ABSTRACT
Old age represents a social group that is undergoing continuous expansion. The aging population will be prone to chronic diseases and falls, which is a marker of frailty and a public health problem. This study aims to examine the relationship between living conditions and the prevalence of the risk of falls in older adults within the community. As an observational cross-sectional study, intentional sampling was carried out on residents of the metropolitan area over 75 years of age. The socio-demographic data of the subjects and their history of falls were collected. Additionally, the subjects were evaluated on the risk of falling, basic activities of daily living, such as walking and balance, fragility, and their fear of falling. The statistical analyses used were based on the Shapiro-Wilk test for normality, statistics of central tendency with description, mean (M) and dispersion, standard deviation (SD), bivariate contingency tables for studying the relationships between the variables, and the analysis of Pearson's relational statistics (χ2). The comparisons of means were resolved by parametric or non-parametric routes. We obtained the following results: 1. The socio-demographic profile of our sample consisted of adults over 75 years of age, the majority of whom were overweight or obese women living in an urban area, specifically in an apartment, and receiving care; 2. Older people in the studied community had mild dependency and frailty, and were also at severe risk of falls; 3. The prevalence of falls was higher in women than in men in this study. Through these results, we confirmed the relationship between living conditions and the prevalence of risk of falls in older adults within the community.
Subject(s)
Frailty , Independent Living , Male , Humans , Female , Aged , Activities of Daily Living , Frailty/epidemiology , Social Conditions , Incidence , Cross-Sectional Studies , FearABSTRACT
BACKGROUND: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. METHODS: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04761289. (February 18, 2021). https://clinicaltrials.gov/ct2/show/ NCT04761289.
ABSTRACT
BACKGROUND: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. METHODS: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).
ABSTRACT
Antecedentes: La disnea constituye una de las principales causas de pérdida de funcionalidad en el paciente con cáncer. Las medidas farmacológicas consiguen una reducción del síntoma, pero sin generalizar esa mejora a la funcionalidad. Proponemos la inclusión de un programa de rehabilitación integral funcional. El objetivo del estudio fue comprobar la eficacia del programa en la mejora tanto de los niveles de autonomía como de disnea en pacientes con cáncer.MétodosEstudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control. El grupo de intervención, además del tratamiento clínico convencional realizado en el grupo control, recibió el Programa de Rehabilitación Funcional. Los resultados principales a medir fueron la funcionalidad (Barthel), los niveles de disnea (MRC) y la CVRS (Euro-QOL). Enmascaramiento con simple ciego, pero análisis estadístico realizado por personal ajeno al estudio.ResultadosMuestra final de 113 individuos, 52 en el grupo control y 61 en el experimental, procedentes de la Unidad de Oncología del Complejo Hospitalario Universitario de Salamanca. A nivel descriptivo buen balanceo entre grupos en edad, género y diagnóstico. Diferencias estadísticamente significativas entre los miembros de ambos grupos en los niveles de funcionalidad (p = 0,000), en los niveles de disnea (p = 0,001) y en los los sub-ítems pertenecientes al cuestionario Euro-QOL, salvo en el sub-ítem relacionado con el dolor (p = 0,311). No se observan efectos adversos importantes o efectos secundarios. (AU)
Background: Dyspnoea is one of leading causes of loss of autonomy in patients with advanced-stage cancer. Pharmacological measures achieve a reduction of the symptom, but without generalizing this improvement to functionality. We propose the inclusion of a comprehensive functional rehabilitation programme. The purpose is to test the efficacy of an integral respiratory rehabilitation programme to improve autonomy levels and relieve cancer-related dyspnoea.MethodsExperimental design, prospective, longitudinal, randomized study based on a parallel fixed allocation scheme using an experimental group and a control group. The intervention group participated in comprehensive functional rehabilitation, while the control group only received standard drug treatment. Single blind masking, but statistical analysis was performed by non-study personnel.ResultsFinal sample of 113 individuals, 52 in the control group and 61 in the experimental group, from the Oncology Unit of the University Hospital Complex of Salamanca. Statistically significant differences (are observed) between the members of both groups in the levels of functionality (p = .000), in the levels of dyspnoea (p =.001) and in the sub-items of the Euro-QOL questionnaire, except in the sub-item related to pain (p = .311). No major adverse effects or side effects are observed. (AU)
Subject(s)
Humans , Dyspnea/etiology , Physical Therapy Modalities , Quality of Life , Medical Oncology , Prospective Studies , PatientsABSTRACT
BACKGROUND: Dyspnoea is one of leading causes of loss of autonomy in patients with advanced-stage cancer. Pharmacological measures achieve a reduction of the symptom, but without generalizing this improvement to functionality. We propose the inclusion of a comprehensive functional rehabilitation programme. The purpose is to test the efficacy of an integral respiratory rehabilitation programme to improve autonomy levels and relieve cancer-related dyspnoea. METHODS: Experimental design, prospective, longitudinal, randomized study based on a parallel fixed allocation scheme using an experimental group and a control group. The intervention group participated in comprehensive functional rehabilitation, while the control group only received standard drug treatment. Single blind masking, but statistical analysis was performed by non-study personnel. RESULTS: Final sample of 113 individuals, 52 in the control group and 61 in the experimental group, from the Oncology Unit of the University Hospital Complex of Salamanca. Statistically significant differences (are observed) between the members of both groups in the levels of functionality (p = .000), in the levels of dyspnoea (p =.001) and in the sub-items of the Euro-QOL questionnaire, except in the sub-item related to pain (p = .311). No major adverse effects or side effects are observed. CONCLUSION: Non-pharmacological interventions using a comprehensive functional rehabilitation programme improve functionality and relieve dyspnoea in cancer patients.
Subject(s)
Dyspnea , Quality of Life , Dyspnea/etiology , Humans , Physical Therapy Modalities , Prospective Studies , Single-Blind MethodABSTRACT
BACKGROUND: Oncology patients experience a large number of symptoms and, those referring to cognitive performance has an ever-increasing importance in clinical practice, due to the increase in survival rates and interest in the patient's quality of life. The studies reviewed showed that chemotherapy-related cognitive impairment might occur in 15 and 50% of oncology patients. The main objective of this research was to study the impact of chemotherapy on the cognitive function of patients with locoregional breast cancer. METHOD: Analytical, prospective, longitudinal study using three measures, unifactorial intrasubject design, non-probability, and random selection sampling. The sample comprised women newly diagnosed with locoregional breast cancer in stages I, II, IIIA who received chemotherapy at the University Hospital of Salamanca (Complejo Asistencial Universitario de Salamanca), randomly selected for three years. Semi-structured interviews were conducted, and anxiety and depression (Hospital Anxiety and Depression scale, HAD); quality of life (QLQ-BR23 scale) and the following cognitive variables were assessed-processing speed, attention, memory, and executive functions (subtests of the Wechsler Intelligence Scale and the Trail Making Test). RESULTS: The final sample size included 151 participants; 23 were excluded. A decline in cognitive performance was observed in patients, which did not completely recover two months after chemotherapy was completed. Additionally, worse cognitive performance was observed in patients with anxious or depressive symptoms. There was a negative impact on the quality of life. CONCLUSION: Chemotherapy had an impact on the cognitive performance of oncology patients in most cognitive domains studied.
Subject(s)
Breast Neoplasms , Chemotherapy-Related Cognitive Impairment , Cognitive Dysfunction , Breast Neoplasms/drug therapy , Cognitive Dysfunction/chemically induced , Cognitive Dysfunction/epidemiology , Female , Humans , Longitudinal Studies , Neuropsychological Tests , Prospective Studies , Quality of LifeABSTRACT
FUNDAMENTO Y OBJETIVO: La astenia debida a la enfermedad oncológica es un fenómeno multifactorial, tratado habitualmente mediante fármacos. Estos tratamientos suelen controlar el síntoma, pero no consiguen mejorar la funcionalidad de los pacientes. En algunos pacientes pueden inducir o incluso aumentar los niveles de astenia. El objetivo principal de nuestro estudio ha sido comprobar la eficacia de un programa de rehabilitación integral funcional en el control de la astenia relacionada con la enfermedad oncológica. PACIENTES Y MÉTODOS: Este es un estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control, realizado con 192 pacientes del Servicio de Oncología del Hospital Universitario de Salamanca. El grupo de intervención, además de recibir tratamiento farmacológico, participó en un programa de rehabilitación integral funcional. El grupo control solo recibió el tratamiento farmacológico habitual. Los resultados principales medidos fueron los niveles de astenia y la realización de actividades de la vida diaria mediante el cuestionario Perform y la escala triple EVA. RESULTADOS: Los pacientes del grupo experimental obtuvieron después de la intervención una importante disminución en los niveles de astenia evaluada con el cuestionario PERFORM (puntuación inicial del grupo experimental: 19,19; puntuación inicial del grupo control: 20,98. Puntuación final del grupo experimental: 36,12; puntuación final del grupo control: 22,48). Estos resultados son estadísticamente significativos con respecto a los obtenidos por el grupo control (p < 0,001; IC 95%). Los pacientes del grupo de intervención obtuvieron también una mejora estadísticamente significativa (p < 0,001; IC 95%) comparada con la obtenida por los sujetos del grupo control en los ítems de niveles de energía, actividades diarias y calidad de vida evaluados con la escala triple EVA. CONCLUSIONES: Las intervenciones no farmacológicas de un programa de rehabilitación integral funcional mejoran los niveles de astenia debida a la enfermedad oncológica: esto supone un incremento importante de sus actividades de la vida diaria
BACKGROUND AND OBJECTIVE: Cancer-related fatigue is a multifactorial phenomenon, which is usually treated exclusively with medication. These treatments usually only achieve control of symptoms but do not improve the functionality of PATIENTS: In some patients they can induce or increase fatigue levels. Our aim is to test the effectiveness of a «comprehensive functional rehabilitation programme» in controlling fatigue-related cancer. PATIENTS AND METHOD: This is an experimental, prospective, longitudinal, randomized study using a parallel fixed allocation scheme with experimental and control group with 192 patients from the Oncology Service of Salamanca University Hospital. The intervention group received pharmacological treatment and then participated in a «comprehensive functional rehabilitation programme»; the control group received only pharmacological treatment. The main outcomes measured were asthenia levels and daily activities through the PERFORMA questionnaire and triple VAS. RESULTS: Patients in the experimental group decrease fatigue levels in PERFORM Questionnaire (Initial score group, 19.19, initial score, control group, 20.98, final score, 36.12, final score, control group, 22.48). We found significant differences (p < 0.001, IC 95%) with patients of CONTROL GROUP: Patients of intervention group improve the energy levels, daily activities and quality of life assessed with the EVA triple scale and also we found again significant differences (p < 0.001, IC 95%) with patients of CONTROL GROUP: CONCLUSIONS: The non- pharmacological interventions of functional rehabilitation program comprehensive decrease fatigue related cancer, therefore patients participating in this program better perform their daily activities
Subject(s)
Humans , Male , Female , Aged , Asthenia/rehabilitation , Neoplasms/complications , Palliative Care/methods , Evaluation of the Efficacy-Effectiveness of Interventions , Pilot Projects , Comprehensive Health Care , Surveys and Questionnaires , Activities of Daily Living , 28599ABSTRACT
Justificación: La revisión de la literatura pone de manifiesto el impacto negativo que la astenia tumoral tiene sobre la calidad de vida y recomienda utilizar además del tratamiento farmacológico para controlar el síntoma, otras terapias centradas en aumentar la autonomía. Nuestro objetivo ha sido comprobar la eficacia del "Programa de entrenamiento en la realización de las actividades de la vida diaria", en la mejora de la Calidad de Vida Relacionada con la Salud (CVRS) de los pacientes oncológicos con astenia. Metodología: Estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control. El instrumento de evaluación para medir la variable dependiente fue el cuestionario SF-12 v2. El estudio se realizó con 180 sujetos reclutados entre diciembre de 2013 y septiembre de 2015. Resultados: Después de la intervención encontramos diferencias estadísticamente significativas (p<0,01) en todos los ítems de calidad de vida en los pacientes incluidos en el grupo experimental, exceptuando el ítem "dolor corporal" (p>0,05). Sin embargo no hemos encontrado relación entre la edad y la mejora de la calidad de vida. Conclusiones: La utilización sistemática y controlada del "Programa de entrenamiento en la realización de las actividades de la vida diaria" mejora todos los niveles de CVRS de los pacientes oncológicos por lo que después de estos resultados nuestro último objetivo será la implementación de este programa y su utilización en nuestra práctica clínica diaria
Background: The review of the literature show a negative impact of the fatigue on quality of life and recommend, in addition of the use of traditional drug treatment to control symptoms, other therapies focused into improve the autonomy. Our aim is to test the efficacy of improving the levels of quality of life related to health (HRQOL) of cancer patients using a "daily activity training program" to control fatigue reported by the oncological disease. Methods/design: experimental, prospective, longitudinal and randomized study using a parallel fixed allocation scheme with experimental and control group. We used the SF-12 v2 questionnaire to measure HRQL .The study was conducted in 180 subjects recruited between December 2013 and September 2015. Results: We found statistically significant differences after intervention (p <0.001) in all items related to quality of life in the experimental group patients, except for the item "bodily pain"(p>0, 05). However, we found no relationship between age and improving of the quality of life. In summary systematic and controlled use of our "daily activity training program" improve all levels of quality of life related to health (HRQOL) of cancer patients. Therefore after these results our ultimate goal will be the implementation of this program and its use in our daily practice
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Asthenia/nursing , Quality of Life , Neoplasms/rehabilitation , Activities of Daily Living , Asthenia/psychology , Occupational Therapy/methods , 28573 , Prospective Studies , Longitudinal Studies , Surveys and QuestionnairesABSTRACT
Objetivo: Determinar la influencia de la alteración del sabor y olor de los alimentos, secundaria al tratamiento antineoplásico, sobre la malnutrición, una de las complicaciones más comunes del enfermo oncológico. Metodología: Mediante una entrevista y el método de Valoración Subjetiva Global Generada por el Paciente (VSG-GP), se determinó la sintomatología y estado nutricional de 62 pacientes en tratamiento quimioterápico en el Hospital Universitario de Salamanca. Resultados: La desnutrición es frecuente (67,8%), y está relacionada con la pérdida de apetito y disminución de ingesta. Estos factores están en cierta medida influenciados por la distorsión gustativa, la cual es frecuente (62,9%). Los resultados muestran que determinados hábitos higiénico-dietéticos podrían prevenir el desarrollo de distorsiones sensoriales. Conclusión: Las aversiones alimentarias debidas a alteraciones del gusto parecen actuar indirectamente sobre el estado de desnutrición del paciente oncológico al ocasionar pérdida de apetito y disminución de ingesta
Objective: To determine the influence of taste and smell disorders, a side effect of antineoplastic treatments, on nutrition of oncologic patients, amongst whom malnutrition is one of the most common complications. Methods: 62 patients from University Hospital of Salamanca, receiving treatment with chemotherapy, were included in our study. To investigate the nutritional state and secondary symptoms of the therapy, we did an interview and used the Patient-Generated Subjective Global Assessment (PG-SGA) method. Results: Malnutrition is frequent (67.8%), and is related to the loss of appetite and reduced intake. These are observed to be influenced by taste disorder, which is also frequent among patients (62.9%). The results show that hygiene-dietetic habits could prevent the development of sensorial disorders. Conclusions: Food aversions due to taste disorders seem to indirectly affect the malnutrition status of oncologic patients by causing loss of appetite and reduced intake
