26 were in experimental group with mean age 62.85±5.56 yrs.,16 (61.5%) males and 10 (38.5%) females. In control, there were 25 subjects with mean age 63.24±5.12 yrs., 15 (60.0%) males and 10 (40.0%) females. Inter-group analysis showed significant improvement in outcomes measures after six weeks of intervention in experimental group (p<0.05). Conclusion: Exergames showed positive effects on cognitive domains in older adults with MCI.

An evaluation of the aged mental health and primary care partnership program.

To evaluate the Mental Health and Primary Care Partnership (MaP) pilot program which operated in a metropolitan Melbourne setting in 2020. Data collection included: surveys, interviews, file audits, and an evaluation of routinely collected data, with MaP consumers, their carers, GPs, Practice Managers and Nurses located in Boroondara, and MaP and Aged Person's Mental Health Service staff. Thirty-five consumers aged between 66 and 101 years old (of whom 63% were female) received support from the MaP program throughout its 12-month operation. Statistically significant improvements in outcome measures assessing for psychological distress and symptoms of mental illness were observed. Strengths of the program included the single referral pathway and the provision of services for those not meeting criteria to access tertiary mental health support. Consumers and clinicians made recommendations for service improvement including provision of a longer duration of care to consumers and greater integration of community and primary care. It is hoped that the learnings from the MaP pilot program can be used to guide future program development.

Outcomes of Arthroscopic Lysis of Adhesions for the Treatment of Postoperative Knee Arthrofibrosis: A Systematic Review.

Background:Postoperative knee arthrofibrosis is a common and potentially detrimental complication affecting knee function and gait. Several cohort studies have reported good outcomes after arthroscopic lysis of adhesions (LOA) with manipulation under anesthesia (MUA).Purpose:To review the literature assessing the efficacy and complications of arthroscopic LOA and MUA for postoperative arthrofibrosis of the knee and evaluate whether any relevant subgroups are associated with different clinical presentation and outcomes.Study Design:Systematic review; Level of evidence, 4.Methods:This review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Eligible studies published from January 1, 1990, to April 1, 2021, were identified through a search of the US National Library of Medicine (PubMed/MEDLINE), EMBASE, and Cochrane databases. All studies included in this analysis included pre- and postoperative range of motion measurements for their treated patients. Studies reporting outcomes for patients with isolated cyclops lesions after anterior cruciate ligament reconstruction were excluded.Results:Eight studies comprising 240 patients were included. The mean time from index surgery to arthroscopic LOA and MUA was 8.4 months, and the mean postoperative follow-up was at 31.2 months. All studies demonstrated a significant improvement (41.6°) in arc of motion after arthroscopic LOA. Clinically significant improvements in outcome measures, including the International Knee Documentation Committee, Western Ontario and McMaster Universities Osteoarthritis Index, and Knee injury and Osteoarthritis Outcome Score, were reported after arthroscopic LOA across all applicable studies. Of 240 patients, a single complication (synovial fistula) occurred after LOA and MUA, which resolved without intervention.Conclusion:The results of this review indicated that arthroscopic LOA and MUA is a safe and efficacious treatment for postoperative arthrofibrosis of the knee.

Most Elite Athletes Who Underwent Hip Arthroscopy for Femoroacetabular Impingement Syndrome Did Not Return to the Same Level of Sport, but the Majority Were Satisfied With the Outcome of Surgery

PurposeTo evaluate the 2-year outcomes after arthroscopic surgical treatment for femoroacetabular impingement syndrome (FAIS) using validated patient-reported outcome measurements in young elite athletes and to report the rate of return to sport.MethodsYoung elite athletes undergoing arthroscopic surgery for FAIS with 2 years of follow-up were included. A young elite athlete was defined as an athlete aged 18 to 22 years at the time of surgery with a Hip Sports Activity Scale (HSAS) level greater than 6 before the onset of symptoms. The following patient-reported outcome measurements were collected prospectively: Copenhagen Hip and Groin Outcome Score, 12-item International Hip Outcome Tool, HSAS, visual analog scale (VAS), European Quality of Life (EQ) 5 Dimensions questionnaire, and EQ VAS. Furthermore, the patients answered a question related to satisfaction with surgery at follow-up.ResultsA total of 84 athletes (67 male and 17 female athletes), with a mean age of 19.8 ± 1.5 years, completed the 2-year follow-up. Bilateral hip arthroscopy was performed in 57 athletes, generating a total of 141 included hips. The improvements in the Copenhagen Hip and Groin Outcome Score subscales, 12-item International Hip Outcome Tool, EQ 5 Dimensions questionnaire, EQ VAS, and VAS for overall hip function were statistically significant (P < .001). At the 2-year follow-up, 42% of the athletes reported an HSAS level of either 7 or 8 whereas 28% reported an HSAS level of 5 or 6. In total, 79% of the athletes were satisfied with the surgical procedure.ConclusionsThere are significant improvements in outcome measurements at the 2-year follow-up in elite young athletes undergoing arthroscopic hip surgery for FAIS. Although many of the athletes remained in high-level sports 2 years after surgery, only 30% of the athletes returned to sport at the same level.Level of EvidenceLevel IV, therapeutic case series.

Sex Education by Theatre (SExT): the impact of a culturally empowering, theatre-based, peer education intervention on the sexual health self-efficacy of newcomer youth in Canada

ABSTRACT Despite rising rates of sexually transmitted infections (STIs) and inequitable access to education and services, few studies have addressed the unique sex education needs of newcomer youth in Canada and other increasingly demographically diverse Western countries. This study involved the design, implementation and evaluation of a novel and innovative participatory action research project, SExT: Sex Education by Theatre. SExT is a theatre-based, culturally empowering, peer education intervention piloted in a multicultural area of Toronto. Young people were trained as peer educators through participation in theatre-based workshops culminating in the performance of a new play for peers. Mixed methods evaluation involved surveys, focus groups, peer interviews and arts-based data collection. Paired-samples t-tests were conducted to investigate changes in sexual health self-efficacy (protection, STI/HIV testing, sexual limit-setting) over three time-points (pre, post, 4-month follow-up). Thematic analysis was used to gain a deeper understanding of outcomes. Quantitative analysis demonstrated significant improvements in outcome measures from pre– to post-intervention that were maintained at follow-up. Qualitative data indicated increased sexual health self-efficacy attributed to SExT. Pilot study findings suggest that SExT may serve as a model for sexual health interventions in areas populated by newcomer and other priority youth groups.

EFFECT OF SOFT TISSUE MOBILISATION ON QUALITY OF LIFE AND PAIN PRESSURE THRESHOLD IN A PATIENT WITH SOMATIC TINNITUS: CASE REPORT

Somatic tinnitus is a condition that results from cervical spine or temporomandibular disorders. It commonly affects 36–43% of the Belgian population. We present a single case experimental design of a 38 year old somatic tinnitus patient having neck pain, headache, and ringing sensation in both ears. Six sessions of soft tissue mobilization were performed for 30 minutes on alternate days for two weeks. Postural re-education exercises were instructed as a home regime. Outcome measures were Visual Analogue Scale, Tinnitus Handicap Inventory, and digital calibrated algometer which were evaluated at baseline and after the last treatment session. Following 6 sessions of treatment there was a significant improvement in outcome measures. This study implies positive results of manual therapy on quality of life and pain pressure threshold in somatic tinnitus patients.

Temporal Trends and Outcome of Patients with Acute Coronary Syndrome and Prior Myocardial Infarction.

Patients who have previously had a myocardial infarction (MI) are considered a high-risk group with increased risk for cardiovascular (CV) events. During the last decade, the outcome of acute coronary syndrome (ACS) patients has improved due to advances in medical therapy and interventional techniques. We aimed to examine temporal trends and outcomes of patients with prior MI admitted due to ACS from the Acute Coronary Syndrome Israeli Survey (ACSIS). Included were 16,934 ACS patients, of whom 31.4% had prior MI. For temporal trend analysis, the cohort was divided into an early period (2000–2008) and late period (2010–2018). For patients with prior MI, patients in the late period had a higher rate of CV risk factors and were treated more frequently with revascularization and guidelines-directed medical therapy. Recurrent MI (6.7% vs. 12%, p < 0.001), MACE (10.6% vs. 21%, p < 0.001) and 1-year mortality (10.7% vs. 14.6%, p < 0.001) were significantly lower in the late period. However, the mortality rate for patients with prior MI remained higher compared with patients without prior MI (10.7% vs. 6.8% p < 0.001) with an overall higher mortality rate in the STEMI group. Thus, despite significant improvement in outcome measures in the contemporary era, ACS patients with prior MI are still at increased risk for recurrent ischemic CV events and mortality.

Comparison of the effectiveness of proprioceptive neuromuscular facilitation exercises and shoulder mobilization patients with Subacromial Impingement Syndrome: A randomized clinical trial

IntroductionThe aim of this study was to compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) exercises and shoulder mobilization (SM) in addition to conventional physiotherapy on pain, range of motion (ROM), functionality, and muscle strength in patients with Subacromial Impingement Syndrome (SIS). MethodsForty-four patients were randomly allocated into three groups as conventional physiotherapy (control group; n = 14), conventional physiotherapy + PNF exercises (PNF group; n = 15), and conventional physiotherapy + SM techniques (SM group; n = 15). Pain, ROM, muscle strength, and functionality were evaluated by using VAS (Visual Analog Scale), goniometer, push-pull dynamometer, Constant-Murley score and DASH (Disabilities of the Arm, Shoulder and Hand) score. Patients were received 20 sessions (4 weeks) of treatment. Assessments were performed at baseline, and weeks two, four, and sixteen. ResultsAfter treatment, significant improvements in outcome measurements were observed in all groups (all p < 0.05). PNF or SM groups were not superior to each other in terms of improving pain and functionality. SM group was superior to PNF group for improving shoulder flexion ROM at week 4 (p = 0.009). The improvements in shoulder extension muscle strength were greater in PNF group at weeks 2 and 16 compared with other groups (p = 0.030, 0.035). ConclusionPNF or SM, in addition to conventional physiotherapy, might help to improve pain and functionality more in patients with SIS. It is recommended to add SM or PNF to conventional treatment to maintain the ROM increase gained with SIS treatment after treatment, and to apply this treatment for 4 weeks for muscle strength increase.

A Mixed-apprOach program To help women wIth breast cancer stay actiVE (MOTIVE program): A pilot-controlled study

Given the benefits of physical activity for breast cancer survivals, this pilot study aims to assess the feasibility of the MOTIVE program at achieving and maintaining the recommended physical activity level in women diagnosed and treated breast cancer, over 16 weeks. We conduct a pilot-controlled study of 20 women diagnosed with breast cancer stage I, II or IIIa. In this study, women of Intervention Arm (n = 10) received the MOTIVE program. This group was compared to women of Control Arm (n = 10) who received only counselling. Health-related fitness measures, and quality of life were assessed at baseline (t0) and after 4 (t1), 8 (t2) and 16 (t3) weeks. Intervention Arm women reached the recommended physical activity guidelines at t1 and t2 (eff.size = 1.9 [1.0–3.1]), and 90% continued to be active, autonomously, at t3 (eff.size = 1.12 [0.21–2.12]). Intervention Arm participants’ arm strength, fitness levels and quality of life also improved over time. No significant improvements in outcome measures were observed in Control Arm participants. These results are encouraging and suggest that the MOTIVE program may be a viable, well tolerated and effective option to help breast cancer women reaching a stable physical activity level over time, which meets prevention-related goals.

Pre-Brief in Simulation-Based Experiences: A Scoping Review of the Literature

BackgroundDespite extensive research in simulation, few studies explored the impact of pre-brief on students’ learning during simulation-based experiences. This scoping review is the first to present available evidence related to the pre-brief component of simulation-based experiences and its impact on achieving learning outcomes. MethodPubMed, CINAHL, and MEDLINE databases were searched for articles focusing on pre-brief with no date or geographic restrictions. Fifteen articles met the inclusion criteria and were integrated in the scoping review. ResultsSimulation experiences following standardized practices of pre-briefing, scenario or case, and debriefing, achieved several educational and professional outcome measures. While studies that isolated the pre-brief effects were limited, findings indicate a significant improvement in outcome measures related to psychological safety and confidence levels. Pre-brief was also associated with reducing learners’ stress, optimizing skills and knowledge, and facilitating a reflective and constructive debriefing. ConclusionIt is essential that simulation facilitators implement pre-brief consistently to create psycholgocial safety for learners, using a standardized approach. More research is required to determine degree to which the pre-brief contributes to simulation outcomes.

An Evaluation of Suicide Prevention Education for People Working With Refugees and Asylum Seekers.

. Background: There are concerning rates of suicidality among asylum seekers and refugees in Australia, and tailored suicide prevention initiatives are needed. Aims: We aimed to evaluate the impact of a tailored suicide prevention education program for people working with asylum seekers and refugees. Method: Attendees of the education program completed self-report questionnaires at pretraining, posttraining, and 4–6 months follow-up. Results: Over 400 workers, volunteers, and students across Australia took part in the education program. A series of linear mixed-effects models revealed significant improvements in outcome measures from pretraining (n = 247) to posttraining (n = 231). Improvements were maintained at follow-up (n = 75). Limitations: Limitations of this research were the lack of a control group and a low follow-up response rate. Conclusion: Findings suggest that a 2 days tailored suicide prevention education program contributes to significant improvements in workers’ attitudes toward suicide prevention, and their confidence and competence in assessing and responding to suicidal distress.

The feasibility of emotion-focused therapy for binge-eating disorder: a pilot randomised wait-list control trial

BackgroundResearch into psychotherapy for binge-eating disorder (BED) has focused mainly on cognitive behavioural therapies, but efficacy, failure to abstain, and dropout rates continue to be problematic. The experience of negative emotions is among the most accurate predictors for the occurrence of binge eating episodes in BED, suggesting benefits to exploring psychological treatments with a more specific focus on the role of emotion. The present study aimed to explore the feasibility of individual emotion-focused therapy (EFT) as a treatment for BED by examining the outcomes of a pilot randomised wait-list controlled trial.MethodsTwenty-one participants were assessed using a variety of feasibility measures relating to recruitment, credibility and expectancy, therapy retention, objective binge episodes and days, and binge eating psychopathology outcomes. The treatment consisted of 12 weekly one-hour sessions of EFT for maladaptive emotions over 3 months. A mixed model approach was utilised with one between effect (group) using a one-way analysis of variance (ANOVA) to test the hypothesis that participants immediately receiving the EFT treatment would demonstrate a greater degree of improvement on outcomes relating to objective binge episodes and days, and binge eating psychopathology, compared to participants on the EFT wait-list; and one within effect (time) using a repeated-measures ANOVA to test the hypothesis that participation in the EFT intervention would result in significant improvements in outcome measures from pre to post-therapy and then maintained at follow-up.ResultsRecruitment, credibility and expectancy, therapy retention outcomes indicated EFT is a feasible treatment for BED. Further, participants receiving EFT demonstrated a greater degree of improvement in objective binge episodes and days, and binge eating psychopathology compared to EFT wait-list control group participants. When participants in the EFT wait-list control group then received treatment and outcomes data were combined with participants who initially received the treatment, EFT demonstrated significant improvement in objective binge episodes and days, and binge eating psychopathology for the entire sample.ConclusionsThese findings provide further preliminary evidence for the feasibility of individual EFT for BED and support more extensive randomised control trials to assess efficacy.Trial registrationThe study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000563965) on 14 May 2020.