Increasing exercise with a mobile app in people with Parkinson's disease: a pilot study.

Background Exercise is crucial for the well-being of people with Parkinson's disease (PD). Although there are challenges to exercising with PD, mobile apps are seen as potential solutions, though their impact is not yet fully understood. We developed a mobile app and a home-based exercise program specialised for people with PD and investigated the effect of the mobile exercise app for the people with PD. Methods Participants from the Movement Disorder Clinic were prompted to download and actively use our app for a duration of 2 weeks. Before commencing, we assessed their self-rated smartphone proficiency. Both at the start and after the 2-week period, we employed the International Physical Activity Questionnaire-Short Form and the PD Questionnaire-39 (PDQ-39) to evaluate their physical activity and overall quality of life (QoL). Exercise metrics were quantified in terms of metabolic equivalent minutes per week (MET-min/week). Furthermore, we gathered feedback on user satisfaction with the app at the end of the study. Results Out of 41 recruited patients, 25 completed the 2-week program and 16 dropped out. Median MET-min/week rose from 1386.0 to 3210.0 (P = 0.009), primarily in moderate activities (P = 0.049) and walking (P = 0.002). Median PDQ-39 scores showed improvement from 17.2 to 8.5 (P = 0.005) after the program. Conclusion The mobile app holds potential to enhance exercise and QoL for people with PD. For optimal benefits, future studies should focus on e-health literacy education, app quality enhancements, and a broader exercise program variety.

Prognostic factors for overall survival in patients with clear cell metastatic renal cell carcinoma: Model development and external validation with Memorial Sloan Kettering Cancer Center model and the international metastatic renal cell carcinoma database consortium model.

ABSTRACT: To develop a new prognostic model for the overall survival of patients with clear cell metastatic renal cell carcinoma (mRCC) using Korean Renal Cancer Study Group (KRoCS) database and compared it with 2 renowned prognostic models: the Memorial Sloan Kettering Cancer Center (MSKCC) and the international metastatic renal cell carcinoma database consortium (IMDC) models.Data of 790 patients diagnosed with mRCC and receiving targeted therapy as their first-line treatment were pooled to this study. Data from 4 hospitals (n = 619) were used to develop the new model and those from other 5 hospitals (n = 171) were used for external validation. After detecting prognostic factors in multivariable Cox proportional-hazards regression analysis, patients were classified into 3 risk groups, favorable (0), intermediate (1-2), and poor (3 and more) by the number of prognostic factors.Seven variables such as more than 2 metastasis sites, no prior nephrectomy, Eastern Cooperative Oncology Group performance status ≥2, low hemoglobin, high serum corrected calcium, high neutrophil, high serum alkaline phosphatase were identified as prognostic factors for poor overall survival. Also, risk groups were categorized into 3 groups; median overall survival was 61.1 months in favorable, 26.5 months in intermediate, and 6.8 months in poor group. KRoCS ranked the first in all 3 statistical parameters including akaike information criterion (AIC), concordance index and generalized R2 among other prognostic models.We developed the KRoCS model and validated it externally with demonstrating its superiority over MSKCC and IMDC models. The KRoCS model can provide useful information for counseling patients with clear cell mRCC regarding life-expectancy.