Short Form-36 Subscales Research Articles

Psychometric properties of the Arabic version of the International Knee Documentation Committee subjective knee form

<b>Background: </b>The International Knee Documentation Committee (IKDC) subjective knee form is a widely used measure to assess symptoms, functional impairments, and sport activity limitations related to knee conditions.<br /> <b>Objectives: </b>This study aimed to assess the psychometric properties of the Arabic version of the IKDC (IKDC-AR) in patients experiencing knee pain.<br /> <b>Methods:</b> The IKDC-AR was compared to the short form 36 (SF-36) questionnaire, and the visual analog scale (VAS) using Spearman’s rank correlation coefficient to evaluate construct validity. Internal consistency was examined using Cronbach’s alpha, while test-retest reliability was analyzed using intraclass correlation coefficient (ICC<sub>2,1</sub>). Measurement precision was quantified through the standard error of measurement (SEM) and minimal detectable change (MDC).<br /> <b>Results: </b>Strong correlations were observed between the IKDC-AR and SF-36 subscales reflecting similar constructs, including physical component summary and physical function (r = 0.71 and r =0.74, respectively). A moderate negative correlation with the VAS (r = -0.65) further supported construct validity. Divergent validity was confirmed by weak correlations with SF-36 subscales for the mental component summary and mental health (r =0.17 and r =0.18, respectively). The IKDC-AR demonstrated excellent internal consistency (Cronbach’s alpha = 0.92) and high test-retest reliability (ICC<sub>2,1 </sub>= 0.95). Measurement precisions was highlighted with a SEM of 3.95 and MDC of 10.95.<br /> <b>Conclusion: </b>The IKDC-AR is a reliable and valid tool for evaluating knee function and symptoms in Arabic-speaking patients with knee pain. Its strong psychometric properties make it suitable for both clinical and research applications.

Preoperative Quality of Life in Patients with Small Vestibular Schwannomas.

Vestibular schwannomas (VS) are benign tumors arising from the eighth cranial nerve. They often cause no symptoms for a long period of time. Due to the improved availability and quality of magnetic resonance imaging diagnostics, even small tumors can be diagnosed at an early stage. The fact that the diagnosis of a VS might negatively affect a patient's quality of life (QoL) should be taken into consideration when informing patients about various treatment options. However, little is known about the level of QoL in patients with small VS prior to scheduled surgery. One hundred forty- one patients with a T1 or T2 VS that had been scheduled for microsurgery via the middle cranial fossa (MCF) approach between 01/2013 and 12/2018 were included. Quality of life was evaluated using the Short-Form-36 (SF-36) survey. Eighty-one patients completed the questionnaire. Additionally, audiological and clinical data were collected. When compared to the German normative QoL data, VS patients showed a significant deterioration in quality of life in 6 of the 8 SF-36 subscales, whereas only 4 of 8 subscales were affected when compared to the normative group of patients with hearing loss. The analysis of predictors did not show any significant relationship between tumor volume, facial nerve function, and QoL. Only preoperative hearing status and sex had a slight impact on one subscale each (emotional health and physical health, respectively). This study shows that patients with small VS have an impairment in QoL before surgical treatment. Most of the examined clinical predictors did not have a significant impact on the QoL.

Bodily pain and vitality are the key factors in the disability of chronic low back pain patients under Short Form 36 base study: a five-year cohort study

BackgroundChronic low back pain (CLBP), a significant cause of disability, is expected to increase with aging. Short Form 36 (SF-36) indicated higher baseline component scores predict CLBP disability at shorter follow-ups, with unexplored five-year associations. The study aimed to test the associations of the physical and mental subscales of the SF-36 at baseline with disability at the five-year follow-up point among patients with CLBP.MethodsPatients aged between 20 and 65 years with CLBP were enrolled at baseline and followed at the five-year point. The Oswestry Disability Index (ODI), the physical functioning (PF) subscale of the SF-36, and self-reported total months of disability (TMOD) over the past five years were used as the indices of disability. The four physical and mental subscales of the SF-36 were used as independent factors, respectively. Multiple linear regression was used to compare the associations of the physical and mental subscales at baseline with disability at follow-up.ResultsTwo hundred twenty-five patients with CLBP were enrolled at baseline and 111 participated in followed at the five-year point. Among the SF-36 subscales, the scores of bodily pain (BP), vitality (VT), and social functioning (SocF) at baseline were significantly correlated with the three indices of disability at follow-up. After controlling for demographic and clinical variables, BP and VT at baseline were most strongly associated with the ODI and TMOD at follow-up among the four physical and mental subscales, respectively. PF at baseline was most strongly associated with itself at follow-up among the four physical subscales.ConclusionOur results demonstrated that both the physical and mental subscales of the SF-36 at baseline could predict disability at the five-year follow-up point among patients with CLBP. The BP and VT subscales were independent factors associated with disability among the physical and mental subscales, respectively.

Quality of life with diverticular disease: translation and validation of the German version of the diverticulitis quality of life questionnaire (DV-QOL).

The DV-QoL is a 17-item questionnaire measuring health-related quality of life in patients affected by symptomatic diverticular disease, covering four domains: physical symptoms, concerns, feelings, and behavioral changes. Given the lack of a diverticulitis-specific questionnaire to be used for German-speaking patients, we prospectively validated the German version of the DV-QoL. German-speaking patients with CT-confirmed history of recurrent diverticular disease admitted to a Swiss surgical department completed the German version of the DV-QoL, along with short form-36 (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI). Reliability was examined using exploratory and confirmatory factor analysis, a Martin-Loef test, and Cronbach's alpha. For convergent validity testing, correlations were calculated with the GIQLI and SF-36. Discriminant validity tests included age and gender. We included 121 patients, of whom 77 were admissions for elective surgery and 44 presented with acute diverticulitis treated conservatively. The DV-QoL's total score showed good correlations with the GIQLI (r = -0.77) and its subscales (r = -0.76 to -0.45), as well as with the SF-36's subscales (r = -0.30 to -0.57). No relationships were found with age or gender (p < 0.05). The Cronbach's alpha coefficient was 0.89 over all items and 0.69, 0.90, 0.78, and 0.77 for the four separated domains (physical symptoms, cognitions/concerns, feelings, and behavioral changes, respectively). A nonsignificant Martin-Loef test indicated unidimensionality (p = 1), further supported by the exploratory factor analysis, which showed an item information sharing of 65%. The German DV-QoL questionnaire can be used as a valid and reliable disease-specific measure for quality of life in patients with recurrent diverticular disease.

Cultural adaptation and validation of the knee injury and osteoarthritis outcome score into Sinhala language in patients with primary knee osteoarthritis: a cross-sectional study

BackgroundKnee Injury and Osteoarthritis Outcome Score (KOOS) scale is a patient-reported outcome measurement tool. It evaluates both short- and long-term consequences of knee injury and primary osteoarthritis. This study aims to translate and validate the KOOS scale for a Sinhala-speaking Sri Lankan population.MethodsA cross sectional study was conducted in three hospitals. Four hundred and fifteen patients comprising 185 males and 227 females (3 subjects did not reveal their gender) with knee osteoarthritis (KOA) participated in the study. Seventy nine participants without KOA were recruited as controls. The functionality and quality of life level in patients and healthy participants were assessed using translated versions of the KOOS and Short Form-36 (SF-36) scales. Internal consistency of the instrument was assessed by Cronbach alpha. Construct validity and test-retest reliability were examined using the Intraclass Correlation Coefficient (ICC). Confirmatory Factor Analysis (CFA) was used to assess factorial validity.ResultsThe mean age (± sd) of the KOA subjects was 54.9 (± 9.2) years and for the control group was 49.2 (± 8.0) years. Majority of the respondents were female and Sinhalese in both groups. Internal consistency reliability was high (Cronbach’s alpha values ≥ 0.70). The test–retest reliability was excellent with the intraclass correlation coefficient for all subscales being above 0.90. Construct validity was assessed by the magnitude of the correlation coefficient between KOOS and SF-36 subscale scores. KOOS Pain scale moderately correlated with SF-36 bodily pain (Pearson’s r = 0.41). SF-36 physical function scores had a weak positive correlation with all KOOS subscales and SF-36 emotional wellbeing was not significantly correlated with KOOS Quality of Life (QoL) subscale. A five-factor Confirmatory Factor Analysis (CFA) model yielded a Comparative Fit Index (CFI) = 0.950, Tucker Lewis Index (TLI) = 0.946, Root Mean Square Error of Approximation (RMSEA) = 0.082 and Standardised Root Mean squared Residual (SRMR) = 0.072.ConclusionThe Sinhala translation of the KOOS scale is a reliable and valid instrument to assess KOA in a Sinhala-speaking Sri Lankan population. Studies to assess its use as a scale to evaluate responsiveness are recommended.

Is conventional radiofrequency ablation of the superolateral branch, one of the three genicular nerves targeted as standard, necessary or not? A non-inferiority randomized controlled trial.

Radiofrequency ablation is an effective treatment modality in the symptomatic treatment of knee osteoarthritis. Our aim was to compare the efficacy of radiofrequency ablation of the superomedial and inferomedial genicular nerves (2 branches) with the superolateral, superomedial, and inferomedial genicular nerves (3 branches) and to show whether the 2-branch procedure is inferior to the 3-branch procedure. This study is a prospective, randomized, single-blind clinical study. Eligible participants were randomized into 2 groups: group A, which applied the procedure to the superomedial and inferomedial genicular nerves, and group B, which applied it to the superomedial, superolateral and inferomedial genicular nerves. Pain was evaluated with the numerical rating scale, quality of life with the Short Form-36 (SF-36), and disability with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index before, and at 1 and 3 months after the procedure. A total of 41 patients were included. There were no differences between the groups except for the SF-36 physical health sub-score at baseline. A significant improvement was seen in the numeric rating scale (NRS) score, SF-36 sub-scores, WOMAC Index total, as well as pain and physical function scores in both groups, though no significant difference was detected between the groups during follow-up. Although we were unable to establish the noninferiority of conventional radiofrequency ablation (CRFA) applied to 2 branches to CRFA applied to 3 branches, in this trial, significant and similar improvement was observed in NRS, WOMAC total, pain, and physical function and SF-36 scores in both groups.

Two-Year Results of a Five-Year Personalized Integrative Obesity Coaching Program (IBO) Based upon a Systems Health Perspective and an Evolutionary Longitudinal Study Approach.

This study presents the outcomes of a 5-year personalized integrative coaching program for adults with obesity (body mass index BMI ≥ 30 kg/m2), based upon a systems health perspective, during the first 2 years. This longitudinal study, which had an evolutionary design, included all adults who enrolled in the program. Health-related quality of life (HRQoL) was measured with the Short Form-36 (SF-36), and physical outcomes included weight, waist circumference, aerobic capacity, lipid profile, and HbA1c. Subsequently, participants completed questionnaires (e.g., the Symptom Checlist-90 (SCL-90) and the Checklist Individual Strength (CIS)). Seventy-nine adults with a mean BMI of 39.5 kg/m2 (SD 5.3) were included. Forty-four participants completed 2 years in the program. Compared to baseline, there were significant improvements in the SF-36 subscales 'physical functioning' (MD 9.9 points, 95% CI: 2.1-17.5, p = 0.013) and 'general health perceptions' (MD 9.3 points, 95% CI 2.9-15.7, p = 0.006). Furthermore, significant improvements in physical outcomes and psychosocial questionnaires (e.g., weight loss (MD 3.5 kg, 95% CI: 1.2-5.7, p = 0.003), waist circumference (MD 5.1 cm, 95% CI: 2.4-7.8, p < 0.001), and CIS fatigue (MD 6.8, 95% CI: 3.1-10.5, p = 0.001) were observed. This study highlights the importance of a systems health perspective supporting the development of a personalized integrative coaching program for adults with obesity in a 'real-world' setting.

Prognostic factors of nonsurgical intervention outcomes for patients with frozen shoulder: a retrospective study

Purpose This study aimed to investigate the correlation between mental and physical health-related quality of life and the outcomes of conservative treatment in patients with frozen shoulder (FS). Methods This was a two-center retrospective study. It included 84 consecutive patients who underwent a 3-month treatment comprising education, physical therapy, and corticosteroid-anesthetic injections. Changes in range of motion (ROM) and Shoulder Pain and Disability Index (SPADI) scores, measured at baseline and after 3 months, were selected as dependent variables. Data on age, sex, Body Mass Index, duration of symptoms, dominant affected limb, and Short Form-36 (SF-36) subscales were gathered at baseline and investigated as prognostic factors. Backward stepwise regression models were used to identify significant associations. Results At 3-month follow-up, all the patients showed significant improvement. Higher SF-36 General Health, Mental Health and Social Functioning scores at baseline were associated with a greater beneficial change in ROM and SPADI. In contrast, lower SF-36 Bodily Pain and Role Emotional scores were found to be associated with greater improvement. Conclusion The study findings indicate that the self-perceived mental and physical health of patients have a significant impact on both subjective and objective clinical outcomes and healthcare professionals should take these aspects into account. Level of Evidence Prognostic Level II

Characterization of cancer survivors clustered by subjective and objective cognitive function scores.

Cancer-related cognitive impairment (CRCI) is a prevalent condition that significantly impacts the quality of life of individuals who receive cancer treatment. Clinical management of CRCI presents challenges due to the absenceof a standardized assessment. This study identified clinically relevant phenotypic clusters of CRCI based on subjective and objective cognitive function scores. In this cross-sectional study, participants were clustered using the VARCLUS™ based on subjective cognitive impairment assessed through the PROMIS® version 1.0 short-form subscales of cognitive abilities and cognitive concerns and the CANTAB Cambridge Cognition® scores, which included measures of visuospatial working memory capacity, visual episodic memory, new learning, working memory, executive function, and sustained attention. Each cluster's characteristics were described using demographics, physical and psychosocial factors (physical function, affect, optimism, and social support), and psychoneurological symptoms (anxiety, depression, fatigue, neuropathic pain, and sleep disturbance). We obtained five clusters from a total of 414 participants, where 99% were female, and 93% were self-reported white. Clusters 4 and 5 showed the highest PROMIS® cognitive abilities and the lowest measures of cognitive concern, while Clusters 1 and 2 showed the lowest cognitive abilities and the highest cognitive concerns. Clusters 4 and 5 had higher education, income, employment, and higher scores in physical function, positive affect, optimism, and social support. Additionally, individuals in these clusters were less prone to experience severe cancer-related psychoneurological symptoms. Our clustering approach, combining subjective and objective cognitive function information, shows promise in identifying phenotypes that hold clinical relevance for categorizing patient presentation of CRCI and facilitating individualized management strategies.

Long-Term Outcomes of Dental Rehabilitation and Quality of Life after Microvascular Alveolar Ridge Reconstruction in Patients with Head and Neck Cancer.

Background/Objectives: Dental rehabilitation after extended tumour resection and jaw reconstruction is challenging. The present study aimed to report the prosthetic outcome and quality of life (QoL) in patients with head and neck cancer (HNC) after microvascular alveolar ridge reconstruction. Methods: The prosthetic outcomes of all consecutive patients with HNC who underwent microvascular alveolar ridge reconstruction at the University Hospital Salzburg between 2011 and 2018 were investigated. Oral health-related QoL (OHrQoL) and overall QoL were assessed using the validated Oral Health Impact Profile-49 (OHIP-49) and Short Form-36 questionnaires. Results: During the study period, 115 consecutive patients with head and neck cancer underwent microvascular jaw reconstruction. Among them, 23.3% and 27.4% received conventional tissue-borne prostheses and implant-supported prostheses, respectively, while 48.7% did not undergo dental rehabilitation. The prosthetic outcome was not associated with tumour stage (p = 0.32). Oral health-related quality of life (OHrQoL) was best in patients with implant-supported dental rehabilitation (OHIP-49 median score = 7) and worst in those with conventional removable dentures (OHIP-49 median score = 54). The corresponding OHIP-49 median score for patients who could not undergo dental rehabilitation was 30.5. All Short Form-36 subscale scores were equal to or higher than the malignancy norm scores. Conclusions: After microvascular jaw reconstruction, approximately one-third of the HNC patients received adequate implant-supported dental rehabilitation. However, the risk of dental rehabilitation failure was 50%. The different prosthetic outcomes affected OHrQoL, but not overall QoL.

Reliability and Validity of the Arabic Version of Shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick-DASH) in Breast Cancer Survivors

This study examined the psychometric properties of the Arabic Quick-Disability of the Arm, Shoulder, and Hand (QDASH-Ar) for breast cancer (BC) survivors. In this cross-sectional study, a convenient sample of 88 BC survivors was recruited and completed both the QDASH-Ar and Short Form-36 (SF-36) Arabic questionnaires. Internal consistency and test–retest reliability were assessed using Cronbach’s alpha and the two-way random intraclass correlation coefficient [ICC (2.1)], respectively. Standard error of measurement (SEM) was used to calculate the minimal detectable change (MDC). Spearman correlation coefficients were used to test construct validity between QDASH-Ar and SF-36. The results demonstrated that QDASH-Ar had a Cronbach’s alpha of 0.86 and an ICC (2.1) of 0.92. The scale’s SEM and MDC were 2.69 and 7.47, respectively. The correlation coefficients between the Quick-DASH score and the subscales of SF-36 ranged from −0.27 to −0.65, supporting the predefined hypotheses for construct validity. The discriminant validity was proven by the Quick-DASH total score between BC survivors with and without lymphedema (20.89 ± 12.78 vs. 33.63 ± 11.58, P &lt; 0.01). In conclusion, QDASH-Ar demonstrated acceptable internal consistency, excellent test–retest reliability, and moderate to strong construct validity. Clinicians and researchers can use this valid instrument to assess and monitor upper extremity activity limitations and symptoms in BC survivors.

Comparison of Allergic Diseases in terms of Anxiety, Depression and Quality of Life

Studies have shown the frequency of anxiety and depression and decreased quality of life (QoL) in patients with allergic diseases. The aim of this study was to evaluate anxiety and depression symptoms and QoL in patients with asthma, allergic rhinitis (AR), urticaria/angioedema (U/A) and drug allergy without any psychiatric diagnosis and to compare these four diseases in these respects. In this cross-sectional study demographic and clinical characteristics were collected from patients’records. Hospital Anxiety and Depression Scale (HADS) and Short Form 36 (SF-36) were used to assess anxiety and depression symptoms and QoL. A total of 159 patients were included in the study and grouped as asthma (n=43, 27.1%), AR (n=45, 28.3%), U/A (n=44, 27.7%) and drug allergy (n=27, 17%). There was a significant difference in HADS anxiety score and SF-36 physical functioning subscore (p&amp;lt;0.001 and p=0.001, respectively). HADS anxiety score was higher in the U/A group and SF-36 physical functioning was lower in asthma group. Among asthmatics, SF-36 subscores of physical role functioning, emotional role functioning, social role functioning were lower in the patients at step 4 and 5 (n=22, 51.2%) than in those at step 2 and 3 (n=21, 48.8%) (p=0.001, p=0.031 and p=0.005, recpectively). In the U/A group, there was a positive moderate correlation between the urticaria activity score 7 and the HADS anxiety score (r:0.579, p&amp;lt;0.001). Our study showed that U/A patients had more anxiety symptoms comparing to other allergic diseases. Disease activity and severity had a significant relationship with anxiety level in U/A patients and with QoL in asthmatics.

Investigation of Health-Related Quality of Life, Anxiety and Satisfaction in Patients with Pulmonary Embolism.

Features of post-traumatic stress disorder and anxiety may be present in pulmonary embolism (PE) patients, along with impaired quality of life (QoL). We aim to evaluate health-related QoL, anxiety and satisfaction with life in patients with PE. Patients with PE were enrolled during their follow-up. All participants completed the Short Form 36 (SF-36) questionnaire, the State-Trait Anxiety Inventory (STAI) X1 and X2 forms, and the Satisfaction with Life Scale (SWLS). 92 PE patients were included (mean age ± SD = 62.50 ± 15.33 years, 56.5% males). The median values of the SF-36 subscales were below the corresponding values of the Greek general population (besides the mental health (MH) subscale). Mean STAIX1 levels were 37.05 ± 11.17 and mean STAIX2 levels were 39.80 ± 10.47. Mean SWLS levels were 23.31 ± 6.58. According to multiple linear regression analysis, the MH and general health subscales were predictive of SWLS levels (F (10.76) = 10.576, p < 0.001, R2 = 0.581). The MH score (β = -0.242, p < 0.01) and STAIX1 level (β = 0.312, p < 0.001) (F (9.77) = 26.445, p < 0.001, R2 = 0.756) were predictive of STAIX2. Patients with PE exhibit slight satisfaction with life, borderline anxiety and impaired HRQoL.

High-intensity interval training in patients with an implantable cardioverter defibrillator: a randomized controlled study

Abstract Background Exercise is an effective treatment in a broad spectrum of cardiovascular diseases. High-intensity interval training (HIIT) has shown superior effect on cardiorespiratory fitness and equal or superior effect on morbidity and quality of life (QoL) compared to moderate continuous exercise training. However, evidence of the efficacy and risks of HIIT in patients with increased risk of ventricular arrhythmia remains limited. Purpose To evaluate the effects of HIIT on exercise capacity, QoL and burden of ventricular arrhythmias in patients with an implantable cardioverter defibrillator (ICD) with or without cardiac resynchronization therapy. Methods Patients with ischemic or dilated cardiomyopathy and ICD were randomized to a supervised 12-week HIIT program or to a control group continuing their usual exercise routines. HIIT consisted of four 4-minute intervals aiming at 85-95% of maximum heart rate (HRmax), and 3-minute active recovery aiming at 60-70 % of HRmax in between intervals, 3 times a week for 12 weeks. Primary outcomes were exercise capacity measured as peak oxygen uptake (VO2 peak) and QoL assessed with the Short Form 36 (SF-36) questionnaire. Main secondary outcome was the burden of ventricular arrhythmias analysed from remote patient monitoring data. Results Fifty-six patients were included (table 1). Three patients in the HIIT group did not complete the intervention. Two withdrew due to a knee injury and due to fear of SARS-CoV-2 exposure, respectively. One experienced an appropriate shock during exercise and was excluded from further training after clinical consideration. Fifty-three patients completed all follow-up examinations. HIIT significantly increased VO2 peak with 7.0 %, with no changes in the control group (p=0.001) (figure 1A). There was a significant increase in the SF-36 subscale scores on physical functioning (p&amp;lt;0.05), general health (p&amp;lt;0.05) and health change (p=0.001) in the HIIT group compared to the control group (figure 1B). There were no significant differences between groups in number of non-sustained or sustained ventricular tachycardias, anti-tachycardia pacing therapy or ICD shocks. Conclusions In patients with ICD due to ischemic or dilated cardiomyopathy, a supervised 12-week HIIT-program significantly increased VO2 peak and QoL without increasing the burden of ventricular arrhythmias.Table 1:Patient characteristicsFigure 1:Peak oxygen uptake and QoL

Lower mental health related quality of life precedes dementia diagnosis: findings from the EPIC-Norfolk prospective population-based study

Lower Health Related Quality of Life (HRQoL) precedes dementia in older adults in the USA. We explore prospective associations between HRQoL and dementia in British adults in mid and late-life, when interventions to optimise cognitive ageing may provide benefit. 7,452 community-dwelling participants (57% women; mean age 69.3 ± 8.3 years) attended the European Prospective Investigation of Cancer-Norfolk study’s third health check (3HC) and reported their HRQoL using Short-Form 36 (SF-36). Cox Proportional Hazard regression models explored associations between standard deviation differences in baseline Physical Component (PCS) and Mental Component Summary (MCS) scores, as well as eight SF-36 sub-scales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health), and incident dementia over ten years. Logistic regression models explored cross-sectional relationships at the 3HC between HRQoL and objective global cognitive function (n = 4435; poor cognition = lowest performance decile). The cohort was examined as a whole and by age-group (50–69, ≥ 70), considering socio-demographics and co-morbidity. Higher MCS scores were associated with lower chance of incident dementia (Hazard Ratio [HR] = 0.74, 95% CI 0.68–0.81) and lower odds of poor cognition (Odds Ratio [OR] = 0.82, 0.76–0.89), with findings similar by age-group. Higher PCS scores were not associated with dementia in the whole cohort (HR = 0.93, 0.84–1.04) or considering age-groups; and were only associated with poor cognition in younger participants (OR = 0.81, 0.72–0.92). Similarly, associations between higher scores on subscales pertaining to mental, but not physical, HRQoL and lower dementia incidence were observed. Lower mental HRQoL precedes dementia diagnosis in middle-aged and older British adults.

Effects of virtual balance training and conservative rehabilitation on balance in chronic stroke patients

Objective: This study aimed to test the comparative efficacy of virtual balance training (VBT) and conservative rehabilitation (CR) relative to CR alone on balance in chronic stroke patients. Methods: Thirty patients with chronic stroke (&gt;6-months post-stroke) were allocated into 2 groups (n=15) as Group CR and Group VBT. CR was performed for 60 min, 4 times a week, for 8 weeks in both groups. VBT was applied for 20 min, 4 times a week, for 8 weeks along with the CR, in Group VBT. Brunnstrom motor recovery (BMR) stage, spasticity degrees, Functional Ambulation Scale (FAS), Short Form-36 (SF-36) scale, Berg Balance Scale (BBS) in both groups were assessed before and after treatment. Mann-Whitney U, Wilcoxon signed rank tests were used to evaluate BBS data (p&lt;0.05). Results: Although, no significant difference was observed between groups in terms of BBS scores, BMR stages, FAS scores, SF-36 scale scores, and spasticity degrees before and after treatment; significant improvements were observed in BBS scores, BMR stages, and FAS scores after treatment in both groups (p&lt;0.05). Comparing the SF-36 subscale scores before and after treatment, significant differences were noted in emotional role limitation scores for Group VBT (p=0.03) and in pain scores for Group CR (p=0.01). Conclusion: VBT along with the CR in chronic stroke patients was not superior to the CR alone, in terms of improving balance, motor recovery, ambulation level, and quality of life.

A study evaluating quality of life and factors affecting it before, during and after menopause

ObjectiveTo determine if quality of life (QoL) changes before, during and after menopause and whether these changes are linked to symptoms, demographics, and/or lifestyle factors. MethodsWe undertook a cross-sectional online survey. We invited women aged between 35 and 60 years to complete the survey which included the Short-Form 36 (SF-36) generic quality of life measure, the menopause specific Utian-Quality of life (UQOL) measure, and questions about health and wellbeing, menopause symptoms and hormonal stage. The data were analysed with one-way ANOVA analysis and multivariate regression modelling. Results279 women completed the survey. Most were aged between 51 and 55 years. In the unadjusted analysis there was a tendency for QoL to deteriorate from pre to peri to menopause and then increase slightly post menopause. This was however not significant in multivariate analysis. Multivariate analysis identified that lifestyle factors significantly influenced QoL. Regular exercise resulted in better QoL scores across a number of the UQol and SF-36 sub-scales. Being very overweight and having more menopause symptoms resulted in worse QoL. ConclusionsAlthough there was a trend towards worse quality of life in the peri and menopause stages this was not significantly different in adjusted multivariate analyses. Those experiencing more symptoms had significantly worse QoL. Lifestyle factors may affect QoL, but the picture is not straightforward. It is promising that there was a trend toward improved QoL in the post-menopausal stage. These findings should inform education material and promote awareness of the menopause and its impact on QoL.(245)

Comparison of long-term quality of life based on surgical procedure in patients with rectal cancer.

Reports on the long-term quality of life (QOL) over 3 years after surgery in patients who have undergone surgery for rectal cancer are limited. Therefore, we aimed to evaluate the long-term QOL of patients who underwent high anterior resection (HAR), low anterior resection (LAR), internal sphincter resection (ISR), or abdominoperineal resection (APR) for rectal cancer. A questionnaire regarding QOL was sent to 360 patients with rectal cancer who underwent curative resection by HAR, LAR, ISR, or APR between January 2005 and December 2015. QOL was assessed using the short-form 36 (SF-36) and modified fecal incontinence QOL (mFIQL) questionnaire. QOL between surgical procedures was analyzed using a multivariate model adjusted for age, sex, and postoperative time. A total of 144 patients responded with a median follow-up period of 94 months (range 38-233 months). According to surgical procedure, HAR was performed in 26 patients, LAR in 80 patients, ISR in 32 patients, and APR in 6 patients. Patients who underwent HAR had significantly better mFIQL scores than those who underwent LAR and ISR (p=0.013 and p=0004, respectively) and significantly better role/social component summary scores on the SF-36 subscales (p=0.007). No difference was observed in the mFIQL scores between patients who underwent ISR and those who underwent APR (p=0.8423). In addition, postoperative anastomotic leakage sutures did not influence the mFIQL and SF-36 scores after surgery. The QOL of patients who underwent anus-preserving surgery was best in the HAR group, with the QOL of other groups similar to the APR group. These results suggest that anus- preserving surgery is acceptable from a QOL standpoint. However, a colostomy may be a more satisfactory procedure in some patients.

The Health-related Quality of Life and Voice Handicap Index in Recovered COVID-19 Patients in Comparison to Healthy Subjects

COVID-19 has various long-lasting effects on different aspects of health and life. This study aimed to evaluate the general health and voice-related quality of life (QOL) and assess their correlation in patients with COVID-19 compared to healthy people. This was a cross-sectional study. Sixty-eight subjects (with a mean age of 40.07±5.62 years) participated in two groups including 34 recovered-COVID-19 patients and 34 healthy subjects. All participants completed the Persian version of Short Form 36 (SF-36) and Voice Handicap Index (VHI). The patients were assessed two months after recovery when they were discharged from the hospital. The results showed the COVID-19 patients got significantly lower scores in all subcategories and two main components of SF-36 compared to the healthy group (P<0.005). Also, the patients held significantly higher results in VHI and its subscales (P<0.005). A significant correlation was observed between the physical and mental component summary (PCS and MCS) of SF-36 with a total score of VHI in the COVID-19 patients. COVID-19 has negative consequences on various aspects of general health and voice-related QOL. Two months after recovery from COVID-19, the patients had the worst scores in all subscales of SF-36 and also, decreased physical, emotional, and functional voice-related QOL which reveals the persistent effect of COVID-19 even after recovery. The general health and voice-related QOL had a noticeable correlation in recovered COVID-19 patients that demonstrates the effect of voice quality in different aspects of life.

Does moderate to vigorous physical activity mediate the association between depression and physical function in midlife: Evidence from two British birth cohort studies

BackgroundMental health and physical health are intrinsically linked, yet the mechanisms are not well understood. We investigated whether moderate-vigorous physical activity (MVPA) mediated the association between depression and physical function (PF) in midlife. MethodsIndividuals from two UK birth cohorts born within one week in 1958 (n = 7278) and 1970 (n = 6097) with data on depression (ages 33/34; Malaise Inventory), MVPA (age 42; self-reported) and PF (ages 50/56; Short Form-36 subscale). Covariates included sex, childhood and adulthood social class, maternal mental health, childhood mood, alcohol consumption, smoking habits, sleep, marital status, BMI and long-standing illness/disability. Linear or multinomial logistic regression models examined associations between depression, MVPA and PF. We used a parametric g-computation mediation analysis approach to estimate percent differences in PF. ResultsDepression was associated with less frequent MVPA and poorer PF. Lower MVPA was associated with worse PF. The direct effect – randomised analogue not operating via MVPA – of depression on PF was −18.8 % (95%CI:--25.8,-11.8) and −15.8 % (20.6,-11.0) in the 1958 and 1970 cohorts, respectively. The indirect effect – operating via MVPA – was −0.5 % (−1.0,-0.03) and −0.2 % (−0.6, 0.3), resulting in a total proportion mediated of 3.1 % (0.1, 6.0) and 0.9 % (−1.6, 3.4). LimitationsMVPA was self-reported. Intermediate confounders and mediators were measured at the same age, however associations did not change in sensitivity analysis considering age 46 MVPA (1958 cohort). ConclusionsAlthough higher MVPA was protective against poor PF, there was only minor evidence that it mediated the association between depression and PF. Further investigation into other potential mediators of pathways from mental to physical health is needed.