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1.
Geriatr Gerontol Int ; 24(5): 493-498, 2024 May.
Article in English | MEDLINE | ID: mdl-38602076

ABSTRACT

AIM: Although the maintenance and improvement of quality of life (QoL) through holistic care are important in geriatric medical care, care priorities might differ depending on three essential aspects of QoL: the quality of daily living, satisfaction and happiness from birth to death, and human vitality, which are "Seikatsu," "Jinsei," "Seimei" in Japanese, respectively. We aimed to clarify these priorities in terms of medical care and examined how the definitions of QoL affected these priorities' rankings. METHODS: This cross-sectional study involved community-dwelling older adults aged ≥65 years living in Kashiwa City, Chiba Prefecture, Japan. The number of participants was 1550 (mean age, 76.1 ± 5.8 years; 699 women [45.1%]). A self-administered questionnaire distributed in advance was used to rank 12 items sought in medical care. Participants were randomly assigned to one of three groups and sent the corresponding questionnaire, which differed only in the definition of QoL. RESULTS: The top priorities for medical care were "effective treatment of illness," "improvement of physical function," and "maintaining a high level of activity." When QoL was defined as "the quality of daily living, satisfaction and happiness from birth to death, and human vitality," participants were significantly more likely to rank QoL improvement as one of the top three items (adjusted odds ratio, 1.46; 95% confidence interval, 1.03-2.05). CONCLUSIONS: As a medical care priority, older adults desire improvement of multidimensional elements of life, including human vitality. Health care providers should consider this when making medical care decisions. Geriatr Gerontol Int 2024; 24: 493-498.


Subject(s)
Activities of Daily Living , Happiness , Independent Living , Personal Satisfaction , Quality of Life , Humans , Female , Male , Aged , Cross-Sectional Studies , Japan , Aged, 80 and over , Surveys and Questionnaires
2.
Neurol Res ; 46(6): 553-560, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38565199

ABSTRACT

OBJECTIVES: Inadequate trunk function is the underlying cause of many problems such as impaired balance and mobility. Although there have been trunk-based physiotherapy approaches in recent years, almost all of these approaches focus on motor problems. This study aims to investigate the effects of sensory training combined with trunk-centered Bobath exercises on trunk control and proprioception, balance, gait, and the activity of daily living (ADL). MATERIALS AND METHODS: This study is a randomized controlled trial included with twenty-seven stroke patients. Participants were separated into two groups, Group 1; 'sensory training combined with trunk-centered Bobath exercises' and Group 2; 'trunk-centered Bobath exercises'. Trunk-centered Bobath exercises were used for motor training. Sensory training included transcutaneous electric nerve stimulation and a set of exercises that provide tactile and proprioceptive stimulation. Trunk Impairment Scale, Trunk Reposition Error, Berg Balance Scale, 2-minute walk test, and Barthel Index were used to assess trunk control, trunk proprioception, balance, gait, and ADL respectively. RESULTS: Intra-group analysis results showed that trunk control, trunk proprioception, balance, gait, and ADL improved in both groups after treatment (p < 0.05). The changes in the Trunk Reposition Error values of the participants in Group 1 before and after treatment was found to be significantly higher than Group 2 (p < 0.05). CONCLUSIONS: The findings indicated that the application of trunk-centered motor training is effective in improving trunk proprioception and trunk control, balance, gait, and ADL in stroke patients. Also, sensory training combined with trunk-centered motor training was found more effective in improving trunk proprioception than solely motor training.


Subject(s)
Exercise Therapy , Postural Balance , Proprioception , Stroke Rehabilitation , Stroke , Torso , Humans , Male , Female , Proprioception/physiology , Stroke Rehabilitation/methods , Middle Aged , Single-Blind Method , Stroke/physiopathology , Stroke/therapy , Stroke/complications , Torso/physiopathology , Exercise Therapy/methods , Postural Balance/physiology , Aged , Activities of Daily Living , Adult , Treatment Outcome
3.
PLoS One ; 19(4): e0300242, 2024.
Article in English | MEDLINE | ID: mdl-38625960

ABSTRACT

BACKGROUND: Acupuncture of the governor vessel and Yangming meridian are widely used in the treatment of acute ischemic stroke (AIS). However, the optimal meridian for acupuncture in the treatment of AIS remains uncertain. PURPOSE: This network meta-analysis study aimed to compare the clinical effectiveness of acupuncture at governor vessel and Yangming meridian in the treatment of AIS. METHODS: All relevant studies published in CNKI, WANFANG, VIP, Sinomed, Cochrane Library, Web of Science, Pub Med, and Embase before January 13, 2024 were systematically retrieved. The two researchers independently screened the studies and extracted the data. Cochrane ROB tool was used to evaluate the quality of the studies, and Stata 14.0 software was used to conduct a network meta-analysis of neurological deficit score, activities of daily living (ADL), clinical effective rate and Fugl-meyer motor function evaluation (FMA). RESULTS: A total of 401 studies were obtained, and 17 studies met the inclusion criteria. The surface under the cumulative ranking curve (SUCRA) values of the four outcome indexes were all ranked by "Governor vessel acupuncture + Conventional neurology treatment(GVAc+CT) > Yangming meridian acupuncture + Conventional neurology treatment(YMAc+CT) > Conventional neurology treatment (CT)". Compared to YMAc+CT and CT, GVAc+CT had the best effect in reducing the degree of neurological deficit score (SMD = -0.72, 95%CI = [-1.22,-0.21] and SMD = -1.07,95%CI = [-1.45,-0.69], respectively) and promoting the recovery of ADL((SMD = 0.59,95%CI = [0.31,0.88] and SMD = 0.96,95%CI = [0.70,1.21], respectively). Compared to CT, GVAc+CT also had a better clinical effective rate in the treatment of AIS (RR = 1.14,95%CI = [1.04,1.25]). CONCLUSIONS: Governor vessel acupuncture combined with conventional neurology treatment has the best effect in reducing the degree of neurological deficit score and promoting the recovery of ADL in AIS patientscompared to YMAc+CT and CT. Governor Vessel acupuncture is the most preferable acupoint scheme for clinical acupuncture treatment of AIS.


Subject(s)
Acupuncture Therapy , Ischemic Stroke , Meridians , Humans , Acupuncture Therapy/methods , Ischemic Stroke/therapy , Ischemic Stroke/physiopathology , Treatment Outcome , Network Meta-Analysis , Activities of Daily Living , Acupuncture Points
4.
J Back Musculoskelet Rehabil ; 37(4): 1023-1030, 2024.
Article in English | MEDLINE | ID: mdl-38517771

ABSTRACT

BACKGROUND: Acupuncture, traditional Chinese herb hot compress and rehabilitation training is useful in post-stroke shoulder-hand syndrome (SHS), but it is less commonly used in combination. OBJECTIVE: To analyse the therapeutic efficacy of a combination of acupuncture, traditional Chinese herb hot compress and rehabilitation training in SHS patients. METHOD: Patients diagnosed with post-stroke SHS and treated from January 2022 to March 2023 at Beijing Friendship Hospital and Beijing Pinggu Hospital were selected and randomly divided into three groups (A, B and C). Group A received conventional rehabilitative treatment (35 cases), Group B underwent conventional rehabilitative treatment + acupuncture (35 cases), and Group C received conventional rehabilitative treatment + acupuncture + traditional Chinese herb hot compress treatment (35 cases). The post-treatment effectiveness rate, visual analogue scale (VAS) score, activities of daily living (ADL) score, Fugel-Meyer assessment (FMA) score, SHS assessment scale (SHSS) score and shoulder joint mobility were compared among the three groups. RESULTS: The post-treatment VAS score (FVAS score= 232.512, P< 0.001), FMA score (FFMA score= 239.412, P< 0.001), ADL score (FADL score= 412.634, P< 0.001), SHSS score (FSHSS score= 212.542, P< 0.001) and shoulder joint mobility (FShoulder Joint Mobility= 197.531, P< 0.001) all showed statistically significant differences. The VAS and SHSS scores decreased in the order of Group A > Group B > Group C, while the FMA, ADL and shoulder joint mobility scores increased in the order of Group C > Group B > Group A. The post-treatment effectiveness rates (χ2= 48.510, P< 0.001) also exhibited statistically significant differences, decreasing in the order of Group C (94.29%) > Group B (82.86%) > Group A (71.43%). CONCLUSION: The treatment efficacy of the combined acupuncture, traditional Chinese herb hot compress and rehabilitation training for SHS patients is significant, warranting its clinical promotion.


Subject(s)
Acupuncture Therapy , Stroke Rehabilitation , Stroke , Humans , Male , Female , Middle Aged , Stroke Rehabilitation/methods , Stroke/complications , Treatment Outcome , Aged , Reflex Sympathetic Dystrophy/rehabilitation , Reflex Sympathetic Dystrophy/therapy , Combined Modality Therapy , Drugs, Chinese Herbal/therapeutic use , Activities of Daily Living , Medicine, Chinese Traditional
5.
Patient ; 17(4): 421-439, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38530509

ABSTRACT

BACKGROUND: Individuals living with transfusion-dependent ß-thalassemia (TDT) experience reduced health-related quality of life due to fatigue and chronic pain, which cause disruptions to daily life. Currently, limited qualitative data exist that describe these impacts. OBJECTIVE: This study aimed to examine the ways in which symptoms and current treatments of TDT impact health-related quality of life, to holistically describe the humanistic burden of TDT, and to identify the unmet needs of individuals living with TDT. METHODS: Adults (aged ≥ 18 years) with TDT and caregivers of adolescents (aged 12‒17 years) with TDT participated in semi-structured one-on-one virtual interviews and focus group discussions. Interviews were conducted in the USA and UK and lasted approximately 60 minutes. After transcription, the interviews were analyzed thematically using a framework approach. RESULTS: A total of ten interviews/focus group discussions (six interviews and four focus group discussions) were conducted with 14 adults with TDT and two caregivers of adolescents with TDT. A framework analysis revealed five themes describing health-related quality of life (negative impacts on daily activities, social life, family life, work and education, and psychological well-being) and three themes describing the lived experience of TDT (impact of red blood cell transfusions and iron chelation therapy, treatment, and stigma). Physical, psychological, and treatment-related factors contributed to negative impacts on daily activities, social and family life, and work and education. Concerns about reduced lifespan, relationships and family planning, and financial independence were detrimental to participants' mental well-being. Participants reported having high resilience to the many physical and psychological challenges of living with TDT. A lack of TDT-specific knowledge among healthcare professionals, particularly regarding chronic pain associated with the disease, left some participants feeling ignored or undermined. Additionally, many participants experienced stigma and were reluctant to disclose their disease to others. CONCLUSIONS: Individuals living with TDT experience substantial negative impacts on health-related quality of life that disrupt their daily lives, disruptions that are intensified by inadequate healthcare interactions, demanding treatment schedules, and stigma. Our study highlights the unmet needs of individuals living with TDT, especially for alternative treatments that reduce or eliminate the need for red blood cell transfusions and iron chelation therapy.


Subject(s)
Caregivers , Focus Groups , Qualitative Research , Quality of Life , beta-Thalassemia , Humans , Male , beta-Thalassemia/psychology , beta-Thalassemia/therapy , Female , Adolescent , United States , Adult , United Kingdom , Middle Aged , Caregivers/psychology , Blood Transfusion/psychology , Interviews as Topic , Child , Young Adult , Activities of Daily Living , Fatigue/psychology , Chronic Pain/psychology
6.
BMC Public Health ; 24(1): 803, 2024 Mar 14.
Article in English | MEDLINE | ID: mdl-38486217

ABSTRACT

BACKGROUND: Although tooth loss appears to be related to functional limitations, the mechanisms that underpin this relationship are unknown. We sought to address this knowledge gap by examining a multiple mediation hypothesis whereby tooth loss is predicted to indirectly affect functional limitations through social participation, subjective well-being, and cognitive function. METHODS: This study included 7,629 Chinese adults from the 2017/2018 Chinese Longitudinal Healthy Longevity Survey wave. The serial mediation effects were examined using Model 6 in the Hayes' PROCESS macro for SPSS. RESULTS: Tooth loss was significantly related to functional limitations. There was a direct (ß = - 0.0308; 95% CI, - 0.0131 to - 0.0036) and indirect (ß = - 0.0068; 95% CI, - 0.0096 to - 0.0041) association between tooth loss and instrumental activities of daily living (IADL) limitations, but only an indirect correlation with activities of daily living (ADL) limitations (ß = - 0.0188; 95% CI, - 0.0259 to - 0.0121). Social participation, subjective well-being, and cognitive function serially mediated the relationship between tooth loss and ADL/IADL limitations. CONCLUSION: The association between tooth loss and functional limitations is serially mediated by social participation, subjective well-being, and cognitive function. Our findings underscore the necessity of considering psychological and social factors as integrated healthcare approaches for the functional health of older adults.


Subject(s)
Social Participation , Tooth Loss , Humans , Middle Aged , Aged , Activities of Daily Living , Tooth Loss/epidemiology , Cognition , China/epidemiology
7.
J Prim Care Community Health ; 15: 21501319241241456, 2024.
Article in English | MEDLINE | ID: mdl-38523428

ABSTRACT

INTRODUCTION/OBJECTIVES: Thailand has approached an aged society in which the proportion of older adults rose from 5% in 1995 to 20.7% in 2022 and is projected to increase to 27.2% in 2030. Older adults face health risks and challenges, requiring supportive care. This research aimed to promote the wellness of older adults through Integrated Health-Promoting Programs and Supportive Peers (IHPP-SP) in semi-urban communities. METHODS: A one-group pretest-posttest quasi-experimental study was conducted among 229 older adults from 22 communities. The interventions covered analyzing community situations and determinants, designing and developing IHPP-SP, enhancing the capabilities of supportive peers, and establishing a support system. Mean and proportion differences were analyzed using the paired t-test and McNemar test. RESULTS: After implementing IHPP-SP, the mean score significantly increased for happiness (P = .004), Activities of Daily Living: ADLs (P = .034), and family support (P < .001), but did not differ regarding depression (P = .413). The proportion of healthy behaviors significantly increased for tobacco use (P = .035), dietary intake (P = .018), and physical activity (P < .001), but not for alcohol consumption (P = .377). CONCLUSIONS: The IHPP-SP provided potential benefits to promote the wellness of older adults.


Subject(s)
Activities of Daily Living , Health Promotion , Humans , Aged , Thailand , Health Behavior
8.
Medicine (Baltimore) ; 103(9): e37167, 2024 Mar 01.
Article in English | MEDLINE | ID: mdl-38428878

ABSTRACT

BACKGROUND: Spastic paralysis is one of the most common sequelae of stroke, severely affecting patients' limb function and reducing their quality of life. Scalp acupuncture (SA) has been shown to significantly improve cerebral blood supply and reduce the severity of limb spasticity. This meta-analysis aims to systematically evaluate the clinical efficacy of SA in the treatment of post-stroke spastic paralysis, providing evidence-based medicine for clinical management of this condition. METHODS: We comprehensively searched databases including China National Knowledge Infrastructure, Wanfang Data, VIP Chinese Science and Technology Periodical Database, China Biomedical Literature Database, PubMed, Embase, and Cochrane Library. Randomized controlled trials investigating the efficacy of SA in post-stroke spastic paralysis were identified until July 28, 2023. Meta-analysis was conducted using RevMan 5.4 and Stata17.0. RESULTS: A total of 16 studies were included. Meta-analysis showed that the modified Ashworth spasticity assessment scale in the SA group was significantly higher than that in the rehabilitation group (mean difference [MD] = -0.56, 95% confidence interval [CI] [-0.75, -0.37], Z = 5.67, P < .00001). The simplified Fugl-Meyer motor function assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.86, 95% CI [3.26, 8.46], Z = 4.41, P < .0001). The modified Barthel index assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.79, 95% CI [4.73, 6.84], Z = 10.77, P < .00001). Additionally, the clinical effective rate in the SA group was significantly higher than that in the rehabilitation group (relative risk = 1.25, 95% CI [1.16, 1.36], Z = 5.42, P < .00001). CONCLUSION: SA combined with rehabilitation therapy has certain advantages in reducing limb spasticity, improving limb function, and enhancing activities of daily living in patients with post-stroke spastic paralysis. This study provides reference and theoretical support for the promotion of SA in the treatment of this condition.


Subject(s)
Acupuncture Therapy , Stroke Rehabilitation , Stroke , Humans , Activities of Daily Living , Muscle Spasticity/etiology , Muscle Spasticity/therapy , Quality of Life , Scalp , Stroke/complications , Hemiplegia/complications , Paralysis , Upper Extremity , Paresis
9.
Complement Ther Med ; 81: 103033, 2024 May.
Article in English | MEDLINE | ID: mdl-38458542

ABSTRACT

OBJECTIVE: To provide a comprehensive overview of existing evidence, research gaps, and future research priorities concerning the treatment of myasthenia gravis (MG) using exercise therapies. METHOD: Clinical studies on exercise treatment for MG were searched in nine databases to conduct a scoping review. Two independent researchers screened the literature and comprehensively analyzed the characteristics and limitations of the included articles. RESULTS: A total of 5725 studies were retrieved, of which 24 were included. The included studies were conducted in 16 different countries/regions and 456 patients were enrolled. Study designs included both interventional and observational studies. Exercise interventions included aerobic exercise, resistance exercise, balance training, and stretch training, and are typically administered in conjunction with medication, usual care, or some other interventions. The intensity, frequency, and duration of exercise interventions varied hugely among studies. Six-minute walk test, adverse events, muscle strength, MG quality of life-15 scale, forced vital capacity, quantitative MG scale, and MG activities of daily living scale were the most frequently used outcomes. All studies reported results in favor of the efficacy and safety of exercise in MG, and exercise-related adverse events were reported in two studies. CONCLUSION: This scoping review provides an overview of the evidence concerning exercise treatment for MG. Key gaps in evidence include a limited number of participants, complex interventions, variability in outcome selection, and insufficient reporting in publications. The promotion of exercise treatment for MG still encounters several obstacles. A larger population, rigorous study design and conduction, standardized interventions and outcomes, and standardized reporting are essential.


Subject(s)
Activities of Daily Living , Myasthenia Gravis , Humans , Quality of Life , Exercise , Muscle Strength/physiology , Exercise Therapy , Myasthenia Gravis/therapy
10.
J Affect Disord ; 354: 82-88, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38452937

ABSTRACT

BACKGROUND: It is a well-established fact that post-stroke depression (PSD) is a prevalent condition that affects a significant proportion of individuals who have suffered a stroke. Hence, our research endeavors to explore the safety, efficacy and the potential molecular mechanism of transcutaneous auricular vagus nerve stimulation (ta-VNS) for the treatment of depression in PSD patients by conducting a double-blind, sham-controlled, randomized trial. METHODS: Patients who had experienced strokes and exhibited depressive symptoms, with a Hamilton Depression Scale (HAMD-17) score of ≥8 and met the DSM-IV criteria, were diagnosed with PSD. A volunteer sample of participants (N = 80) were randomly divided into either the ta-VNS group (which received ta-VNS in addition to conventional treatment) or the control group (which received conventional treatment only), in a 1:1 ratio. The effectiveness of the interventions was evaluated using the 17-item Hamilton Rating Scale for Depression (HAMD-17), Zung Self-Rating Depression Scale (SDS), and Barthel Index (BI) scores. Furthermore, Plasma BDNF, CREB1, and 5-HT levels were measured before and after treatment. RESULTS: The concomitant application of ta-VNS demonstrated a remarkable reduction in HAMD-17 and SDS scores, leading to noteworthy enhancements in patients' daily functioning, as evidenced by improved activities of daily living, at all assessed time points, in contrast to the control group (p < 0.0001). Notably, the ta-VNS group exhibited superior effects in modulating the measured neurotrophic biomarkers when compared to the control group (p < 0.05). CONCLUSIONS: The synergistic approach of combining ta-VNS with conventional treatment has demonstrated remarkable efficacy and tolerability in managing depression following a stroke.


Subject(s)
Stroke , Transcutaneous Electric Nerve Stimulation , Vagus Nerve Stimulation , Humans , Depression/etiology , Depression/therapy , Vagus Nerve Stimulation/adverse effects , Activities of Daily Living , Stroke/complications , Stroke/therapy , Double-Blind Method , Vagus Nerve , Treatment Outcome
11.
BMC Complement Med Ther ; 24(1): 102, 2024 Feb 26.
Article in English | MEDLINE | ID: mdl-38409065

ABSTRACT

BACKGROUND: The refractory and disabling nature of sensory disorders after stroke seriously affects patients' daily lives and reduces hospital turnover. Acupuncture, as an alternative therapy, is commonly used in combination with rehabilitation training to improve sensory disorders. To compare the effects of different acupuncture-related treatments combined with rehabilitation training on sensory impairment and the daily living ability of patients with stroke, we conducted a network meta-analysis to provide evidence-based findings for clinical practice. METHODS: Randomized controlled trials on the treatment of sensory disorders in patients with stroke were systematically retrieved from several databases, including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal(VIP), Wanfang Database, Chinese Biological Medical (CBM), PubMed, Embase, Web of Science, Cochrane Library, and Clinical trials. The retrieval period ranged from January 2012 to December 2023. Two independent reviewers screened the included literature, extracted the data, and assessed the risk quality using Cochrane Handbook 5.1.0 and ReviewManager 5.4.1. Stata16.0 software was employed for data analysis. The study protocol was registered in PROSPERO: CRD42023389180. RESULTS: After screening, 20 studies were included, involving a total of 1999 subjects. The network meta-analysis results indicate that, compared to standard rehabilitation, acupuncture plus massage plus rehabilitation showed the most significant reduction in Numbness Syndrome Scores (MD = -0.71(-1.11,-0.31)). Acupuncture combined with rehabilitation demonstrated the most substantial improvement in Sensory Impairment Scores (MD = -0.59,(-0.68,-0.51)) and daily living ability of patients (MD = 17.16,(12.20,22.12)). CONCLUSIONS: In comparison to standard rehabilitation, the combination of acupuncture-related treatments and modern rehabilitation training not only improves the symptoms of sensory impairment and numbness after stroke but also enhances the daily living ability of patients, especially when acupuncture is combined with rehabilitation. However, further demonstration is required to strengthen these conclusions.


Subject(s)
Acupuncture Therapy , Network Meta-Analysis , Stroke Rehabilitation , Stroke , Humans , Acupuncture Therapy/methods , Stroke Rehabilitation/methods , Stroke/complications , Stroke/therapy , Randomized Controlled Trials as Topic , Sensation Disorders/etiology , Sensation Disorders/therapy , Sensation Disorders/rehabilitation , Combined Modality Therapy , Activities of Daily Living
12.
JAMA Netw Open ; 7(2): e2356106, 2024 02 05.
Article in English | MEDLINE | ID: mdl-38358742

ABSTRACT

Importance: Older adults with advanced cancer are less likely to tolerate treatment with cytotoxic chemotherapy compared with younger patients due to their aging-related conditions. Hence, oncologists sometimes opt to employ primary treatment modifications (deviation from standard of care) during the first cycle of chemotherapy. Objective: To examine the association between primary treatment modification and treatment tolerability in older adults with advanced cancer who were starting new palliative chemotherapy regimens. Design, Setting, and Participants: This cohort study was a secondary analysis of the GAP70+ (Geriatric Assessment Intervention for Reducing Toxicity in Older Patients with Advanced Cancer) trial, which was conducted between July 2014 and March 2019. The GAP70+ trial included patients aged 70 years or older who had advanced (ie, incurable) cancer, had 1 or more geriatric assessment domain impairments, and planned to start a new palliative chemotherapy regimen. Data analysis was conducted in November 2022. Exposures: Receipt of standard-of-care chemotherapy regimens vs primary treatment modification defined as any change from National Comprehensive Cancer Network guidelines or published clinical trials (eg, primary dose reduction, schedule change). Main Outcomes and Measures: Tolerability outcomes were assessed within 3 months of treatment. These outcomes included the following: (1) any grade 3 to 5 toxic effect, according to the National Cancer Institute Common Terminology Criteria for Adverse Events; (2) patient-reported functional decline, defined as the development of worse dependency in activities of daily living using scale scores; and (3) a composite adverse outcome (an end point that combined toxic effects, functional decline, and 6-month overall survival). Multivariable cluster-weighted generalized estimating equation models examined the association between primary treatment modification and outcomes adjusting for covariates. Results: This study included 609 patients with a mean (SD) age of 77.2 (5.2) years; more than half (333 [54.7%]) were men. Race and ethnicity was available for 607 patients: 39 (6.4%) were Black, 539 (88.5%) were non-Hispanic White, and 29 (4.8%) were of other race or ethnicity. Nearly half (281 [46.1%]) received a primary modified treatment regimen. The most common cancer types were gastrointestinal cancer (228 [37.4%]) and lung cancer (174 [28.6%]). In multivariable analysis, primary treatment modification was associated with a reduced risk of grade 3 to 5 toxic effects (relative risk [RR], 0.85 [95% CI, 0.77-0.94]) and functional decline (RR, 0.80 [95% CI, 0.67-0.95]). Patients who received primary treatment modification had 32.0% lower odds of having a worse composite adverse outcome (odds ratio, 0.68 [95% CI, 0.48-0.97]). Conclusions and Relevance: In this cohort study, primary treatment modification was associated with improved tolerability of chemotherapeutic regimens among older adults with advanced cancer and aging-related conditions. These findings may help optimize cancer treatment dosing in older adults with advanced cancer and aging-related conditions.


Subject(s)
Activities of Daily Living , Lung Neoplasms , Aged , Female , Humans , Male , Cohort Studies , Data Analysis , Drug Tapering
13.
Altern Ther Health Med ; 30(10): 292-296, 2024 Oct.
Article in English | MEDLINE | ID: mdl-38330579

ABSTRACT

Objective: This study aimed to assess the efficacy of collaborative care in patients with dysphagia after cerebral infarction (CIS) and its preventive impact on aspiration pneumonia (AP), providing valuable clinical insights. Methods: A total of 78 patients with swallowing disorders following CIS, treated at West China Hospital, Sichuan University, from March 2021 to March 2023, were included in this study cohort. The control group comprised 35 patients receiving conventional care, while the research group comprised 43 patients receiving collaborative care. Swallowing function pre- and post-care was compared between the groups, and AP incidence was statistically analyzed. The patients' daily living abilities and emotional well-being were assessed using the Activities of Daily Living (ADL) Scale, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Additionally, the care satisfaction level among patients was investigated. Results: After care, the research group demonstrated significantly improved swallowing function and a notable reduction in AP incidence compared to the control group (P < .05). ADL scores increased in both groups, with higher scores observed in the research group (P < .05). Moreover, SAS and SDS scores decreased, with lower scores in the research group (P < .05). Additionally, care satisfaction was higher in the research group (P < .05). Conclusions: Collaborative care proves effective in enhancing the recovery of patients with swallowing disorders following CIS and reducing the occurrence of AP. Its clinical use is recommended.


Subject(s)
Activities of Daily Living , Deglutition Disorders , Pneumonia, Aspiration , Humans , Deglutition Disorders/therapy , Deglutition Disorders/etiology , Female , Male , Pneumonia, Aspiration/prevention & control , Pneumonia, Aspiration/etiology , Middle Aged , Aged , Ischemic Stroke/complications , Ischemic Stroke/therapy , China/epidemiology
14.
Zhen Ci Yan Jiu ; 49(2): 164-170, 2024 Feb 25.
Article in English, Chinese | MEDLINE | ID: mdl-38413037

ABSTRACT

OBJECTIVES: To observe the effects of the local stimulation with 3 acupuncture techniques, i.e. Canggui Tanxue (needle insertion method like dark tortoise detecting point) technique, electroacupuncture (EA) and warm needling (WN) with filiform needles on shoulder pain, shoulder joint function, quality of life, inflammatory indicators and recurrence rate in the patients with chronic scapulohumeral periarthritis (CSP), so as to explore the optimal needling method of acupuncture for the predominant symptoms of CSP during the attack stage in the patients. METHODS: A total of 108 patients with CSP were randomly divided into a manual acupuncture (MA) group (36 cases, one case dropped off), a WN group (36 cases, 3 cases dropped off) and an EA group (36 cases, 1 case dropped off). In the three groups, Jianqian (EX-UE12), Jianyu (LI15), Jianzhen (SI9), Ashi (Extra) and Yanglingquan (GB34) on the affected side were selected. Canggui Tanxue needling technique, WN technique and EA were delivered in the MA group, the WN group and the EA group, respectively, 30 min each time, 3 times weekly for 4 weeks. The Neer test scores were compared;the visual analogue scale (VAS) was used to assess the degree of shoulder joint pain;the daily life activity abilities was evaluated using the activities of daily living (ADL) scale;the serum prostaglandin E2 (PGE2) content was measured using ELISA before and after treatment. The effectiveness rate and recurrence rate were calculated, and the occurrences of adverse reactions were recorded. RESULTS: Compared with the scores before treatment, the scores of pain, joint function, and range of motion as well as the total score of Neer test were all increased after treatment in the three groups (P<0.05);the VAS score, ADL score and the content of serum PGE2 were decreased (P<0.05). After treatment, the pain score of Neer test in the EA group and the WN group were higher than those of the MA group (P<0.05), the joint function score of Neer test in the MA group and the WN group were higher than that of the EA group (P<0.05), and the range of motion score of Neer test in the MA group was higher when compared with the EA and WN groups (P<0.05). There was no statistical difference in the total score of Neer score among the three groups. VAS score in the EA group was lower than that of either the WN group or the MA group (P<0.05). ADL score in the MA group was lower compared with that of the WN group (P<0.05). PGE2 levels in both the WN group and the MA group were lower than that of the EA group (P<0.05). The total effective rate was 85.71% (30/35) in the MA group, 91.43% (32/35) in the EA group and 90.91% (30/33) in the WN group, there was no statistical differences among the three groups. At the end of the 6-month follow-up visit after treatment, there was no significant difference in the recurrence rate among three groups. No serious adverse reaction was found. CONCLUSIONS: In the treatment of CSP, the short-term effect is equivalent among EA, WN and MA. But, the analgesic effect is the best in the EA group, the treatment for anti-inflammation is the most effective in the MA and WN groups, and the needling technique of Canggui Tanxue in the MA group obtains the most favorable effect of releasing adhesion and recovering the range of motion in the shoulder joint.


Subject(s)
Acupuncture Therapy , Periarthritis , Humans , Periarthritis/therapy , Activities of Daily Living , Dinoprostone , Quality of Life , Acupuncture Points , Shoulder Pain/therapy , Treatment Outcome
15.
Zhongguo Zhen Jiu ; 44(2): 123-128, 2024 Feb 12.
Article in English, Chinese | MEDLINE | ID: mdl-38373754

ABSTRACT

OBJECTIVES: To compare the clinical effect on acute ischemic stroke (AIS) between the combined treatment of Sun's abdominal acupuncture combined with the routine acupuncture and the simple routine acupuncture, and explore the influences on inflammatory factors i.e. interleukin (IL)-1ß and IL-10. METHODS: Eighty patients with AIS were randomly divided into an observation group (40 cases, 1 case dropped out) and a control group (40 cases, 1 case dropped out). The routine regimens of western medicine were administered in the two groups. In addition, the routine scalp acupuncture and the body acupuncture were used in the patients of the control group. The scalp acupuncture stimulation region and acupoints included the anterior parietal-temporal oblique line, Hegu (LI 4), Chize (LU 5), Shousanli (LI 10), etc. of affected side. In the observation group, on the base of the intervention of the control group, electroacupuncture was applied to "fouth abdominal area" of Sun's abdominal acupuncture, with the continuous wave and the frequency of 5 Hz. In the two groups, the intervention was given twice per day, once in every morning and afternoon separately, with the needles retained for 40 min in each intervention. The interventions were delivered for 6 days a week, lasting 3 weeks. The scores of Fugl-Meyer assessment scale (FMA), Berg balance scale (BBS) and the modified Barthel index (MBI), and the levels of IL-1ß and IL-10 in the serum were observed before and after treatment in the two groups; the effect and safety of interventions were compared between the two groups. RESULTS: After treatment, the scores of FMA, BBS and MBI increased in comparison with those before treatment in the two groups (P<0.01), and these scores in the observation group were higher than those in the control group (P<0.05, P<0.01). After treatment, in the two groups, the levels of IL-1ß in the serum were reduced in comparison with those before treatment (P<0.01), and the IL-1ß level in the observation group was lower than that in the control group (P<0.05); the levels of IL-10 in the serum were elevated in comparison with those before treatment in the two groups (P<0.01) and the IL-10 level in the observation group was higher than that in the control group (P<0.05). The total effective rate was 92.3% (36/39) in the observation group, which was superior to that in the control group (84.6% [33/39], P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSIONS: Sun's abdominal acupuncture combined with the routine acupuncture can ameliorate the motor impairment, adjust the balance dysfunction and improve the activities of daily living in the patients with AIS. The therapeutic effect of this combined regimen is better than that of the routine acupuncture, which may be associated with the regulation of the inflammatory factors after cerebral infarction.


Subject(s)
Acupuncture Therapy , Ischemic Stroke , Stroke , Humans , Stroke/complications , Ischemic Stroke/complications , Interleukin-10 , Activities of Daily Living , Treatment Outcome , Acupuncture Points
16.
Zhongguo Zhen Jiu ; 44(2): 129-133, 2024 Feb 12.
Article in English, Chinese | MEDLINE | ID: mdl-38373755

ABSTRACT

OBJECTIVES: To observe the effects of interactive scalp acupuncture on upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke. METHODS: One hundred and twenty patients with upper limb motor dysfunction after stroke were randomly divided into an observation group(60 cases, 2 cases dropped out)and a control group(60 cases, 1 case dropped out). Both groups were treated with routine medication and rehabilitation. The observation group was treated with interactive scalp acupuncture combined with suspension digital occupational therapy, interactive scalp acupuncture was applied at middle 2/5 of the parietal and temporal anterior oblique line, middle 2/5 of the parietal and temporal posterior oblique line and second lateral line of parietal of the hemiparalysis contralateral side, 30 min each time.The control group was treated with suspension digital occupational therapy alone. The treatment was given once a day, 5 times a week for 4 weeks in the two groups. The scores of Fugl-Meyer assessment scale of upper extremity(FMA-UE), action research arm test(ARAT), the modified Barthel index (MBI) and surface electromyography(sEMG)signal of the biceps and triceps on the affected side were observed before and after treatment in the two groups, and the clinical efficacy was evaluated. RESULTS: After treatment, the FMA-UE, ARAT and MBI scores were increased compared with those before treatment in both groups(P<0.05), the changes of the observation group were greater than those in the control group(P<0.05). After treatment, the integrated electromyography(iEMG)value and root mean square(RMS)value of the biceps and triceps on the affected side during elbow flexion and extension were increased compared with those before treatment in both groups(P<0.05), the changes of the observation group were greater than those in the control group(P<0.05). The total effective rate was 94.8%(55/58) in the observation group, which was higher than 83.1%(49/59) in the control group(P<0.05). CONCLUSIONS: Interactive scalp acupuncture could improve upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke.


Subject(s)
Acupuncture Therapy , Occupational Therapy , Stroke Rehabilitation , Stroke , Humans , Activities of Daily Living , Scalp , Stroke/complications , Stroke/therapy , Upper Extremity , Treatment Outcome
17.
BMC Med Inform Decis Mak ; 23(Suppl 3): 300, 2024 Feb 13.
Article in English | MEDLINE | ID: mdl-38350979

ABSTRACT

BACKGROUND: Older adults face unique health challenges as they age, including physical and mental health issues and mood disorders. Negative emotions and social isolation significantly impact mental and physical health. To support older adults and address these challenges, healthcare professionals can use Information and Communication Technologies (ICTs) such as health monitoring systems with multiple sensors. These systems include digital biomarkers and data analytics that can streamline the diagnosis process and help older adults to maintain their independence and quality of life. METHOD: A design research methodology is followed to define a conceptual model as the main artifact and basis for the systematic design of successful systems centered on older adults monitoring within the health domain. RESULTS: The results include a conceptual model focused on older adults' Activities of Daily Living (ADLs) and Health Status, considering various health dimensions, including social, emotional, physical, and cognitive dimensions. We also provide a detailed instantiation of the model in real use cases to validate the usefulness and feasibility of the proposal. In particular, the model has been used to develop two health systems intended to measure the degree of the elders' frailty and dependence with biomarkers and machine learning. CONCLUSIONS: The defined conceptual model can be the basis to develop health monitoring systems with multiple sensors and intelligence based on data analytics. This model offers a holistic approach to caring for and supporting older adults as they age, considering ADLs and various health dimensions. We have performed an experimental and qualitative validation of the proposal in the field of study. The conceptual model has been instantiated in two specific case uses, showing the provided abstraction level and the feasibility of the proposal to build reusable, extensible and adaptable health systems. The proposal can evolve by exploiting other scenarios and contexts.


Subject(s)
Activities of Daily Living , Quality of Life , Humans , Aged , Research Design , Health Status , Biomarkers
18.
Altern Ther Health Med ; 30(9): 415-419, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38290446

ABSTRACT

Background: Alzheimer's disease (AD) is a major disease that affects neurological, cognitive, and memory functions in older adults, and care for AD patients needs to be more specialized and targeted. Objective: To analyze the effect of music and art combined with Kinect game therapy as a special care on improving cognitive function and alleviating negative emotions in AD patients in a nursing facility. Methods: One hundred AD patients admitted to a residential aged care facility in Changsha, Hunan Province, China, from December 2020 to December 2022, were selected as the study subjects. They were divided into the observation group (OG; n=50) for special care of music art combined with Kinect game therapy and the control group (CG; n=50) for conventional care. The activities of daily living scale (ADL) and mini-mental state examination (MMSE) were used to assess the neurological and cognitive functional changes in the two groups before and after the nursing intervention. The Pittsburgh sleep quality index (PSQI) and self-rating scale of sleep (SRSS) were used to assess the quality of sleep in both groups, and the GQOL-74 scale was used to evaluate the quality of life before and after the intervention. The negative emotions were tested by the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Finally, patient satisfaction with the care was investigated. Results: After the nursing intervention, scores of ADL, PSQI, SRSS, SAS and SDS of the OG were lower compared with the CG, while MMSE and GQOL-74 scores were higher (P < .05). The results of the nursing satisfaction survey were also higher in the OG than in the CG (P < .05). Conclusion: The combined music and art therapy with Kinect game therapy in elderly institutions can effectively enhance AD patients' neurological and cognitive functions, improve their sleep and quality of life, and alleviate negative emotions.


Subject(s)
Alzheimer Disease , Cognition , Music Therapy , Humans , Alzheimer Disease/therapy , Alzheimer Disease/psychology , Male , Female , Aged , Music Therapy/methods , Aged, 80 and over , Video Games/psychology , Quality of Life/psychology , Emotions , Homes for the Aged , China , Nursing Homes , Art Therapy/methods , Activities of Daily Living/psychology
19.
J Neuroeng Rehabil ; 21(1): 16, 2024 01 30.
Article in English | MEDLINE | ID: mdl-38291426

ABSTRACT

BACKGROUND: Although some studies suggest that robot-assisted technology can significantly improve upper limb function in stroke patients compared to traditional rehabilitation training, it is still necessary to incorporate an auxiliary intervention to alleviate negative emotions, thereby alleviating the post-stroke fatigue and encouraging patients to actively respond to rehabilitation. However, the effect of the auxiliary intervention is unknown. OBJECTIVE: To evaluate the effect of reminiscent music therapy combined with robot-assisted rehabilitation in elderly patients with upper limb dysfunction. METHODS: From November 2022 to March 2023, elderly patients with upper limb dysfunction after stroke were assigned to one of three groups, with group A receiving usual rehabilitation treatment and care plus robot-assisted rehabilitation and reminiscent music therapy, group B receiving usual rehabilitation treatment and care plus robot-assisted rehabilitation, and group C receiving only usual rehabilitation treatment and care. Thirty patients completed this study, with 10 participants in each group. Activities of daily living, self-esteem, rehabilitation self-efficacy, positive emotion and upper limb function were measured before and after the intervention. One-way analysis of variance, paired-sample t-test, Kruskal-Wallis H test, Wilcoxon signed rank sum test and Chi-square test were used to analyze the data. RESULTS: According to the intragroup comparisons, in the three groups, all outcome measurements were significantly higher than those at baseline (all P < 0.05). After the intervention, the differences in the self-management effectiveness, rehabilitation self-efficacy, and positive emotion score were statistically significant among the three groups (all P < 0.05). In accordance with the results of Bonferroni analysis, the self-management effectiveness score of group A was significantly higher than that of Group B and Group C (all P < 0.05). The rehabilitation self-efficacy score of group A was significantly higher than that of Group B and Group C (P < 0.05). The positive emotion score of group A was significantly higher than that of Group B and Group C (P < 0.05). CONCLUSION: Reminiscent music therapy combined with robot-assisted rehabilitation is a promising approach to improve rehabilitation self-efficacy and positive emotion, which is evidence that reminiscent music therapy may be an effective auxiliary intervention to improve rehabilitation outcomes.


Subject(s)
Music Therapy , Music , Robotics , Stroke Rehabilitation , Stroke , Humans , Aged , Stroke Rehabilitation/methods , Pilot Projects , Activities of Daily Living , Robotics/methods , Recovery of Function , Upper Extremity , Treatment Outcome
20.
Lasers Med Sci ; 39(1): 49, 2024 Jan 27.
Article in English | MEDLINE | ID: mdl-38280042

ABSTRACT

The purpose of this study is to confirm the effect of small, portable low-level laser therapy (light sources in square configuration: 830 nm GaAs diode 3.2 mW at the center, 4 × 650 nm InGaAIP diodes over the corners) treatment in reducing and enhancing hand function in patients with wrist pain. This study was a prospective, randomized, sham-controlled, and home-based self-therapy trial. A total of thirty subjects with wrist pain were enrolled. All participants received low-level laser therapy on painful area at the wrist. The experimental group (n = 15) received laser stimulation, while the control group (n = 15) received sham stimulation using identical equipment that generated only a red light without the laser output. Both groups self-treated for 30 min a day, 5 days per week for 3 weeks, total of 15 sessions. The primary outcome was assessed using a visual analogue scale (VAS) for wrist pain from 0 (painless) to 10 (extreme pain). The secondary outcomes were measured with patient-rated wrist evaluation (PRWE), grip strength, lateral, palmar, and tip pinch strength. Measures were taken before and after treatment. A total of thirty participants provided outcome data. After the intervention, both groups showed a significant decrease in VAS score, from 4.93 to 3.67 in experimental group, from 5.53 to 4.00 in control group (the experiment group: p = 0.020, the control group: p = 0.003). The experimental group showed a significant improvement in function scale score (p = 0.012), the control group did not. Lateral and pinch strength was significantly improved in the experimental group (p = 0.017) and in the control group (p = 0.034) respectively. There were no side effects in the patients. Medical laser irradiation is a portable and easy-to-use laser irradiator without side effects. Clinical Trial Registration number: KCT0006604.


Subject(s)
Low-Level Light Therapy , Wrist , Humans , Prospective Studies , Pain , Low-Level Light Therapy/adverse effects , Activities of Daily Living , Treatment Outcome
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