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1.
J Glob Health ; 11: 04038, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484706

RESUMO

Background: By 2030, Sustainable Development Goal 3.4 aims to reduce the premature mortality caused by non-communicable diseases through prevention and treatment. Chronic obstructive pulmonary disease is the second leading cause of mortality and disability-adjusted life years in India. This review was conducted to estimate the prevalence of COPD using systematic review and meta-analysis technique. Method: Search was conducted using six databases for studies on COPD among population above 30 years in India between years 2000 to 2020. Cross-sectional and cohort studies reporting prevalence of COPD and associated risk factors were included in the present review. Screening and data extraction was done by two authors independently. Studies were appraised for quality using the modified New Castle Ottawa scale and reporting quality was assessed using STROBE guidelines. Result: Our search returned 8973 records, from which 23 records fulfilled the eligibility criteria. Overall, the prevalence of COPD among population aged 30 years and above in India was 7%. Risk factors like active and passive smoking, biomass fuel exposure, environmental tobacco smoke, occupational exposure to dust, indoor and outdoor pollution, and increasing age were reported to have a significant association with COPD among Indian population. Conclusion: Our findings suggest the need for a multicentric national-level research study to understand COPD burden and its contributing risk factors. The findings also suggest the need for COPD sensitive health literacy program focused on early screening and primary prevention of risk factors for COPD, which may help early initiation of self-management practices, that are crucial for better quality of life.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Estudos Transversais , Humanos , Índia/epidemiologia , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco
2.
Top Stroke Rehabil ; : 1-11, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34180370

RESUMO

Background: Adherence to prescribed exercises is essential for home-based programs to be effective, but evidence for strategies to enhance exercise adherence in people with stroke is lacking.Objectives: To determine the effect of adherence strategies on the proportion of people with stroke who adhere to prescribed home-based exercises and their level of adherence at 6 and 12 weeks of intervention. Our secondary objective was to determine the effect of the combined intervention on mobility and quality of life post-stroke.Methods: We conducted an RCT among people with stroke (Exp = 27, Con = 25) living in semi-urban India. Both groups received standard hospital care and a home exercise program. The experimental group also received adherence strategies delivered over five sessions. Adherence was measured using the Stroke-Specific Measure of Adherence to Home-based Exercises (SS-MAHE) , mobility using Mobility Disability Scale, and quality of life using the Stroke Impact Scale.Results: The experimental group had better exercise adherence compared to the control group both at six (mean difference [MD] 45, 95% CI 40, 64, p < .001) and 12 weeks (MD 51, 95% CI 39, 63, p < .001). The experimental group also had better mobility at 12 weeks (median (IQR), experimental 42 (57), median (IQR), control 95 (50), p = .002). There was no difference in the quality of life scores between groups at six or 12 weeks.Conclusion: The adherence strategies were effective in improving exercise adherence and mobility post-stroke but did not improve quality of life.Trial registration: CTRI/2018/08/015212.

4.
Complement Ther Clin Pract ; 39: 101110, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32379645

RESUMO

BACKGROUND: The evidence on aquatic therapy (AT) for improving balance and gait deficits post-stroke is unclear. Therefore, this study aimed to determine the effect of AT on balance and gait in stroke survivors. METHODS: We searched CINAHL, PubMed, Web of Science, Aqua4balance, Ewac, Cochrane, and EMBASE databases from inception to 1st November 2019. RESULTS: Eleven studies with 455 participants were included for the review. Meta-analysis showed that AT was effective for improving balance (MD 3.23, 95% CI 1.06, 5.39; p = 0.004; I2 = 61%) and gait speed (MD 0.77, 95% CI 0.25, 1.29; p = 0.004; I2 = 0%) when delivered alone. AT was effective in improving cadence (MD 4.41, 95% CI 0.82, 8.00; p = 0.02; I2 = 68%) when delivered as an adjunct to land-based therapy. CONCLUSION: AT may be used to improve balance and gait after stroke; however, the evidence to support its use is still low.


Assuntos
Terapia por Exercício/métodos , Marcha/fisiologia , Hidroterapia/métodos , Equilíbrio Postural/fisiologia , Reabilitação do Acidente Vascular Cerebral/métodos , Humanos
5.
Physiother Res Int ; 25(2): e1827, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31880059

RESUMO

OBJECTIVES: To develop an adherence questionnaire specific to stroke and measure the level of adherence to home-based exercises among community-dwelling stroke survivors. METHODS: We developed and validated the "Stroke-Specific Measure of Adherence to Home-based Exercises" (SS-MAHE). We measured the exercise adherence among 92 community-dwelling stroke survivors in a cross-sectional study. RESULTS: The SS-MAHE has two sections covering (a) the dosage of prescribed exercises and (b) dosage of actual exercises done by the participants. It was found to be reliable with ICC score of 0.81 (95% CI, 0.44, 0.94, p = .001.) Adherence was measured by comparing prescribed exercises to the actual exercises performed at home. We rated participants as "adherent" if they were following more than 70% of the prescribed exercise dosage. In our sample of 92 stroke survivors, only 28% of participants were adherent to prescribed home-based exercises. CONCLUSION: SS-MAHE is a practical and reliable tool to measure adherence to home-based exercises after a stroke. Exercise adherence among stroke survivors is less than ideal. There is a need for strategies to specifically target exercise adherence in stroke survivors.


Assuntos
Terapia por Exercício/psicologia , Cooperação do Paciente/psicologia , Autocuidado/psicologia , Reabilitação do Acidente Vascular Cerebral/psicologia , Sobreviventes/psicologia , Idoso , Estudos Transversais , Feminino , Humanos , Vida Independente , Índia , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral/métodos , Inquéritos e Questionários
6.
Int J Telemed Appl ; 2019: 5903106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31186627

RESUMO

Background: Stroke is a leading cause of disability and requires continued care after hospital discharge. Mobile-based interventions are suitable to reduce the cost of stroke rehabilitation and facilitate self-management among stroke survivors. However, before attempting to use mobile-based home exercise program, it is crucial to recognize the readiness of stroke survivors and their caregivers to opt for such interventions. Objective: To assess the acceptability and attitude towards a mobile-based home exercise program among stroke survivors and their primary caregivers. Methods: A cross-sectional study was conducted among 102 participants to understand their attitude and acceptability towards mobile-based home exercise program. A validated 10-item questionnaire was adapted for the study. The questions which assessed the attitude were rated on a three-point Likert scale, with three denoting agree and one denoting disagree. The acceptability was assessed by their willingness to opt for a mobile-based home program services. A Chi-square analysis and cross-tabulation were performed to test differences between caregivers and patients. A logistic regression was performed to determine the effects of age, gender, and mobile phone on acceptability. Results: Ninety-two percent of caregivers and 90% of patients showed willingness to opt for mobile-based intervention. Majority of the participants showed a positive attitude towards this mode of treatment. There was no difference in the attitude noted among caregivers and patients (p>0.05) towards mobile-based intervention. Conclusion: The stroke survivors and caregivers welcomed the concept of mobile-based home exercise program even in a low-resource settings, but further studies to understand treatment and cost-effectiveness of this technology among the stroke survivors would lead to better implementation.

7.
Arch Phys Med Rehabil ; 100(4): 751-768, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30452892

RESUMO

OBJECTIVES: (1) To determine the effect of transcutaneous electrical nerve stimulation (TENS) on poststroke spasticity. (2) To determine the effect of different parameters (intensity, frequency, duration) of TENS on spasticity reduction in adults with stroke. (3) To determine the influence of time since stroke on the effectiveness of TENS on spasticity. DATA SOURCES: PubMed, PEDro, CINAHL, Web of Science, CENTRAL, and EMBASE databases were searched from inception to March 2017. STUDY SELECTION: Randomized controlled trial (RCT), quasi-RCT, and non-RCT were included if (1) they evaluated the effects of TENS for the management of spasticity in participants with acute or subacute or chronic stroke using clinical and neurophysiological tools; and (2) TENS was delivered either alone or as an adjunct to other treatments. DATA EXTRACTION: Two authors independently screened and extracted data from 15 of the 829 studies retrieved through the search using a pilot tested pro forma. Disagreements were resolved through discussion with other authors. Quality of studies was assessed using Cochrane risk of bias criteria. DATA SYNTHESIS: Meta-analysis was performed using a random-effects model that showed (1) TENS along with other physical therapy treatments was more effective in reducing spasticity in the lower limbs compared to placebo TENS (SMD -0.64; 95% confidence interval [95% CI], -0.98 to -0.31; P=.0001; I2=17%); and (2) TENS, when administered along with other physical therapy treatments, was effective in reducing spasticity when compared to other physical therapy interventions alone (SMD -0.83; 95% CI, -1.51 to -0.15; P=.02; I2=27%). There were limited studies to evaluate the effectiveness of TENS for upper limb spasticity. CONCLUSION: There is strong evidence that TENS as an adjunct is effective in reducing lower limb spasticity when applied for more than 30 minutes over nerve or muscle belly in chronic stroke survivors (review protocol registered at PROSPERO: CRD42015020151).


Assuntos
Espasticidade Muscular/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Estimulação Elétrica Nervosa Transcutânea/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/etiologia , Resultado do Tratamento
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