Short Form-36 Total Score Research Articles

Visual analogue scale foot and ankle vs. short-form 36 quality of life scores: artificial intelligence using machine learning analysis with an external validation.

We aimed to utilize artificial intelligence (AI) via machine learning (ML) to analyze the relationship between visual analogue scale foot and ankle (VASFA) and short-form 36 (SF-36) quality of life scores and determine AI's performance over the aforementioned analysis. We collected data from our registry of 819 data units or rows of datasets of foot and ankle patients with VASFA, SF-36 scores, and other demographic data. They were prepared and verified to be a proper input for building ML models using a web-based algorithm platform. After the first ML model was developed using random forest regression, the SF-36 percentage value was set as an endpoint. We developed a second ML model to evaluate it against the current algorithm. This new model employed a gradient-boosting regressor, where we omitted a key parameter, SF_Total, to correct the overfitting. We performed an external validation based on an unseen dataset from 42 data units of patients. Internal validity showed an excellent relationship among the VASFA, SF-36 total score, and overall SF-36 percent values at a correlation coefficient (R2 score) of 1.000 based on the random forest regression model of ML (first model: 28XJ). The VASFA percent value of the total score (0=worst; 100=best) demonstrated the dynamic changes in the three zones of the score levels; these were unsatisfactory: ≤ 57.25; borderline: 57.26-80.99; satisfactory: ≥ 81 and could impact the levels of overall SF-36 percent value. A second ML model (model FK13) showed an R2 score of 0.977, which was a great performance. External validation showed no significant difference between the predicted and actual values, with a two-tailed p-value of 0.2136. Our ML models predicted excellent relationships among VASFA, with or without SF-36 total score and overall SF-36 percentage values, with evidence from external validation.

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.

Translation, Validity, and Reliability of the Persian Version of “Keele Assessment of Participation” (P-KAP) Questionnaire among Community-Dwelling Older Adults

Introduction The Keele Assessment of Participation (KAP) is a clear, short, valid, and reliable questionnaire developed specifically to evaluate participation restrictions. KAP has been translated into various languages. This study aimed to translate and determine the psychometric properties of the “Keele Assessment of Participation” in healthy community-dwelling elderly people. Methods A forward/backward translation procedure was used for translating the KAP questionnaire into Persian. Older adults (N = 165) aged 60 and over participated. Content and face validity were evaluated. Convergent validity was assessed by evaluating the correlation between KAP and the short-form 36 (SF-36), and community integration measure (CIM). Internal consistency and test-retest reliability (N = 110) were determined by assessing the Kappa and Cronbach’s alpha. Results The content and face validity of the Persian version of KAP (P-KAP) were appropriately reported as good. The P-KAP demonstrated acceptable internal consistency (α = 0.77) and test-retest reliability (Kappa = 0.82). The correlation between the P-KAP, the CIM, and the SF-36 total score was moderate and respectively −0.416 and −0.468 (p < 0.0001). Discussion The results of the current study found P-KAP to be an acceptable, reliable, and valid instrument.

A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain

BackgroundLumbar facet joint pain is a common disorder. The main symptom is chronic lumbar pain, which can reduce quality of life. Radiofrequency has often been used to treat lumbar facet joint pain. However, the effectiveness of this technique has been controversial. This study was conducted to compare the effectiveness of pulsed radiofrequency (PRF) and radiofrequency denervation (RD) for lumbar facet joint pain.MethodsOne hundred and forty-two patients with lumbar facet joint pain were allocated to two treatment groups: PRF group (N = 72) and RD group (N = 70). Patients enrolled in the study were assessed using a visual analogue scale (VAS), Roland-Morris questionnaire (RMQ), Oswestry disability index (ODI) and Short-Form 36 (SF-36) questionnaire before therapy, 3 months and 12 months later.ResultsThere were no significant differences in VAS, RMQ score, ODI score and SF-36 score at 3 months (p > 0.05). Significant differences in pain control were observed in both groups at 12 months (3.09 ± 1.72 vs. 2.37 ± 1.22, p = 0.006). There was a significant difference in RMQ score (11.58 ± 3.58 vs. 8.17 ± 2.34, p < 0.001) and ODI score (43.65 ± 11.01 vs. 35.42 ± 11.32, p < 0.001) at 12 months. The total SF-36 score was higher in the RD group than in the PRF group at 12 months (58.45 ± 6.97 vs. 69.36 ± 6.43, p < 0.001). In terms of complications, skin numbness occurred in three patients. Mild pain such as burning and pinking at the puncture site in two patients. One patient experienced a decrease in back muscle strength and back muscle fatigue. These complications disappeared in 3 weeks without any treatment. There were no serious adverse events in the PRF group.ConclusionRadiofrequency is an effective and safe treatment option for patients with lumbar facet joint pain. RD could provide good and lasting pain relief, with significant improvement in lumbar function and quality of life at long-term follow-up.

Validity and reliability studies of the Indonesian version of Atrial Fibrillation Severity Scale (AFSS)

BackgroundIn the atrial fibrillation (AF) population, worsened quality of life (QOL) has been reported even before complications occur. Symptom-based questionnaires can be used to evaluate AF treatment. The Atrial Fibrillation Severity Scale (AFSS) was first developed in Canada in English, which is not the main language in Indonesia. This study aims to test the reliability and validity of the Indonesian version of the Atrial Fibrillation Severity Scale (AFSS).MethodsTranslation of the AFSS from English to Indonesian was done using forward and backward translation. The final version was then validated with the Short Form-36 (SF-36) questionnaire, and a test-retest reliability study was done in a 7-14-day interval.ResultsAn Indonesian version of AFSS was achieved and deemed acceptable by a panel of researchers. This version is reliable and valid, with Cronbach’s α of 0.819, Intraclass Correlation Coefficient (ICC) ranging from 0.803 to 0.975, and total score correlation ranging from 0.333 to 0.895. Pearson’s analysis of AFSS and SF-36 revealed that the total AF burden domain was poorly correlated with role limitations due to emotional problems (r:0.427; p < 0.01) and pain (r:0.495; p < 0.01). The symptom severity domain was poorly correlated with physical functioning (r:-0.335; p < 0.01), role limitations due to emotional problems (r:0.499; p < 0.01), pain (r:0.458; p < 0.01), and total SF-36 score (r:-0.361; p < 0.01). Total AFSS score was moderately correlated with role limitations due to emotional problems (r:0.516; p < 0.01) and pain (r:0.538; p < 0.01). The total AFSS score was poorly correlated with the European Heart Rhythm Association (EHRA) score (r:0.315; p < 0.01).ConclusionThe Indonesian version of AFSS has good internal and external validity with good reliability.

The impact of inhibitors on the quality of life in patients with hemophilia.

To investigate the association of health-related quality of life in hemophilia patients with inhibitor and clinical and demographic characteristics. In this multi-center cross-sectional study, 41 male patients with hemophilia A were investigated from May to October 2021. All patients were registered at the Hemophilia Clinic affiliated with Shiraz and Zahedan Universities of Medical Sciences in Iran. Health-related quality of life of the patients was evaluated by the Short Form-36 questionnaire. The patients' mean ± SD of age was 36.9 ± 13.2 (range: 18-76) years. Eleven patients (26.8%) were inhibitor positive. In univariate analysis, physical function, mental health dimension, and total Short Form-36 scores were significantly lower in the inhibitor-positive patients (p < 0.001, p = 0.045, and p = 0.035, respectively). Moreover, patients with severe disease showed significantly lower scores in physical function (p < 0.001), physical health dimension (p = 0.018), and total Short Form-36 (p = 0.031) than those with mild and moderate hemophilia. Also, blood-borne infections showed a significant association with lower score in physical health dimension (p = 0.038). In addition, annual bleeding rate showed significant negative correlations with physical health dimension (rs = -0.609, p < 0.001), mental health dimension (r = -0.317, p = 0.044), and total Short Form-36 (r = -0.455, p = 0.003) scores. In multiple linear regression analysis, disease severity revealed a significant negative relationship with scores in physical function (p = 0.001), role physical (RP) (p = 0.015), general health (GH) (p = 0.006), physical health dimension (p = 0.006), and marginally in total Short Form-36 score (p = 0.054). Also, age of the patients showed a significant negative association with physical function and GH scores (p < 0.001 and p = 0.015, respectively). Disease severity and age were shown as independent factors affecting health-related quality of life, but inhibitor alone was not an independent influencing factor. Reduced health-related quality of life was also observed in hemophilia patients with higher annual bleeding rate and blood-borne infections. Therefore, it is necessary to pay more attention to these subgroups. Further studies with larger sample size are needed for more accurate results.

Efficacy and safety of a mobile app intervention in patients with inflammatory arthritis: a prospective pilot study

EULAR highlighted the essential role of digital health in increasing self-management and improving clinical outcomes in patients with arthritis. The objective of this study was to evaluate the efficacy and safety of the digital health application (DHA) in patients with inflammatory arthritis. We assessed demographic parameters, treatment regimen, disease activity, and other patient-reported outcomes at baseline and after 4 weeks of DHA use added to standard care treatment. Of 17 patients, who completed the study, 7 (41.2%) patients were male, ranging from 19 to 63 (40.5 ± 12.2) years. No significant change in antirheumatic treatment was observed during the study. Statistically significant improvements (p < 0.05) were noted for health-related quality of life (increase in Physical Component Summary of Short Form-36 (SF-36) by 23.6%) and disease activity (decrease of Clinical Disease Activity Index and Simple Disease Activity Index by 38.4% and 39.9%, respectively). Clinically significant improvement was demonstrated for SF-36 Total Score (+ 14.4%), disease activity (Rheumatoid Arthritis Disease Activity Index− 5 to 15.9%), and depression (Patient Health Questionnaire− 9 to 13.5%). None of the efficacy parameters showed negative trends. No adverse events were reported throughout the study. The usability level was high i.e., the mean mHealth Application Usability Questionnaire Score of 5.96 (max.: 7.0) demonstrated a high level of application usability. This suggests that using a personalized disease management program based on DHA significantly improves several measures of patient-reported outcomes and disease activity in patients with inflammatory arthritis in a timely manner. These findings highlight the potential of complementary digital therapy in patients with inflammatory arthritis.

P51. Which subscales of Oswestry Disability Index and Short Form 36 are related with sagittal and coronal parameters in degenerative lumbar scoliosis patients: a prospective study

<h3>BACKGROUND CONTEXT</h3> Degenerative lumbar scoliosis (DLS) patients had various degrees of disability. Previous studies have been inconclusive as to the correlation between radiographic and clinical parameters in DLS. <h3>PURPOSE</h3> The aim of this study was to identify the relationship between Oswestry Disability Index (ODI) and Short Form 36 (SF-36) total and subscale scores and global spinal parameters in DLS patients. <h3>STUDY DESIGN/SETTING</h3> A prospective study. <h3>PATIENT SAMPLE</h3> We enrolled 126 consecutive patients with degenerative de novo lumbar or thoracolumbar scoliosis patients who were referred to a tertiary hospital between August 2018 and December 2019. <h3>OUTCOME MEASURES</h3> ODI and SF-36 total and subscale scores. <h3>METHODS</h3> Sagittal (sagittal vertical axis; thoracic kyphosis; lumbar lordosis [LL]; pelvic tilt; pelvic incidence [PI]; PI-LL) and coronal (Cobb angle [CA]; coronal C7 plumb line; pelvic obliquity) parameters were measured on whole spinal radiographs. Pearson's correlation analysis was performed to reveal the relationship between parameters. <h3>RESULTS</h3> There were 76 female and 15 male patients with an average age of 70.2±8.4 years. The CA averaged 18.9±8.0°. ODI total score and SF-36 PCS had correlations with only coronal spinal parameters. ODI walking, standing, social life, and traveling domains were correlated with both coronal and sagittal parameters. Pain intensity, personal care, lifting, sitting and sex life domains were correlated with only coronal parameters. SF-36 physical function (PF) domain had correlations with both coronal and sagittal parameters. Bodily pain and vitality domains had correlations with only coronal parameters. <h3>CONCLUSIONS</h3> Only coronal parameters were correlated with ODI total score and SF-36 PCS in DLS patients. Coronal parameters were also correlated with most ODI subscales and SF-36 PF, BP and VT subscales. Although sagittal parameters were not correlated with ODI total score and SF-36 PCS, those were correlated with some subscale scores of ODI (walking, standing, social life and traveling) and SF-36 PF subscale. Analysis using subscale scores of ODI and SF-36 is helpful to understand and treat various degree of disability in DLS patients. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Dermatological Findings in Fibromyalgia Syndrome and Their Effects on Quality of Life, Clinical Findings, and Depression

Purpose: The aim was to investigate the skin findings in patients with Fibromyalgia Syndrome (FMS), and the relations of these findings with the clinical symptoms of the disease, quality of life and depression levels of the patient. Materials and Methods: A total of 77 patients with FMS were included in the study as the study group, 74 individuals were included as the control group. The pain levels were evaluated with Visual Analogue Scale (VAS). The short form-36 (SF-36) was used to evaluate the quality of life levels of the patients. The Beck Depression Scale (BDS) was used to evaluate the depression levels of the patients. All participants were evaluated by the same dermatology specialist. Results: Although 37.1% patients who had FMS had at least one cutaneous symptom, 19.9% of the control group had at least one cutaneous symptom (p<0.01). According to the BDS, significant increases were detected in FMS patients (p=0.001). Significant decreases were detected in terms of all SF-36 parameters in the FMS group (p=0.001). There was at least one dermatological disease in 43% of the patients, and in 20.5% of the controls. Although no significant differences were detected between BDS and VAS scores of the FMS patients with and without dermatological findings, SF-36 total score and physical role strength score were found to be significantly lower in the patients who had dermatological symptoms. Conclusions: It must be known that there may be dermatological symptoms in FMS, a more multidisciplinary approach must be used in treatment and follow-up.

Sedentary Time in Older Adults With Acute Cardiovascular Disease

BackgroundOlder adults may be subject to prolonged bedrest during hospitalization for acute cardiovascular disease, which can contribute to poor functional outcomes posthospitalization. Our objective was to describe mobility status in hospitalized older adults with acute cardiovascular disease. MethodsPatients aged ≥ 60 years old in the cardiac intensive care unit and cardiovascular ward at a tertiary care academic centre in Montréal, Québec were prospectively enrolled from April 2019 to March 2020. Activity levels were measured with the ActiGraph GT9X Link 3-axis accelerometer (ActiGraph, Pensacola, FL). Sedentary was defined as lying in bed or in a sitting position. Health-related quality of life (HRQOL) was measured with the Short-Form 36 (SF-36) questionnaire by telephone at 1 month posthospitalization. The primary outcome was percentage of sedentary time during hospitalization. ResultsThere were 35 patients included in the analysis (75.7 ± 6.9 years old; 45.7% female; 22.9% ischemic heart disease; 20.0% heart failure). Patients spent 91.2% ± 5.5 in a sedentary position during their hospital stay. Mean steps per minute were 1.0 ± 1.2, and mean kcals consumed per day were 116.6 ± 124.5. In the multivariable analysis, a higher percentage of sedentary time and lower steps per minute were each associated with lower total SF-36 scores at 1-month posthospitalization (both P < 0.05). ConclusionsOlder adults with acute cardiovascular disease may be sedentary for a large part of their hospital stay. Increased sedentary time is associated with worse self-reported posthospital HRQOL. Future studies are needed to determine whether interventions to increase activity during hospitalization improve posthospital HRQOL and functional outcomes.

Nocturnal bladder emptying and Quality of Life in patients with spinal cord injury.

Little is known about the relationship between sleep disruption due to nocturnal bladder emptying and Quality of Life in patients with spinal cord injury. The aim of this study was to evaluate the possible influence of number of nocturnal bladder emptying, bladder emptying method and nocturnal incontinence on the Quality of Life of patients with spinal cord injury. The design of this paper is a cross-sectional descriptive study. The setting is in- and outpatient. Seventy-nine patients aged between 18 and 77 years with SCI in a first rehabilitation period or follow-up. Patients were asked to complete Short Form-36 and Incontinence Quality of Life questionnaires and a medical information form. Independent samples t-tests and ANOVA were used to compare scores between groups. The response rate was 71 out of 79 (89%; 51 males and 20 females). 16 paraplegic and 4 tetraplegic patients were chronic, 29 paraplegic and 22 tetraplegic patients were in rehabilitation therapy or had finished this treatment recently. The paraplegic group had a significantly better Short Form-36 total score and emotional function score, while the tetraplegic group had a significantly better Incontinence Quality of Life total score and avoidance and limiting behavior score. The paraplegic patients with 0-1 nocturnal bladder emptying had better Short Form-36-derived Quality of Life than those with ≥2 emptying. Quality of Life score was not associated with gender, leg oedema, incontinence, or acute/chronic group. Incontinence Quality of Life score was significantly better for patients with incomplete spinal cord injury. Fully completed questionnaires were returned by 36 patients; at least 1 item was missing for 35 participants. General Short Form-36-derived Quality of Life was better for the paraplegic population. Incontinence-related Quality of Life was better in tetraplegic patients, most of whom used suprapubic catheterization. Paraplegic patients had compromised sleep and Quality of Life when the patient had to wake up two or more times at night to empty the bladder by voiding or intermittent catheterization. The high number of incomplete responders indicates the shortcomings of Quality-of-Life questionnaires for wheelchair-bound patients with spinal cord injury. The use of suprapubic catheterization should be considered to improve Quality of Life for tetraplegic patients. For paraplegic patients, we must focus urological policy on aiming to reduce the number of nighttime bladder emptying to one or none.

Prospective investigation of Oswestry Disability Index and short form 36 subscale scores related to sagittal and coronal parameters in patients with degenerative lumbar scoliosis.

This study investigated relationships of Oswestry Disability Index (ODI) and Short Form 36 (SF-36) total and subscale scores with global spinal parameters in patients with degenerative lumbar scoliosis (DLS). This was a prospective single-center study of 126 consecutive patients with DLS. Disability was evaluated using the ODI and SF-36 total and subscale scores. Sagittal and coronal parameters were measured. Pearson's correlation analysis was performed to determine relationships between disability and radiographic parameters. The study population included 76 women and 15 men (mean age, 70.2 ± 8.4years). Mean Cobb angle was 18.9° ± 8.0°. The ODI total score and SF-36 physical component score were only correlated with coronal parameters. ODI pain intensity, personal care, lifting, sitting, and sex life domains were only correlated with coronal parameters. The walking, standing, social life, and traveling domain scores were correlated with coronal and sagittal parameters. The SF-36 bodily pain and vitality domain scores were only correlated with coronal parameters. The SF-36 physical function domain score was correlated with both coronal and sagittal parameters. Among the clinical and radiographic parameters, the personal care score and the coronal vertical-axis had the strongest correlation (r = 0.425), although the r2 value was only 0.18. ODI total score and most of the subscale scores were significantly, but weakly correlated with coronal parameters. Sagittal parameters were only correlated with some of the ODI and SF-36 subscale scores. Analysis using ODI and SF-36 subscale scores may aid in understanding and treatment of disability in patients with DLS.

The Effectiveness of Matrix Rhythm Therapy in Patients with Chronic Low Back Pain.

Randomized clinical study. Our study was planned to determine the effect of matrix rhythm therapy (MRT) on pain, level of disability, and quality of life in chronic low back pain. Low back pain is a complex and heterogeneous disorder. Different therapy options can be applied in the treatment of low back pain. In the literature, there are very few studies showing the effect of MRT in patients with chronic low back pain. A total of 32 participants with a mean age of 36.41 ± 8.91 years were randomly divided into two groups (intervention group and control group). Each participant was treated with ten sessions a combined physiotherapy program (hot pack, transcutaneous electrical nerve stimulation, therapeutic ultrasound, home exercise and patient education program). Additionally, intervention group received six sessions of MRT. Pain (McGill Pain Questionnaire), level of disability (Oswestry Disability Index) and quality of life (Short Form-36) were measured before and after the treatment programme. When pre- and post-treatment results were compared in the intervention group, a statistically significant difference was found in total pain level, disability level, and all subdimensions except the "Emotional Role" subdimension of Short Form-36 (SF-36) and total SF-36 scores (P ≤ 0.05). In the control group, statistically significant differences were found in disability level, the "Vitality" and "Bodily Pain" subdimensions of SF-36 and total SF-36 scores (P ≤ 0.05). When the delta values were compared between groups, there was a statistically significant difference only in the "general health perceptions" subdimension of SF-36 (P ≤ 0.05) in favor of the intervention group. It was determined that both the combined physiotherapy program and the MRT application in addition to the combined physiotherapy program have a positive effect on pain, disability level, and quality of life in patients with chronic low back pain.Level of Evidence: 2.

Takayasu's Arteritis from the Patients' Perspectives: Measuring the Pulse to the Patient-Reported Outcomes

Patients with Takayasu's arteritis (TA) experience important changes in lifestyle, quality of life, and functional status due to ischemic symptoms or treatment toxicity. To describe the clinical characteristics and the patient-reported outcomes (PROs), such as quality of life, disability, fatigue, and perception/impact of the disease in Mexican patients with TA. Cross-sectional study including patients with established diagnosis of TA recruited at a tertiary care center. Demographics, comorbidities, clinical characteristics, laboratory, imaging, and treatment were retrieved. Disease activity (the Indian Takayasu Clinical Activity Score (ITAS) 2010), damage (Vasculitis Damage Index (VDI)), quality of life (Short Form 36 (SF-36)), disability (Health Assessment Questionnaire Disability Index (HAQ-DI)), fatigue (Multidimensional Fatigue Inventory-20), and patient's disease perceptions were assessed. Fifteen women were included, with a median age of 41years (interquartile range (IQR) 30-45) and disease duration of 108months (IQR 55-197). Median ITAS 2010 and VDI scores were 0 (IQR 0-2) and 3 points (IQR 2-6), respectively. Mean SF-36 score was 71.38±13.39, with mean physical and mental component summaries of 66.52±13.37 and 76.24±14.89, respectively. HAQ-DI mean score was 0.48±0.62, being grip the most affected domain. Among fatigue subscales, the higher scores were present in the physical fatigue (16.3±5.8). Correlations between the HAQ-DI and the VDI score (r=0.64, P=0.03); between the general fatigue, score, and disease duration (r=-0.71, P=0.01); and between the SF-36 total score and the HAQ-DI (r=-0.87, P=0.0004) were found. It is important to identify disease-specific outcomes of interest to the patients to develop tools that assess them with a holistic approach.

Abstract 16532: Sedentary Time in Hospitalized Older Adults With Acute Cardiovascular Disease

Background: Older adults may be subject to prolonged bedrest during hospitalization for acute cardiovascular (CV) disease, which can contribute to poor functional outcomes posthospitalization. Our objective was to describe mobility status in hospitalized older adults with acute CV disease. Methods: Patients aged ≥ 60 years old in the cardiac ICU and CV ward at a tertiary care academic centre in Montreal, Quebec were prospectively enrolled from April 2019 to March 2020. Activity levels were measured with an accelerometer (ActiGraph GT9 Link). Sedentary was defined as lying in bed or in a sitting position. Health-related quality of life (HRQoL) was measured with the Short-Form 36 (SF-36) questionnaire by telephone at 1 month post-hospital discharge. The primary outcome was percentage of sedentary time during hospital stay. Secondary outcomes were step counts, steps per minute, and kcal/day consumption. Results: There were 35 patients included in the analysis (75.7 6.9 years old; 45.7% females; 22.9% ischemic heart disease; 20.0% heart failure). Patients spent 91.2% ± 5.5 in the sedentary position during their hospital stay (range 80.0-100%; Figure ). There was no difference in percentage sedentary time by primary diagnosis or sex. Mean steps per minute were 1.0 ± 1.2 and mean kcals consumed per day were 116.6 ± 124.5. In the multivariable analysis, a lower percentage of sedentary time and lower steps per minute were each associated with lower total SF-36 scores at 1-month posthospitalization (both P&lt;0.05). Conclusion: Older adults with acute CV disease are sedentary for a large part of their hospital stay. Increased sedentary time is associated with worse self-reported posthospital HRQoL. Future studies are needed to determine whether interventions to increase activity during hospitalization improve posthospital HRQoL and functional outcomes.

Impact of depressive disorders on quality of life after middle ear surgery in patients with chronic otitis media

PurposeThe aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM).MethodsThis prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index.ResultsAfter middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001).ConclusionPreoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.

Do Therapeutic Exercises Improve Kinesophobia and Health-Related Quality of Life in Adult Hemophilia Patients? A randomized controlled trial.

Objectives: Pain, risk of injury and physical limitations lead to the development of kinesophobia and decrease in health-related quality of life in hemophilia patients. The aim of this study was to investigate the effects of therapeutic exercises on kinesophobia and health-related quality of life in adult hemophilia patients. Material and Methods: A total of 24 patients aged 18 to 42 years were included in the study. Patients were randomly allocated to the control and exercise groups.Tampa Scale of Kinesiophobia (TSK) was used for evaluation of kinesiophobia, Short Form-36 (SF-36) and Haemophilia Adult Quality of Life (Hem-A-Qol) were used to assess health related quality of life. These evaluation scales were applied on the participants of both groups before and at the end of the study. Therapeutic exercises were administered to the exercise group three days a week for two months. Results: At baseline in physical, sociodemographic-clinical data, SF-36 and Hem-A-Qol scores there was not a significant difference between groups (p&amp;gt;0.05). However in kinesophobia level, there was a significant difference in favor of the control group (p&amp;lt;0.05). After the exercise program, there was a significant decrease in kinesophobia and increase in total SF-36 score in the exercise group compared to the control group (p&amp;lt;0.05). However there was a decrease clinically in favor of the exercise group in total Hem-A-Qol value, whereas this difference was not statistically meaningful (p&amp;gt;0.05). Conclusions: Therapeutic exercises are simple and safe treatment modalities that can be used to improve kinesophobia and health-related quality of life in adult hemophilia patients. This improvement can be attributed to physical wellness caused by exercises.

Combined aerobic resistance exercise improves dialysis adequacy and quality of life in patients on maintenance hemodialysis .

This study aims to compare the effect of pure aerobic exercise and combined aerobic resistance exercise on dialysis adequacy and quality of life in patients on maintenance hemodialysis. A total of 45 patients on maintenance hemodialysis were divided into three groups: pure aerobic exercise group, combined aerobic resistance exercise group, and control group. Patients in the control group were only given the usual treatment, which included dietary guidance, drug therapy, and hemodialysis. The other training groups underwent 12-week exercise intervention therapy on the basis of the usual treatment. Blood samples were collected before and after the hemodialysis, at the beginning and end of the intervention for these three groups. Then, the blood urea nitrogen (BUN) concentration was determined, the urea clearance index (Kt/v) and urea degradation rate (URR) were calculated, the dialysis adequacy was evaluated, and the short form-36 (SF-36) scale was used to evaluate the life quality. Before intervention, there was no significant difference in general health condition (GH), Kt/v, URR, SF-36 total score, and the score of each dimension in the three groups. After the intervention therapy, the Kt/v, URR, GH, vitality (VT), and SF-36 total score markedly improved in the pure aerobic exercise group, while the Kt/v, URR, GH, VT, physical functioning (PF), and SF-36 total score significantly increased in the combined aerobic resistance exercise group. Furthermore, compared with the pure aerobic exercise group, the improvement effect of body function (PF score) was better in the combined aerobic resistance exercise group. Both pure aerobic exercise and combined aerobic resistance exercise can significantly improve the dialysis adequacy and quality of life of maintenance hemodialysis patients. Compared with the pure aerobic exercise group, the effect of combined aerobic resistance exercise on PF was better. .

Impact of disease activity on health related quality of life in patients with Behçet's disease: A cross-sectional study.

BackgroundBehçet's syndrome (BD) is a systemic inflammatory vasculitis of unknown aetiology, affecting vessels of different types, sizes and locations and characterized by recurrent episodes of acute inflammation, including mucocutaneous manifestations (oral aphthous ulcers, genital ulcers and skin lesions) and gastrointestinal, musculoskeletal, neurological, ophthalmic and vascular involvement which lead to a significant morbidity and impaired health related quality of life (HRQoL). Few studies reported impact of disease activity on HRQoL.ObjectiveTo assess the impact of BD activity on HRQoL.Patients and methodsThis cross sectional study included patients with Behçet's disease diagnosed according to the International Study Group criteria 1990 for BD. Age of the patients, sex, smoking status, educational level, disease duration, organ involvement, age at disease onset, and medications used were recorded. Behçet's Disease Disease activity was assessed using Behçet's Disease Current Activity Form (BDCAF) and HRQoL was evaluated using The Short Form-36 (SF-36).ResultsA total of 71 patients (45 males, 26 females) with Behçet's disease were enrolled in this study. Mean age of patients was 36.0 ± 10.8 years, Males represented the majority of patients (63.4%). BDCAF was significantly and negatively correlated with total SF-36 score (standardized β = − 0.520, p < 0.0001). The mean BDCAF was significantly more in females compared to males (6.154 ± 2.444 vs 4.467 ± 2.785, p = 0.012). While the mean SF36 was significantly more in males compared to females (57.722 ± 21.627 vs 41.435 ± 18.993, p = 0.002). After multiple linear stepwise regression analysis, still BDCAF significantly and negatively affected HRQoL in BD (partial r = −0.255, p = 0.043). Male gender, cyclosporine users, infliximab users, and Adalimumab users had significant positive impact on total SF-36 score (partial r = 0.293, p = 0.020; partial r = 0.256, p- = 0.043, partial r = 0.414; p = 0.00, partial r = 0.399, p = 0.001 respectively). While disease duration, and MMF users (partial r = −0.295, p = 0.019; partial r = −0.250, p = 0.043) had significant negative impact on total SF-36 score, and there was weak positive correlation between vascular involvement and total SF36 score (partial r = 0.244,p = 0.053) and a negative weak correlation between the use of anticoagulant with total SF-36 score (partial r = −0.233, p = 0.066).ConclusionsBehçet's disease activity has a significant negative impact on HRQoL This may suggest that treating activity of disease may improve HRQoL.

The Impact of Body Mass Index on Quality of Life in Women with Osteoporosis

Background: Improving the quality of life in osteoporotic women is one of the crucial goals of health systems. Hence, recognizing the factors affecting the quality of life in such patients is an important issue. The body mass index (BMI) seems to be capable of affecting quality of life. Besides, BMI is a quantitative index simple to measure. Objectives: The purpose of this study was to examine the impact of BMI on quality of life in a group of osteoporotic women. Methods: One hundred osteoporotic women aged 50 - 60 participated in this descriptive-analytical study. These women were referring to the internal clinic of Mousavi Hospital of Zanjan. The body mass index was calculated after measuring both height and weight. Based on the BMI, the patients were divided into three groups: BMI &lt; 18.5 underweight, 18.5 ≤ BMI &lt; 25 normal and BMI ≥ 25 overweight. The short form 36 (SF-36) questionnaire was employed for measuring the quality of life. Given the normal distribution of data, one-way-ANOVA and Independent t-test were utilized to compare the means of the three groups. In all tests, P &lt; 0.05 was accepted as a significant level. Results: Comparison groups using the one-way ANOVA test on SF-36 subscale and total QOL scores showed in all components of QOL; underweight, overweight and normal groups were significantly different (P &lt; 0.05). Considering the Independent t-test, osteoporotic women in overweight group reported a poor quality of life as measured by the SF-36. Yet, the quality of life score in the normal group and the underweight group did not have a significant difference. Conclusions: The results of this study demonstrated that increased BMI negatively affects quality of life. Therefore, it can be avowed that keeping the BMI low and controlling it are effective in raising the quality of life in osteoporotic women. Thus, so as to improve the quality of life in those patients, therapists ought to take greater heed of their BMI and its changes.