The effect of resistance exercise on strength and safety outcome for people with haemophilia: A systematic review.

INTRODUCTION: Haemophilia is a congenital bleeding disorder with severe musculoskeletal complications. Resistance exercise is important to increase joint stability and to improve physical performance. AIM: This review aimed to investigate the safety and efficacy of resistance exercise interventions on people with haemophilia (PwH) and evaluate whether the American College of Sports Medicine resistance exercise criteria for healthy adults are valid for this population. METHODS: A systematic search in literature was conducted, using the databases PubMed, MEDLiNE, CINAHL, SCOPUS, PEDro and Cochrane Library. Out of 2.440 studies published between 1960 and November 2019, 14 studies (9 randomized controlled trials, 1 controlled trial, 4 single-group prospective studies) applying resistance exercise in juvenile and adult PwH corresponded to the inclusion criteria. RESULTS: Studies performed dynamic, isokinetic or a combination of isometric and dynamic resistance training. Most interventions were carried out in the context of a multimodal training. Resistance was provided using fixed and free weights, body weight, resistance bands and water resistance. Study protocols included clinical and home-based settings. Several studies suggest that training intensities lower than those known to increase the strength of healthy people are effective in increasing the strength of PwH. Resistance exercise seems to be a safe intervention if it is adequately monitored, individually adapted and applied with sufficient factor therapy. Due to the heterogeneity of study designs, training interventions and outcome measures a meta-analysis could not be performed. CONCLUSIONS: Further studies of higher methodological quality are needed to determine the optimal types of exercise, optimal dosage and timing.

Taking a Closer Look: "Evaluating Online Video Content for Rehabilitation after Distal Radius Fracture".

Background: Fractures of the distal radius are among the most common bone injuries, and their frequency is constantly increasing, leading to an elevated need for subsequent rehabilitation. This growing need has led to the emergence of online content aimed at providing guidance on rehabilitation. Nonetheless, unreviewed online content raises concerns about its reliability; therefore, the objective of this study was to evaluate the quality, reliability, and comprehensiveness of online videos concerning rehabilitation following a distal radius fracture. Methods: A total of 240 YouTube videos were screened, identifying 33 videos that met the inclusion criteria. These selected videos were evaluated by five independent experts from various professional groups, using the Global Quality Scale, the DISCERN reliability tool, and the JAMA Benchmark Score, as well as a structured set of questions to assess their comprehensiveness and coverage of pertinent aspects. Results: The observers' assessment of the Global Quality Scale exhibited a broad spectrum of viewpoints, indicating considerable variability in evaluations. In most cases, therapy aligned well with the diagnosed condition, and most raters deemed the indication and instruction in the videos acceptable. A proportion of 87% of the videos was deemed suitable for home training by at least three raters. However, a concerning trend emerged, as potential risks and pitfalls were scarcely addressed. Conclusions: The moderate overall quality of the videos and the divergence in expert opinions highlight the need for a regulatory authority to ensure adherence to guidelines and maintain high-quality content. Additionally, our results raise concerns about the applicability of established assessment tools in this context.

Post-COVID: effects of physical exercise on functional status and work ability in health care personnel.

PURPOSE: Post-COVID fatigue significantly limits recovery and return-to-work in COVID-19 survivors. We aimed to assess the effects of physical exercising on post-COVID-19-symptoms, physical/mental capacities and workability within a workplace-health-promotion project in health-care personnel. MATERIALS AND METHODS: Thirty-two HCWs were enrolled in two groups based on Post-COVID-Functional Scale (PCFS) scores: (1) severe (SSG, n = 11) and (2) mild (MSG, n = 21) symptoms. The participants underwent an eight week exercise intervention program consisting of two supervised resistance exercise sessions per week plus individual aerobic exercise recommendations. Primary outcome-parameter for physical fitness was VO2peak. Further, physical function (6MWT, 30 s sit-to-stand test (30secSTS)), mental health (anxiety (GAD-7), depression (PHQ-9), stress (PSS-10), fatigue (BFI), resilience (BRS)), cognitive capacity (MoCA) and workability (WAI) were assessed at baseline, after 4 weeks and after completion of exercise intervention. RESULTS: VO2peak improved significantly in the SSG by 2.4 ml/kg/min (95% CI [1.48; 3.01], adj.p < 0.001) and non-significantly in the MSG by 1.27 ml/kg/min (adj.p = 0.096). Both groups significantly improved their 30secSTS (p = 0.0236) and 6MWT (p = 0.0252) outcomes in both follow-ups (4 weeks and 8 weeks after inclusion). The SSG improved more than the MSG in VO2peak and 6MWT both after 4 and 8 weeks, respectively, although not statistically significant; findings were vice versa for the 30secSTS. 30secSTS outcomes correlated significantly with mental health outcomes and workability. CONCLUSIONS: Post-COVID exercise intervention improved physical fitness, psychological outcomes and workability in HCWs. Cases with severe fatigue showed higher benefit levels compared to those with mild symptoms. The safe and highly feasible 30secSTS correlated well with physical and mental outcomes and better workability in COVID-19 survivors.Implications for rehabilitationPhysical exercising showed to be an effective intervention method in the rehabilitation of COVID-19 survivors suffering from post-COVID syndrome by positively affecting both physical and mental health.In health care workers suffering from post-COVID syndrome, increases in physical performance are directly related to improvements in work ability.The 30 s sit-to-stand test (30secSTS) showed promising results as clinical assessment tool.The results of this study indicate that physical exercising will need to play a large and substantial role over the next years in the rehabilitation of COVID-19 survivors suffering from post-COVID-19-syndrome as it positively affects both physical and mental dimensions of the post-COVID-19-syndrome as well as work ability.

TLIF Online Videos for Patient Education-Evaluation of Comprehensiveness, Quality, and Reliability.

Over the last few decades, the number of lumbar interbody fusion surgeries performed has been constantly increasing, with transforaminal lumbar interbody fusion (TLIF) being one of the most common surgical techniques. Due to easy accessibility, patients frequently use YouTube to obtain information on health-related issues. Consequently, online video platforms may be a valuable tool for patient education. The aim of this study was to assess the quality, reliability, and comprehensiveness of online videos on TLIF. We screened 180 videos on YouTube, yielding a total of 30 videos that met the inclusion criteria. These videos were evaluated using Global Quality Scale, DISCERN reliability tool, and JAMA Benchmark Score, and assessed in regard to their comprehensiveness and coverage of relevant aspects. At the time of rating, the videos had between 9188 and 1,530,408 views and between 0 and 3344 likes. The median rater assessment for all videos was "moderate quality". GQS and subjective grades showed a moderate to strong statistically significant association with views and likes. Considering this association of GQS and subjective grade with views and likes, these criteria could be used by laypersons to identify good-quality content. Nevertheless, there is an urgent need for peer-reviewed content that covers all of the relevant aspects.

The impact of lockdowns during the COVID-19 pandemic on work-related accidents in Austria in 2020.

BACKGROUND: This study aims to investigate the impact of the lockdowns during the COVID-19 (Corona-Virus-Disease 19) pandemic in Austria on work-related accidents in the year 2020. Apart from the lockdowns, multiple work-related measures were introduced in 2020, such as the new law on short-term work and regulation on accidents during home-office. Their combined effects on work-related accidents are unknown and a secondary parameter of this study. METHODS: Daily data on the number of accepted and rejected cases of work-related accidents from the Allgemeine Unfallversicherungsanstalt were obtained for the years 2019 and 2020. Based on data provided by the World Health Organization and government publications, the beginning and end dates of national hard and soft lockdown periods were derived. From this database, a difference-in-differences regression analysis on the absolute number of daily work-related accidents was conducted. RESULTS: On average 272.3 work-related accidents per day were registered in 2019 and 199.4 in 2020, a statistically significant reduction of 72.9 accidents per day and total decrease of 26,164 less accidents compared to 2019. Both lockdowns had a statistically highly significant effect on work-related accidents: The hard lockdown reduced the average number of daily registered work-related accidents by 40%. The light lockdown phases reduced this number by an average of 51%. Weekends and holidays had the greatest impact on work-related accidents with a reduction of 69% and 73%, respectively. CONCLUSION: Both lockdown qualities during the COVID-19 pandemic in Austria led to a significant reduction in work-related accidents for their duration. These findings merit further investigation with more detailed data on sectors and injury-quality.

The effect of biofeedback interventions on pain, overall symptoms, quality of life and physiological parameters in patients with pelvic pain : A systematic review.

BACKGROUND: Biofeedback is recognized as an effective additive method for treating certain phenotypes of chronic pelvic pain syndrome and is a therapeutic option in other pelvic pain conditions. This review aims to evaluate evidence from the literature with a focus on the effect of biofeedback on pain reduction, overall symptom relief, physiological parameters and quality of life. METHODS: A systematic literature search was conducted using the databases PubMed, MEDLINE, Embase, Cochrane Library and PEDro from inception to July 2020. Data were tabulated and a narrative synthesis was carried out, since data heterogeneity did not allow a meta-analysis. The PEDro scale and the McMaster Critical Review Form-Quantitative Studies were applied to assess risk of bias. RESULTS: Out of 651 studies, 37 quantitative studies of primary research evaluating pelvic pain conditions in male and female adults and children were included. They covered biofeedback interventions on anorectal disorders, chronic prostatitis, female chronic pelvic pain conditions, urologic phenotypes in children and adults and a single study on low back pain. For anorectal disorders, several landmark studies demonstrate the efficacy of biofeedback. For other subtypes of chronic pelvic pain conditions there is tentative evidence that biofeedback-assisted training has a positive effect on pain reduction, overall symptoms relief and quality of life. Certain factors have been identified that might be relevant in improving treatment success. CONCLUSIONS: For certain indications, biofeedback has been confirmed to be an effective treatment. For other phenotypes, promising findings should be further investigated in robust and well-designed randomized controlled trials.

Effects of a structured exercise program on physical performance and function, quality of life and work ability of physically active breast cancer survivors : A retrospective data analysis.

BACKGROUND: Purpose of this retrospective data analysis was to depict the effects of a structured off-season conditioning program with breast cancer survivors competing in dragon boat paddling. METHODS: In this study 10 breast cancer survivors (mean age 52.0 ± 5.4 years) who had finished the primary cancer treatment and who were paddlers of the Vienna Pink Dragon self-help group underwent a structured 10-week exercise program as part of their routine supportive treatment. Upper extremity strength, endurance capacity, shoulder flexibility, quality of life and work ability were assessed at baseline and after completion of the exercise program. RESULTS: Out of 10 patients 8 completed more than 80% of the exercise sessions. A multivariate analysis of variance (MANOVA) of the pooled exercise effects showed a very large effect size (Η2 = 0.982); however, the change from baseline to follow-up was non-significant (p = 0.363). In the European Organisation for Research and Treatment of Cancer Quality of Life of Cancer Patients Questionnaire (EORTC QLQ-C30) the exercise program led to a significant improvement of body image (p = 0.02) and less arm symptoms in the affected arm (p = 0.04). CONCLUSION: A structured and well-planned exercise intervention program can have a large effect on the physical performance of pretrained breast cancer survivors. Moreover, it can increase the body image and decrease the arm symptoms in this population.

Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome : A randomized, placebo-controlled pilot study.

BACKGROUND: The carpal tunnel syndrome is the most common entrapment neuropathy in the general population. A conservative treatment should be considered in mild to moderate cases. The aim of this study was to assess the effect of a focused extracorporeal shock wave therapy in the treatment of mild to moderate carpal tunnel syndrome. MATERIAL AND METHODS: In this study 30 patients were randomly assigned into 2 groups. Subjects in the study group received three sessions of focused extracorporeal shock wave therapy, whereas the control group underwent a sham therapy. Patients were evaluated 3 and 12 weeks after treatment. The primary outcome was the visual analogue scale score. Secondary outcome measurements included hand grip strength, Boston Carpal Tunnel Syndrome Questionnaire, SF-36 Health Survey and electrodiagnostic measurements. RESULTS: A significant improvement of visual analogue scale at week 3 (p = 0.018) and week 12 (p = 0.007) as well as hand grip strength at week 12 (p = 0.019) could be observed in the study group. The study group showed a significantly better sensory nerve conduction velocity at week 12 than the control group, before correcting for multiple testing, and also a significant improvement in distal motor latency of the median nerve at week 12 (p = 0.009) as well as in both questionnaires (SF-36 subscale bodily pain, p = 0.020 and severity symptom scale, p = 0.003). No such improvement was observed in the control group. CONCLUSION: Focused extracorporeal shock wave therapy is an effective and noninvasive treatment method for mild to moderate carpal tunnel syndrome.

Online Videos as a Source of Physiotherapy Exercise Tutorials for Patients with Lumbar Disc Herniation-A Quality Assessment.

Background: During the last few decades the prevalence of lumbar disc herniation has been increasing constantly, thereby imposing a significant socioeconomic burden. Physiotherapy plays a crucial role in both surgical and conservative treatment of lumbar disc herniation, consequently the current COVID-19 pandemic with concomitant lockdowns has led to a shortage of physiotherapeutical care. In the light of these recent events publicly available physiotherapy tutorials may be a useful tool to address this problem. Aim: The main aim of this study was to assess the quality of online physiotherapy exercise tutorials for lumbar disc herniation. Materials & Methods: With YouTube being a widely known and used platform we screened 240 of the most viewed videos. A total of 76 videos met the inclusion criteria and were statistically analyzed. The videos were assessed using Global Quality Score, DISCERN Score and JAMA benchmark criteria and in regard to their applicability. Results: They displayed a wide range of views (44,969 to 5,448,717), likes (66 to 155,079) and dislikes (6 to 2339). The videos were assessed using Global Quality Score, DISCERN Score and JAMA benchmark criteria and in regard to their applicability. Neither the number of "Views", "Likes", nor "Dislikes" was found to have a significant association with any of the quality measures used in this study. Conclusion: Overall quality grade was determined as "moderate". Based on the data examined in this study, the use of YouTube videos as a source of therapy advice for lumbar spine disc herniation cannot be recommended universally.

Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma : A pilot study.

PURPOSE: This pilot study aimed to describe physical performance, self-reported physical activity, health-related quality of life, anxiety and depression in patients who were assigned from Austrian self-help groups for multiple myeloma patients. These parameters were then discussed in the context of clinical decision-making concerning the recommended type of regular physical activity and exercise. METHODS: Members of the self-help groups were invited to participate. Physical performance and physical activity were assessed with the 6 min walk test (6MWT), handgrip strength test, timed up and go test (TUG), Tinetti performance oriented mobility assessment (POMA), falls efficacy scale (FES), international physical activity questionnaire (IPAQ), health-related quality of life (EORTC QLQ-C30) and the hospital anxiety and depression scale (HADS). RESULTS: A total of 40 patients (female:male = 15:25, mean age: 63.8 ± 9.0 years, range 41-80 years) were identified. In total 20 (50%) reached the performance of healthy peers in the tests 6MWT, handgrip strength, TUG and POMA, while 50% showed at least 1 result below the reference value or cut-off-point for each test. Self-reported activity levels were high. Patients showed a tendency to overestimate the risk of falling but a case by case analysis revealed a tendency for underestimating the actual performance in the respective tests (TUG, POMA). CONCLUSION: The performance of healthy peers was reached by a substantial number of the participants in tests of physical performance and they reported high levels of physical activity. Nevertheless, they tended to overestimate the specific risk of falling. Patients with notably impaired physical performance might be suitable to perform regular physical activity and exercise in an individual therapy, whereas those with good physical performance are suited for training in exercise groups; however, individual contraindications and clinical considerations should be noted in a multiprofessional and interdisciplinary setting.