Investigation of the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in unilateral breast cancer surgery survivors: a cross-sectional study.

PURPOSE: Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment METHODS: This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis. RESULTS: Increased thoracic curvature angle was associated with decreased FEV1 (r=-0.360, p=0.026) and decreased subcostal mobility (r=-0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=-0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=-0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from -0.357 to 0.661, p<0.05). CONCLUSION: The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients' spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.

Investigation of the dual-task performance and affecting factors in female patients with fibromyalgia syndrome.

Recent studies report that dual-task (DT) performance might be affected in patients with fibromyalgia syndrome (FMS). This cross-sectional study aims to compare the DT performance in female patients with FMS and healthy controls, and to investigate the DT-related factors in these patients. This study was conducted at a university hospital between November 2021 and April 2022. Forty females aged 30-65, diagnosed with FMS, and 40 aged-matched pain-free healthy controls were included. All participants performed the Timed Up and Go Test under a single task (ST) and a cognitive DT condition, and the DT cost was calculated. The following evaluations were applied; The six-minute walk test, Baecke Habitual Physical Activity Questionnaire, Multidimensional Fatigue Inventory-20, Toronto Alexithymia Scale, Trail Making Test, and the Revised Fibromyalgia Impact Questionnaire. As a result of the study, the patient group showed lower performance than controls in both, ST and DT conditions (p < .05). Disease duration, pain and fatigue severity, functional capacity, leisure time and physical activity total scores, alexithymia scores, health status, and cognitive variables were correlated with DT performance in the patient group (p < .05). According to our results, we consider that the rehabilitation approach for females with FMS should take into account DT and related characteristics.

Investigation of the Factors Affecting Quality of Life in Patients with Mild to Moderate Alzheimer's Disease in Terms of Patients and Caregivers.

Background and Objectives: As with other chronic diseases with limited medical treatment, the most important goal of Alzheimer's disease (AD) treatment is to provide a better quality of life (QoL). The purpose of this study was to investigate the factors affecting the QoL of patients with mild to moderate AD in terms of patients and caregivers. Materials and Methods: Seventy-three home-dwelling patients with AD and their caregivers participated in this prospective, cross-sectional study. The patients were asked about their cognition, depression and a self-rating part of a QoL questionnaire. The caregivers were asked about their patients' sociodemographic information, sleepiness, activities of daily living and a proxy rating part of a QoL questionnaire. Results: The self-rated QoL was higher than that provided by the proxy rating. Cognition (p = 0.02), sleepiness (p < 0.01) and depression (p = 0.03) were correlated with the self-rated QoL, while the patient's independence level in activities of daily living was correlated with the proxy-rated QoL (p < 0.05). In regard to predicting QoL according to linear regression analysis, the following were statistically significant: depression was for total score, depression and cognition were for the self-rating and instrumental activities of daily living was for the proxy rating (p < 0.01). Conclusions: While individual factors such as psychology are an important determinant of QoL for patients with AD, objective conditions such as the independence of the patient in daily life are important for the caregiver. While evaluating the quality of life of AD patients, it is important to remember that patients and caregivers have different priorities, and the priorities of both should be taken into account when planning a treatment program.

Associations of Upper-Extremity Exercise Capacity and Grip Strength With Cognitive Domains in Patients With COPD.

BACKGROUND: Cognitive impairment (CI), which has been reported in COPD, has been related to physical performance. However, the association between CI and upper-extremity functions is unknown. We aimed to compare upper-extremity exercise capacity and grip strength between subjects with COPD with and without CI and to determine the relationship of upper-extremity functions with specific cognitive domains. METHODS: In this cross-sectional study, 76 subjects with COPD (mean age 66.8 ± 7.5 y, FEV1% 47.12 ± 14.10) were classified as with and without CI according to the Montreal Cognitive Assessment. Clinical characteristics, upper-extremity exercise capacity (6-min pegboard ring test [6PBRT]), grip strength (hand dynamometer), dyspnea severity (modified Medical Research Council dyspnea scale), disease-specific health status (COPD Assessment Test), and disease-specific quality of life (St George Respiratory Questionnaire) were compared between groups, and the relationship of upper-extremity functions with cognitive subdomains was analyzed by multivariate regression analysis. RESULTS: The number of 6PBRT rings (P = .01) and the grip strength (P = .033) were lower in subjects with CI. Subjects with CI had lower FEV1% (P = .038), arterial oxygenation (P = .002), exercise habits (P = .033), health status (P = .01), quality of life (P = .042); and higher dyspnea (P < .001), smoking consumption (P = .032), emergency admission (P = .02), and hospitalization (P = .042). The adjusted model showed that executive functions and attention were related to upper-extremity capacity (ß = 14.4 and ß = 10.2, respectively) and hand-grip strength (ß = 1.85 and ß = 1.49, respectively). CONCLUSIONS: These findings suggest that upper-extremity functions might be decreased especially concerning executive functions and attention in subjects with COPD with CI.

A Randomized Cross-Over Analysis of the 6-Minute Step Test When Administered in Different Music Listening Conditions to Healthy Young Adults.

The 6-Minute Step Test (6-MST) is a simple, inexpensive field test that is increasingly used to evaluate cardiorespiratory fitness. Whether sufficient performance is revealed by this test and the effect on it of motivational factors such as music is unknown. In this cross-sectional, randomized, and crossover research design, we aimed to analyze 6-MST performance and test outcomes in different music-related auditory conditions of non-musical/non-rhythmic [NM/NR], musical/non-rhythmic [M/NR], and musical/rhythmic [M/R]). We had 38 healthy young adults (M age = 21.21, SD = 1.21 years; 60% male) complete all tests, and we measured their number of steps taken, heart rate, blood pressure, respiratory rate, peripheral oxygen saturation, perceived dyspnea, and fatigue on the modified Borg scale. We recorded individually calculated submaximal values according to heart rate reached after three tests. The number of steps increased in the M/R condition relative to other conditions (p = 0.003), and the amount of change in perceived leg fatigue was also higher in the M/R condition (p < 0.017). Despite variable test performances in different auditory conditions, we found no statistically significant difference in cardiovascular fitness and symptoms (p > 0.05). We concluded that the 6-MST is a useful tool for assessing maximum cardiac tolerance, especially if administered while listening to rhythmic music.

Breathlessness Beliefs and Related Factors in Male Patients with Chronic Obstructive Pulmonary Disease.

OBJECTIVE: Dyspnea may be a debilitating factor for people with pulmonary problems as it may cause fear of movement. The aim of the present study was to determine the related factors with breathlessness beliefs, in other words, dyspnea-related fear of movement, in patients with chronic obstructive pulmonary disease. MATERIAL AND METHODS: Male patients with chronic obstructive pulmonary disease were included in the study. Breathlessness beliefs (Breathlessness Belief Questionnaire), perceived dyspnea severity (modified Medical Research Council Dyspnea Scale and modified Borg Scale), pulmonary function tests (forced vital capacity, forced expiration volume in 1 second, and peak expiratory flow), emotional status (Hospital Anxiety and Depression Scale), fatigue (Fatigue Impact Scale and Fatigue Severity Scale), physical activity level (International Physical Activity Questionnaire-Short Form), disease-related quality of life (St. George Respiratory Questionnaire), and generic quality of life (Short-Form 36) were evaluated. RESULTS: A total of 70 patients were included. Significant correlations were detected between breathlessness beliefs and perceived dyspnea severity, pulmonary function tests, emotional status, fatigue, physical activity level, disease-related quality of life, and generic quality of life (P < .001). No correlations were detected between physical characteristics and dyspnea-related fear of movement (P > .05). CONCLUSION: Dyspnea-related fear of movement was found to be strongly related to perceived dyspnea severity, pulmonary function tests, emotional status, fatigue, physical activity level, and quality of life; thus, including breathlessness beliefs assessment into clinical examination may help clinicians to understand their patients' needs comprehensively.

Comparing Physical Activity and Quality of Life of Caregivers of Children With Physical Disabilities and Typically Developing Children.

There are conflicting reports of the level of physical activity (PA) and its relationship to quality of life (QoL) among caregivers of children with physical disabilities (CwPD). In this cross-sectional study, we aimed to compare the PA levels and QoL of two groups of caregivers - a CwPD group and caregivers of typically developing children (CwTD). We included 32 family caregivers in the CwPD group (22 women, 10 men; M age = 42.1, SD = 6.2 years) and 32 caregivers in the CwTD group (24 women, 8 men; M age = 42.3, SD = 6.1 years). We assessed PA with the International Physical Activity Scale-Short Form (IPAQ-SF) and self-reported activity diaries, and we assessed QoL with the Short-Form 36 (SF-36) questionnaire. Although the IPAQ scores and sitting times of caregivers in these two groups were not statistically different (p > .05), many parameters of self-reported activity diary data and total energy expenditure were significantly higher in the CwPD than the CwTD group (p < .05, effect size = .53-1.10). The CwPD group reported a lower QoL according to the SF-36 and its sub-scores (p < .05, effect size = .54-.77), and higher PA levels than those in the CwTD group. In the CwPD group, moderate, vigorous, and total PA scores were mildly to moderately associated with the total Qol score, and many of its subscores (r = .36 to .60, p < .05). The lower quality of life observed in CwPD, despite high-intensity physical activity levels, suggested that investigators and care providers should consider QoL in the CwPD group to be multifactorial and that here is a need for caregiver interventions to enhance QoL in this underserved population.

Kinesiophobia and Associated Factors in Patients With Myocardial Infarction.

Kinesiophobia is a well-known barrier to positive clinical outcomes among patients with various diseases, but there remain few comprehensive studies of kinesiophobia among patients with myocardial infarction (MI). In this cross-sectional study, we investigated the presence of kinesiophobia and its relationship with clinical outcomes among 42 patients with MI who completed the Tampa Scale of Kinesiophobia Swedish Version for Heart (TSK-SV Heart) the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Six-Minute Walk Test (6MWT), the Hospital Anxiety and Depression Scale (HADS), the modified Medical Research Council (mMRC) Dyspnea Scale, the Charlson Comorbidity Index (CCI), and the MacNew Heart Disease Health-Related Quality of Life Questionnaire. The participants' mean TSK-SV Heart score was 39.24 (SD = 6.65), and 71.4% of these patients reported a high level of kinesiophobia. The TSK-SV Heart score demonstrated a strong correlation with the IPAQ-SF, 6MWT walking distance, and mMRC score (p < .001), and a moderate correlation with the HADS, CCI, and MacNew Heart Disease HRQoL (p < .05). Patients with a high level of kinesiophobia had lower IPAQ-SF, 6MWT walking distance, and HRQoL and higher mMRC, CCI, and HADS scores than patients with low levels of kinesiophobia (p < .05). Kinesiophobia was common and represented a considerable risk factor for physical-psychosocial dysfunctions in these patients with MI. To maintain functional independence and to increase physical activity level, clinicians should consider kinesiophobia from early to late-stage disease and should add a treatment focus that seeks to eliminate kinesiophobia in cardiac rehabilitation programs.

Effect of home-based high-intensity interval training versus moderate-intensity continuous training in patients with myocardial infarction: a randomized controlled trial.

BACKGROUND: Supervised high-intensity interval training (HIIT) has been proposed to be more effective than moderate-intensity continuous training (MICT) for improving exercise capacity, but there are not sufficient information effects of home-based HIIT and MICT in patients with myocardial infarction (MI). AIMS: To compare the effects of home-based HIIT and MICT in patients with MI. METHODS: Twenty-one patients with MI were randomly assigned to one of two home-based exercise modes: HIIT group and MICT group. Home-based HIIT and MICT were performed twice a week for 12 weeks with an exercise intensity of 85-95% of heart rate (HR) reserve and 70-75% HR reserve, respectively. The primary outcome measure was functional capacity. Secondary outcomes included resting blood pressure and HR, peripheral oxygen saturation, pulmonary function and respiratory muscle strength, dyspnea severity, body composition (body fat%, body mass index (BMI), fat free muscle), peripheral muscle strength, and health-related quality of life (HRQoL). RESULTS: Functional capacity, measured by 6-minute walk test, increased in HIIT and MICT group (p < 0.05). Resting BP and HR, body fat%, and BMI were significantly decreased, and pulmonary functions, respiratory-peripheral muscle strength, and HRQoL were significantly increased in the both groups (p < 0.05). Home-based HIIT was more effective than MICT in improving pulmonary functions and lower extremity muscle strength (p < 0.05). CONCLUSIONS: This study suggests that HIIT and MICT can be applied at home-based in patients with MI and play an important role in improving functional capacity, health outcomes, and HRQoL. TRIAL REGISTRATION: Clinical Trials Number: NCT04407624.