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Introduction Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer. Objective Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training. Methods This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention. Expected results The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.
Introducción El ejercicio terapéutico juega un rol importante en la población con cáncer, ya que mejora la función, la calidad de vida y reduce los síntomas del tratamiento contra el cáncer. Hay poca evidencia clínica sobre los efectos del ejercicio hipopresivo en mujeres con cáncer ginecológico. Objetivo Evaluar los efectos de cuatro semanas de ejercicio hipopresivo asociado con entrenamiento de fuerza muscular y ejercicios aeróbicos sobre la fatiga, los síntomas de incontinencia urinaria, la función sexual y la calidad de vida en mujeres tratadas por cáncer ginecológico, en comparación con un grupo que realizará entrenamiento convencional. Métodos El escenario para este estudio de ensayo clínico aleatorizado y simple ciego es el Laboratorio de Investigación Clínica, Departamento de Kinesiología, en una Universidad Chilena. Las pacientes serán asignadas aleatoriamente a un grupo experimental de ejercicios hipopresivos asociados con entrenamiento de fuerza muscular y ejercicios aeróbicos, o a un grupo de control de entrenamiento de fuerza muscular y ejercicios aeróbicos. Se realizarán doce sesiones de telerehabilitación. Participarán mujeres mayores de 18 años con cáncer ginecológico a quienes se les haya indicado radioterapia o quimioterapia. Se evaluarán la fatiga, la calidad de vida, los síntomas de incontinencia urinaria y la función sexual antes y después de la intervención. Resultados esperados Los resultados de este ensayo clínico tienen importantes implicaciones en términos del tratamiento específico para la población con cáncer y generan nuevas técnicas en la práctica de kinesiólogos especializados en oncología. Se espera que el ejercicio hipopresivo reduzca los síntomas de incontinencia debido a la activación neuromuscular de los músculos del suelo pélvico. Sin embargo, se necesitan más estudios para confirmar los efectos beneficiosos de los ejercicios hipopresivos, ya sea en rehabilitación presencial o a distancia.
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Introduction: Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer. Objective: Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training. Methods: This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention. Expected results: The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.
Introducción: El ejercicio terapéutico juega un rol importante en la población con cáncer, ya que mejora la función, la calidad de vida y reduce los síntomas del tratamiento contra el cáncer. Hay poca evidencia clínica sobre los efectos del ejercicio hipopresivo en mujeres con cáncer ginecológico. Objetivo: Evaluar los efectos de cuatro semanas de ejercicio hipopresivo asociado con entrenamiento de fuerza muscular y ejercicios aeróbicos sobre la fatiga, los síntomas de incontinencia urinaria, la función sexual y la calidad de vida en mujeres tratadas por cáncer ginecológico, en comparación con un grupo que realizará entrenamiento convencional. Métodos: El escenario para este estudio de ensayo clínico aleatorizado y simple ciego es el Laboratorio de Investigación Clínica, Departamento de Kinesiología, en una Universidad Chilena. Las pacientes serán asignadas aleatoriamente a un grupo experimental de ejercicios hipopresivos asociados con entrenamiento de fuerza muscular y ejercicios aeróbicos, o a un grupo de control de entrenamiento de fuerza muscular y ejercicios aeróbicos. Se realizarán doce sesiones de telerehabilitación. Participarán mujeres mayores de 18 años con cáncer ginecológico a quienes se les haya indicado radioterapia o quimioterapia. Se evaluarán la fatiga, la calidad de vida, los síntomas de incontinencia urinaria y la función sexual antes y después de la intervención. Resultados: esperados Los resultados de este ensayo clínico tienen importantes implicaciones en términos del tratamiento específico para la población con cáncer y generan nuevas técnicas en la práctica de kinesiólogos especializados en oncología. Se espera que el ejercicio hipopresivo reduzca los síntomas de incontinencia debido a la activación neuromuscular de los músculos del suelo pélvico. Sin embargo, se necesitan más estudios para confirmar los efectos beneficiosos de los ejercicios hipopresivos, ya sea en rehabilitación presencial o a distancia.
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Terapia por Ejercicio , Fatiga , Neoplasias de los Genitales Femeninos , Calidad de Vida , Entrenamiento de Fuerza , Incontinencia Urinaria , Humanos , Femenino , Entrenamiento de Fuerza/métodos , Método Simple Ciego , Terapia por Ejercicio/métodos , Neoplasias de los Genitales Femeninos/terapia , Incontinencia Urinaria/terapia , Incontinencia Urinaria/rehabilitación , Fatiga/terapia , Fatiga/etiología , Ejercicio Físico/fisiología , Fuerza Muscular/fisiología , Ensayos Clínicos Controlados Aleatorios como Asunto , ChileRESUMEN
OBJECTIVES: To evaluate the internal consistency and construct validity of the QLQ-MY20 for assessing the quality of life in multiple myeloma survivors in Chile. METHODS: This was a cross-sectional study conducted between March 2020 and December 2022. It involved 118 individuals from two public hospitals. The QLQ-C30 and QLQ-MY20 questionnaires were used. Internal consistency was assessed using Cronbach's alpha(α), and construct validity was evaluated through hypothesis testing (Mann-Whitney and Spearman correlation). RESULTS: The average age of participants was 67.2 years (SD=9.2). Internal consistency for the complete scale was α=0.779, for the "disease symptoms" dimension α=0.671, for the "side effects of treatments" dimension α=0.538, and for the "future perspective" dimension α=0.670. Four of the five construct validity hypotheses were confirmed: women, individuals with worse performance status, those with pain, and those with worse fatigue showed more symptoms. CONCLUSIONS: The Chilean version of the QLQ-MY20 demonstrates adequate internal consistency and construct validity.
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Mieloma Múltiple , Psicometría , Calidad de Vida , Humanos , Mieloma Múltiple/psicología , Mieloma Múltiple/complicaciones , Calidad de Vida/psicología , Femenino , Masculino , Estudios Transversales , Psicometría/instrumentación , Psicometría/métodos , Psicometría/normas , Chile , Encuestas y Cuestionarios , Anciano , Persona de Mediana Edad , Reproducibilidad de los Resultados , Anciano de 80 o más AñosRESUMEN
AIM: To assess the value of a prehabilitation program adapted to the current COVID-19 pandemic using a teleprehabilitation modality in a public Latin American hospital. METHODS: The medical records of candidates for elective colorectal cancer surgery (CRC) and who completed a teleprehabiltation program were analyzed. Sociodemographic, clinical, and functional variables were analyzed, such as cardiorespiratory capacity with the sit-to-stand test (STST), independence in activities of daily living with the Barthel index, balance with the five-times STST (FSTST) and fatigue with Brief Inventory Fatigue (BFI). The feasibility of the program was analyzed in terms of recruitment, retention, user satisfaction, and reporting of adverse events. RESULTS: Of 107 people recruited, 57 completed the program (54%, 68.78 ± 12.36 years). There was a significant difference in the BFI, FSTST, and STS 1-min scores after the intervention (p < .01), with an effect size (Cliff's delta) that varied between -.13 and .21. There were no differences in the Barthel index score. In relation to the viability of the program, 99% of patients referred for surgery could be recruited into the program, with 53% retention. Regarding user satisfaction with the program, seven items (77.7%) were rated as "very satisfied," and two items (22.3%) as "satisfied." No adverse events were recorded. CONCLUSION: The structured prehabilitation program adapted to teleprehabilitation for CRC candidates for surgery was effective in optimizing functional results prior to surgery and was feasible to implement in a public hospital with limited resources during the COVID-19 pandemic.
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COVID-19 , Neoplasias Colorrectales , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Actividades Cotidianas , Estudios de Factibilidad , Pandemias/prevención & control , Neoplasias Colorrectales/cirugíaRESUMEN
ABSTRACT Objectives: To evaluate the internal consistency and construct validity of the QLQ-MY20 for assessing the quality of life in multiple myeloma survivors in Chile. Methods: This was a cross-sectional study conducted between March 2020 and December 2022. It involved 118 individuals from two public hospitals. The QLQ-C30 and QLQ-MY20 questionnaires were used. Internal consistency was assessed using Cronbach's alpha(α), and construct validity was evaluated through hypothesis testing (Mann-Whitney and Spearman correlation). Results: The average age of participants was 67.2 years (SD=9.2). Internal consistency for the complete scale was α=0.779, for the "disease symptoms" dimension α=0.671, for the "side effects of treatments" dimension α=0.538, and for the "future perspective" dimension α=0.670. Four of the five construct validity hypotheses were confirmed: women, individuals with worse performance status, those with pain, and those with worse fatigue showed more symptoms. Conclusions: The Chilean version of the QLQ-MY20 demonstrates adequate internal consistency and construct validity.
RESUMO Objetivos: Avaliar consistência interna e validade de construto do QLQ-MY20 para avaliação da qualidade de vida em sobreviventes de mieloma múltiplo no Chile. Métodos: Estudo transversal, realizado entre março de 2020 e dezembro de 2022. Participaram 118 pessoas de dois hospitais públicos. Foram utilizados questionários QLQ-C30 e QLQ-MY20. A consistência interna foi avaliada com alfa de Cronbach(α) e a validade de construto através de testes de hipóteses (Mann Whitney e correlação de Spearman). Resultados: A idade média dos participantes era de 67,2 (DP=9,2) anos. Consistência interna para escala completa (α=0,779), dimensão "sintomas da doença" (α=0,671), dimensão "efeitos colaterais dos tratamentos" (α=0,538) e dimensão "perspectiva de futuro" (α=0,670). Quatro das cinco hipóteses de validade de construto foram confirmadas: as mulheres apresentaram mais sintomas, assim como pessoas com pior estado de desempenho, com dor e com maior fadiga. Conclusões: A versão chilena do QLQ-MY20 apresenta consistência interna adequada e validade de construto.
RESUMEN Objetivos: Evaluar consistencia interna y validez de constructo del QLQ-MY20 para valoración de calidad de vida en sobrevivientes de mieloma múltiple en Chile. Métodos: Estudio transversal, realizado entre marzo 2020 y diciembre 2022. Participaron 118 personas de dos hospitales públicos. Se utilizaron los cuestionarios QLQ-C30 y QLQ-MY20. Fueron evaluadas la consistencia interna con alfa de Cronbach (α) y validez de constructo mediante pruebas de hipótesis (Mann Whitney y correlación de Spearman). Resultados: El promedio de edad de los participantes era 67,2 (DE=9,2) años. Consistencia interna para escala completa (α=0,779), dimensión "síntomas de la enfermedad" (α=0,671), dimensión "efectos secundarios de los tratamientos" (α=0,538) y dimensión "perspectiva de futuro" (α=0,670). Se comprobaron cuatro de las cinco hipótesis de la validez de constructo: presentaron más síntomas las mujeres, personas con peor performance estatus, con dolor y con peor fatiga. Conclusiones: La versión chilena del QLQ-MY20 presenta adecuada consistencia interna y validez de constructo.
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Background: COVID-19 has been one of the most critical public health challenges of recent decades. This disease develops severely in one in five patients, and approximately 5% require admission to a critical care unit. Due to the impact of the sequelae, the Post-COVID-19 Functional Status Scale (PCFS) was developed. This study is aimed at determining the interrater reliability of the Spanish (Colombia) version of the PCFS in adult patients with post-COVID-19 infection. Methods: This is an observational study performed with patients diagnosed with COVID-19. Two evaluators repeated the test-retest of the PCFS scale with knowledge and clinical experience in the care of patients with COVID-19 and had previously applied the test. The PCFS assesses functional limitations at discharge and can be used at 4 and 8 weeks to evaluate practical consequences and determine the degree of disability these patients may have. For interrater reliability, Cronbach's alpha was applied with its respective confidence interval and the Bland-Altman method. A 95% confidence interval (CI) was taken as the basis for the interpretation of the Intraclass Correlation Coefficient (ICC). Results: A total of 112 adult patients participated in the study, aged 51.46 ± 15.94 years. It was evidenced that the survival, constant care, and activities of daily living questions have an ICC of one (1.000) with an ICC (1.000-1.000), demonstrating excellent reliability, while those close to one were instrumental activities, role participation, symptoms, and final score with an ICC 0.918 to 0.984 and an ICC (0.881-0.989). Thus, a homogeneous distribution of the interrater data was evident. Conclusions: Excellent interobserver reliability of the Spanish (Colombia) version of the PCFS in patients with different degrees of functional status was reported.
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PURPOSE: Bowel complaints are very common among patients with colorectal cancer. However, the most used questionnaires for colorectal cancer survivors do not comprehensively comprise bowel symptoms. This study aimed to examine construct and criterion validity, as well as internal consistency, of the Chilean Version of the International Consultation on Incontinence Questionnaire Bowel Module (ICIQ-B) among people with colorectal cancer. METHODS: Cross-sectional, validation study performed with 106 colorectal cancer patients from Hospital del Salvador, Chile. Bowel function was assessed with the ICIQ-B. Construct validity was assessed with confirmatory factor analysis and hypothesis testing. Specific items of a quality-of-life questionnaire (EORTC QLQ-CR29) were used to correlate with similar ICIQ-B items for criterion validity. For internal consistency, Cronbach's alpha was computed. RESULTS: For construct validity, the confirmatory factor analysis showed that the three factors model did not fit our data. Meanwhile, hypothesis testing favored the construct validity of the instrument, considering that rectal cancer patients showed worse bowel pattern (p = 0.001), bowel control (p = 0.001) and quality of life (p < 0.001) scores compared to colon cancer patients. In addition, those patients assessed before surgery also presented worse scores bowel control (p = 0.023) and quality of life (p = 0.009) compared to post-surgical patients. Regarding criterion validity, the ICIQ-B items showed a significant correlation with similar QLQ-CR29 items. The internal reliability of the instrument was good (Cronbach's α = 0.909). CONCLUSION: Considering that this questionnaire appraises bowel function in more depth, it is recommended for use in clinical practice and research with colorectal cancer patients.
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Neoplasias Colorrectales , Incontinencia Fecal , Humanos , Defecación , Calidad de Vida , Reproducibilidad de los Resultados , Estudios Transversales , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/cirugía , Psicometría , Incontinencia Fecal/etiología , Encuestas y CuestionariosRESUMEN
BACKGROUND: Therapeutic exercise has an important role to manage chemotherapy-induced peripheral neuropathy symptoms. However, there is little evidence of its effectiveness. OBJECTIVE: To synthesize the evidence regarding therapeutic exercise during chemotherapy to improve peripheral neuropathy symptoms. DATABASES: PubMed, CINAHL, Cochrane Library, PEDro, ScienceDirect, Scopus, Web of Science and BIREME. METHODOLOGY: Randomized clinical trials were included. GRADE was used to synthesize evidence and an inverse variance model for meta-analysis. RESULTS: Up to May 2022, 2172 references were analyzed and 14 studies that evaluated 1094 participants were included. The exercises were highly effective in improving pain threshold and moderately effective in improving peripheral neuropathy symptoms at the 8-week follow-up and the 4-24 weeks. Furthermore, the evidence was low in improving thermal threshold, tactile and vibratory sensitivity. CONCLUSION: Therapeutic exercise generates a significant reduction in peripheral neuropathy symptoms in patients in short- and long-term follow-up with a moderate level of evidence quality.
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Introduction: As breast cancer survivorship rates increase, so does the necessity to improve survivors' health-related quality of life (HRQoL). Objective: To analyze HRQoL among Chilean breast cancer survivors, in general and considering geographic location. In addition, to correlate HRQoL with age, education level and body mass index (BMI). Method: Cross-sectional observational study which included 125 female breast cancer survivors from three public hospitals in three Chilean Macroregions: Central, North Central, and South. The EORTC Questionnaires, QLQ-C30 and QLQ-BR23, and sociodemographic and clinical records were applied. Results: The mean age was 56.1 (±11.9) years with a HRQoL summary score of 67.6 (21.9). HRQoL was reduced mainly in emotional functioning, pain, and insomnia. Fatigue, dyspnea, appetite loss, constipation, financial difficulties, breast and arm symptoms were also reported. The women from the South Macroregion Hospital presented the worst HRQoL scores for most of the domains [general health, functioning (physical, emotional, cognitive and social), fatigue, and nausea], p<0.001. The summary score of HRQoL was correlated to age (Spearman Ìs rho=0.202, p=0.033), BMI (rho=-0.341, p<0.001), and education level (rho=0.310, p=0.001). Conclusion: Women from three Macroregions showed differences in HRQoL. The latter correlated to age, BMI, and education level. Considering the high presence of symptoms, it is necessary to improve survivorship care plans, providing access to rehabilitation in the continuum of care.
Introdução: À medida que as taxas de sobrevivência do câncer de mama aumentam, também aumenta a necessidade de melhorar a qualidade de vida relacionada à saúde (QVRS) dos sobreviventes. Objetivo: Analisar a QVRS em geral e considerando a localização geográfica entre sobreviventes de câncer de mama chilenas. Além disso, correlacionar a QVRS com idade, nível educacional e índice de massa corporal (IMC). Método: Estudo observacional transversal que incluiu 125 mulheres sobreviventes de câncer de mama de três hospitais públicos em três Macrorregiões chilenas: Central, Norte-Central e Sul. Foram utilizados os Questionários EORTC QLQ-C30 e QLQ-BR23 e os registros sociodemográficos e clínicos. Resultado: A média de idade foi de 56,1 (±11,9) anos com escore resumido de QVRS de 67,6 (21,9). A QVRS estava reduzida principalmente no funcionamento emocional, dor e insônia. Fadiga, dispneia, perda de apetite, constipação, dificuldades financeiras, sintomas de braço e mama também foram mencionados. As mulheres do hospital da Macrorregião Sul apresentaram os piores escores de QVRS para a maioria dos domínios [saúde geral, funcionamento (físico, emocional, cognitivo e social), fadiga e náusea], p<0,001. A pontuação geral de QVRS esteve correlacionada com idade (rho de Spearman=0,202, p=0,033), IMC (rho=-0,341, p<0,001) e nível educacional (rho=0,310, p=0,001). Conclusão: As mulheres das três Macrorregiões apresentaram diferenças na QVRS.Esta última se correlacionou com idade, IMC e nível educacional. Considerando a alta presença de sintomas, há necessidade de aprimoramento dos planos de atenção à sobrevivência, possibilitando acesso à reabilitação no contínuo do cuidado
Introducción: A medida que aumentan las tasas de supervivencia al cáncer de mama, también aumenta la necesidad de mejorar la calidad de vida relacionada con la salud (CdV) de las sobrevivientes. Objetivo: Analizar la CdV entre supervivientes chilenas de cáncer de mama, en general y considerando ubicación geográfica. Además, correlacionar CdV con edad, nivel educacional e índice de masa corporal (IMC). Método: Estudio observacional transversal que incluyó a 125 mujeres sobrevivientes de cáncer de mama de tres Hospitales públicos de tres Macrorregiones de Chile: Centro, Centro Norte y Sur. Se utilizaron los Cuestionarios EORTC QLQ-C30 y QLQ-BR23, historias sociodemográficas y clínicas. Resultados: La edad media fue de 56,1 (±11,9) años con una puntuación resumida de CdV de 67,6 (21,9). La CdV estuvo disminuida principalmente en funcionamiento emocional, dolor e insomnio. Fatiga, disnea, pérdida de apetito, estreñimiento, dificultades financieras, síntomas de brazo y mama también fueron reportados. Las mujeres del hospital de la Macrorregión Sur presentaron las peores puntuaciones de calidad de vida en la mayoría de los dominios [salud general, funcionamiento (físico, emocional, cognitivo y social), fatiga y nausea], p<0,001. El puntaje de CdV estuvo correlacionado con edad (rho de Spearman =0,202, p=0,033), IMC (rho=-0,341, p<0,001) y nivel educacional (rho=0,310, p=0,001). Conclusión: Las mujeres pertenecientes a tres regiones presentaron diferencias en la CdV.Esta última se correlacionó con edad, IMC y nivel educacional. Considerando la elevada presencia de síntomas, es necesario mejorar los planes de atención a las sobrevivientes, posibilitando acceso a rehabilitación en el continuo de los cuidados.
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Humanos , Masculino , Femenino , Calidad de Vida , Neoplasias de la Mama , Determinantes Sociales de la Salud , Supervivientes de Cáncer , Promoción de la SaludRESUMEN
Background: Chemotherapy-induced peripheral neuropathy is a common adverse effect of chemotherapeutic treatment and is associated with decreased quality of life. The aim of this study was to evaluate the validity and reliability of the neurotoxicity subscale of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) for the Chilean population. Methods: A cross-sectional study in which 101 participants with haematologic, colorectal, breast, gastric, gynaecological, and other types of cancer completed the FACT/GOG-Ntx. Content validity (n = 14 health professionals evaluated the subscale in four categories: test-retest reliability (n = 20 patients), dimensionality, internal consistency, and concurrent validity and discriminant validity. In all analyses, p < 0.05 was considered significant. Results: There was an agreement among the evaluators for all categories of the subscale (Kendall's coefficient, W = 0.4, p < 0.01) and moderate to high intrarater reliability (intraclass correlation coefficient = 0.7-0.9). Of the 11 original items that make up the subscale, none was eliminated. The factor analysis generated four factors that represented 72.2% of the total variance. Cronbach's α was 0.8 for the 11 items. Women showed greater compromise in emotional well-being and neurotoxicity symptoms compared with men, and age was directly correlated with the questions 'I have difficulty hearing' (r = 0.2, p = 0.019) and 'I feel a noise or buzzing in my ears' (r = 0.2, p = 0.03). Conclusion: The Chilean version of the FACT/GOG-Ntx neurotoxicity subscale is a valid and reliable scale for evaluating neurotoxicity symptoms in adult cancer survivors in Latin America. The scales also adequately distinguish between sex-based well-being among the afflicted population.
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Objective: To assess the effectiveness of the resistance training to improve fatigue levels in people with cancer who are enrolled in adjuvant and/or neoadjuvant treatment. Methods: MEDLINE, Web of Science, Embase, SPORTDiscus, LILACS, CENTRAL, and CINAHL databases were searched from May to December 7, 2021. Randomized clinical trials (RCT) that evaluate the effects of resistance training on fatigue levels in people undergoing cancer treatment were included. The PEDro scale was considered to assess methodological quality of studies, and the evidence was summarized through the GRADE system. The standardized average differences, effect size, and inverse variance model for meta-analysis were calculated. Results: Fifteen RCT for qualitative synthesis and thirteen for meta-analysis were selected. A moderate to high level of evidence of resistance training was identified to improve fatigue in people undergoing cancer treatment. Meta-analysis showed a significant reduction in fatigue (SMD = -0.31, CI 95% = -0.58, -0.12, P = 0.001) after 10 to 35 sessions of resistance training. Conclusion: The 10 to 35 sessions of resistance training are effective in reducing fatigue level in cancer patients who are undergoing cancer treatment and have a moderate level of quality evidence.
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Purpose: To describe the English-to-Spanish translation process and preliminary psychometric analysis (face validity, cultural adaptation, and test-retest reliability) of the International Consultation on Incontinence Questionnaire - Bowels Module (ICIQB) among Chilean colorectal cancer patients. Materials and Methods: The face validity was studied with 10 colorectal cancer patients, and the test-retest reliability, with 15 patients, 1 month before and 6 months after cancer surgery. Results: Two rounds of translation/back translation resulted in a Spanish version. The English expression open your bowels was translated as defecar, as it is easily understandable in Spanish. The patients reported that the instrument was easy to answer, with clear instructions, and that it was adequate to appraise their health condition. The testretest reliability was good (Spearman rho [ρ] ≥ 0.842); only item 15a, the Bristol Stool Scale, obtained a moderate correlation (ρ=0.639). The patients reported a variety of symptoms, including increased bowel movements, nocturnal bowel movements, fecal urgency, and incontinence. Conclusions: The first Spanish version of the ICIQ-B was culturally adapted for Chilean colorectal cancer patients, and showed good test-retest reliability. It might be a reference for other Spanish-speaking countries and for patients with other conditions. The ICIQ-B is a robust comprehensive questionnaire for bowel function. (AU)
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Encuestas y Cuestionarios , Incontinencia Fecal , TraducciónRESUMEN
BACKGROUND: With treatment for breast cancer, women treated may present significant sensory abnormalities in the upper extremity. However, there are no conclusive studies that have evaluated pressure pain thresholds (PPT) in the shoulder of postoperated women for breast cancer. The aim of this study was to compare PPT in the shoulder, stress, anxiety, depression symptoms, and quality of sleep among postoperated women for breast cancer (PO group) and asymptomatic women of shoulder pain (control group). METHODS: 40 women participated (n = 20, PO group, age: average ± standard deviation, 49.2 ± 8.3 years; body mass index (BMI): 27.5 ± 3.0 kg/cm2; surgery time: 22.2 ± 34.4 months; n = 20, control group, 46.9 ± 8.1 years; BMI: 26.8 ± 3.5 kg/cm2). The PPT was evaluated with a digital algometer at 32 points in the shoulder region and one control point in the tibialis anterior. Stress, anxiety, and depression were evaluated with the Depression, Anxiety and Stress Scale 21 (DASS-21) and the quality of sleep by the Pittsburgh Sleep Quality Index. RESULTS: Significant differences were observed over 1.5 kgf/cm2 in 33 points evaluated (p < 0.01) with a small to high effect size (Cliff's delta range = 0.16; 0.92) and higher levels of anxiety and stress in the PO group (anxiety: median [first; third quartile], 5[3; 12.5]; stress: 9.7 ± 4.7 (7.8; 11.8)) in comparison with the control group (anxiety: 2.5[1; 4.8]; stress: 6.7 ± 3.31 (5.2; 8.3), (p < 0.05)). No significant differences were found between the groups in depression and sleep quality (p > 0.05). CONCLUSION: Postoperated women for breast cancer present hyperalgesia in the shoulder anterior and posterior region, low PPT in the tibialis anterior, and higher levels of stress and anxiety compared to the control group.
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BACKGROUND: There is scarcity of trials about preventative strategies for low anterior resection syndrome (LARS) in rectal cancer patients. The aim of this study is to evaluate the effectiveness of a pre- and post-surgical pelvic floor rehabilitation program on the bowel symptoms, pelvic floor function, and quality of life of rectal cancer patients. METHODS: A randomized controlled trial with parallel groups (pelvic floor rehabilitation versus control group), with a blinded evaluator. PARTICIPANTS AND SETTING: 56 stage I to III rectal cancer patients aged from 18 to 80 years old undergoing sphincter preservation surgery at Hospital del Salvador and who have a sufficient knowledge of Spanish. MAIN OUTCOME MEASURES: ICIQ-B questionnaire for intestinal symptoms, high-resolution anorectal manometry (Alacer Multiplex 24-channel manometry equipment) for anorectal function, pelvic floor muscle strength test with Oxford Modified Scale, and a quality of life test with the EORTC QLQ C30 questionnaire. The evaluations will be carried out at five stages: before surgery, before and after the pelvic floor rehabilitation, and during a 3-month and 1-year follow-up. INTERVENTIONS: one pre-rehabilitation session and 9 to 12 sessions of pelvic floor rehabilitation, including patient education, pelvic floor muscle exercises, pelvic floor electromyography biofeedback, and capacitive and sensory rectal training with a balloon probe. Rehabilitation will begin 3-5 weeks before the ileostomy is removed (four sessions) and around 3 weeks after stoma removal (5-8 sessions). DISCUSSION: We expect the program to improve the bowel symptoms, pelvic floor function, and quality of life of rectal cancer patients. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Register ACTRN12620000040965 . Registered on 21 January 2020.
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Diafragma Pélvico , Neoplasias del Recto , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Australia , Humanos , Persona de Mediana Edad , Diafragma Pélvico/cirugía , Modalidades de Fisioterapia , Complicaciones Posoperatorias , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias del Recto/cirugía , Síndrome , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Patients with COVID-19 can present functional status and disability alterations in the medium- and long-term. On the international level, a multicentered study is being carried out to validate the Post-COVID-19 Functional Status scale for different nations, thus allowing visualizing the needs for a multidisciplinary approach and planning intervention plans. The objective of this study was to perform a linguistic validation and cross-cultural adaptation of the Post-COVID-19 Functional Status scale for people infected with COVID-19 for the Chilean population. METHODS: A cross-sectional study of scale validation was carried out. The study was performed in two phases: (1) forward-translation, reverse-translation and (2) apparent cross-validity adaptation. For the apparent validity analysis, 29 individuals who had been hospitalized in Hospital del Salvador with a COVID-19 infection diagnosis and at the time of the interview were in their homes participated. RESULTS: In phase 1 forward-translation, an item required semantical changes. The reverse-translation versions were similar, and the most relevant doubts were resolved in a consensus meeting. In phase 2, the pilot study confirmed adequate understanding and scale applicability. CONCLUSIONS: Using a systematic and rigorous methodology allowed obtaining a Spanish version of the Post-COVID-19 Functional Status scale for Chile, which is conceptually and linguistically equivalent to the original instrument and adequate to assess the functional status of people infected with COVID-19.
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Actitud Frente a la Salud , COVID-19/psicología , Estado Funcional , Encuestas y Cuestionarios/normas , Adulto , COVID-19/rehabilitación , Chile , Comparación Transcultural , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Psicometría , Calidad de Vida/psicología , Reproducibilidad de los Resultados , TraduccionesRESUMEN
Abstract Aim: To characterize functional outcomes and oncological fatigue in older cancer patients, and verify the relation of these outcomes with age, number of hospitalizations, and falls within 12-months. Methods: Cross-sectional study involving 116 older adults with cancer undergoing treatment in a hospital in Santiago de Chile. Participants were assessed for independence on the activity of daily living (Barthel index), functional mobility with "timed up and go" (TUG) test, handgrip strength with a Baseline® Hydraulic Hand Dynamometer, and fatigue with Brief Fatigue Inventory. Information about the number of falls and hospitalizations from the previous 12-months was also collected. Results: 21.6% had experienced at least one fall during the previous 12-months, and 52% had been hospitalized over the same period. Handgrip strength was below the cut-off thresholds for older adults and 78.4% were classified with the risk of falls according to the TUG test. Forty-nine percent of participants experienced moderate fatigue, and 58% were dependent to perform activities of daily living. There was a correlation of TUG results with age (r = 0.204; p = 0.028). Conclusions: Older adults with cancer in our study experienced moderate fatigue, a high dependence to perform activities of daily living, especially those associated with mobility, dressing, and bladder or bowel function. Older adults with cancer are more likely to develop functional decline which leads to increased dependency or death. The data suggests they present functional impairment. Physical activity interventions would benefit this population.
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Humanos , Evaluación Geriátrica/métodos , Rendimiento Físico Funcional , Neoplasias/patología , Chile , Estudios Transversales/instrumentación , FatigaRESUMEN
OBJECTIVE: to determine the incidence and rate of risk of falls in adult patients treated for hematologic malignancies in the Intensive Hematology Unit of a reference hospital. METHOD: this is a retrospective observational study. A total of 101 patients were evaluated. The occurrence of falls was obtained from records of the unit and the predictive variables of the Hendrich II model were collected, namely: sex, presence of dizziness or vertigo, mental confusion, elimination problems, depression, use of benzodiazepines, use of anticonvulsants, and the Get up and Go test. RESULTS: two fall events were reported in 101 patients (incidence of 1.98% over a 1.5-year period). Based on the cut-off point 5 of the Hendrich II Model, 30 patients (29.7%) were at risk of fall at the moment of hospital admission, 41 (40.6%) in the middle of the hospitalization period, and 38 (37.6%) at the moment of hospital discharge. CONCLUSIONS: patients treated for hematological malignancies presented low incidence and high risk of falls during hospitalization.
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Accidentes por Caídas/estadística & datos numéricos , Neoplasias Hematológicas/terapia , Unidades de Cuidados Intensivos/estadística & datos numéricos , Adulto , Anciano , Chile/epidemiología , Femenino , Hematología , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Masculino , Estudios Retrospectivos , Medición de Riesgo , Factores de RiesgoRESUMEN
Objetivo: determinar a incidência e a taxa de risco de quedas em pacientes adultos tratados por neoplasias hematológicas na Unidade de Hematologia Intensiva de um hospital de referência. Método: corresponde a um estudo observacional retrospectivo. Foram avaliados 101 pacientes. A ocorrência de quedas foi obtida a partir do registro da unidade e as variáveis preditivas do modelo Hendrich II foram coletadas: sexo, presença de tontura ou vertigem, confusão mental, problemas de eliminação, depressão, uso de benzodiazepínicos, uso de anticonvulsivantes e o teste Get up and Go. Resultados: dois eventos de quedas foram relatados em 101 pacientes (incidência de 1,98% em um período de 1,5 ano). Usando o ponto de corte cinco do Modelo Hendrich II, identificou-se que 30 pacientes (29,7%) apresentaram risco de queda no primeiro dia de hospitalização, 41 (40,6%) ao meio e 38 (37,6%) no momento da alta hospitalar. Conclusões: pacientes tratados por neoplasias hematológicas apresentaram baixa incidência e alto risco de quedas durante a hospitalização.
Objective: to determine the incidence and rate of risk of falls in adult patients treated for hematologic malignancies in the Intensive Hematology Unit of a reference hospital. Method: this is a retrospective observational study. A total of 101 patients were evaluated. The occurrence of falls was obtained from records of the unit and the predictive variables of the Hendrich II model were collected, namely: sex, presence of dizziness or vertigo, mental confusion, elimination problems, depression, use of benzodiazepines, use of anticonvulsants, and the Get up and Go test. Results: two fall events were reported in 101 patients (incidence of 1.98% over a 1.5-year period). Based on the cut-off point 5 of the Hendrich II Model, 30 patients (29.7%) were at risk of fall at the moment of hospital admission, 41 (40.6%) in the middle of the hospitalization period, and 38 (37.6%) at the moment of hospital discharge. Conclusions: patients treated for hematological malignancies presented low incidence and high risk of falls during hospitalization.
Objetivo: determinar la incidencia y la tasa de riesgo de caídas en pacientes adultos tratados por neoplasias hematológicas en la Unidad de Hematología Intensiva de un hospital de referencia. Método: corresponde a un estudio observacional retrospectivo. Se evaluaron 101 pacientes. La ocurrencia de caídas se obtuvo del registro de la unidad y las variables predictivas del modelo Hendrich II fueron recopiladas: sexo, presencia de mareos o vértigo, confusión mental, problemas de eliminación, depresión, uso de benzodiacepina, uso de anticonvulsionantes y la prueba Get up and Go. Resultados: dos eventos de caídas fueron reportados en 101 pacientes (incidencia de 1,98% en un período de 1,5 años). Utilizando el punto de corte 5 del Modelo Hendrich II, fue identificado que 30 pacientes (29,7%) tenían riesgo de caída al ingreso hospitalario, 41 (40,6%) en la mitad y 38 (37,6%) al egreso hospitalario. Conclusiones: los pacientes tratados por neoplasias hematológicas presentaron una incidencia baja y un alto riesgo de caídas durante la hospitalización.