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Clinical Rheumatology Nov 2021The positive effects of physical activity in both rheumatoid arthritis and ankylosing spondylitis have been proven, but no clear data is yet published regarding... (Review)
Review
INTRODUCTION
The positive effects of physical activity in both rheumatoid arthritis and ankylosing spondylitis have been proven, but no clear data is yet published regarding psoriatic arthritis (PsA). The aims of this study were (i) to assess the level of physical activity (PA) in these patients and (ii) to review the effects of PA on articular disease, extra articular symptoms, and overall well-being.
METHODS
The research strategy was performed on Pubmed, Cochrane, PEDro databases using the following keywords: "psoriatic arthritis AND physical activity" without restriction. The PRISMA methodology was used to select and analyze articles. We searched for all studies published online and in English before January 2021.
RESULTS
A total of 319 studies were retrieved by our search but only 13 could be included. Two reports showed that 17 and 68% of patients reported practicing regularly physical activity. Exercise improved the BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), the general symptoms (pain and fatigue), and the quality of life. Muscle strength and some of cardiovascular comorbidities were also improved. While the studies concerning the risk of enthesitis or flare induced by physical activity are conflicting, recent clinical trials did not mention any adverse event. Finally, rehabilitation programs were associated with a reduction mainly of pain and fatigue.
CONCLUSION
Studies show clear beneficial effects of exercise in PsA on disease activity, on well-being, and on comorbidities, and they seem to outweigh the risk of enthesitis induced by mechanical stress. Further investigations are necessary to confirm these results and to precise the modalities of exercise. Key Points • Psoriatic arthritis patients have a sedentary lifestyle • Physical activity has beneficial effects on disease activity, well-being and reduced some cardiovascular risk factor in psoriatic arthritis • Risk of enthesitis and flares is low with exercise in psoriatic arthritis.
Topics: Arthritis, Psoriatic; Enthesopathy; Exercise; Humans; Quality of Life; Severity of Illness Index
PubMed: 33913069
DOI: 10.1007/s10067-021-05739-y -
International Journal of Nursing Studies Apr 2024Cancer-related fatigue is one of the most common symptoms in cancer patients, usually accompanied by anxiety, depression and insomnia, which seriously affect patients'... (Meta-Analysis)
Meta-Analysis
The efficacy of progressive muscle relaxation training on cancer-related fatigue and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled studies.
BACKGROUND
Cancer-related fatigue is one of the most common symptoms in cancer patients, usually accompanied by anxiety, depression and insomnia, which seriously affect patients' quality of life. Progressive muscle relaxation training is widely used for cancer-related fatigue, but the overall effect is unclear.
OBJECTIVES
The aim of this study was to summarize the evidence on the effects of progressive muscle relaxation training on cancer-related fatigue and quality of life in cancer patients.
DESIGN
Systematic review and meta-analysis.
METHODS
Nine electronic databases (PubMed, Excerpta Medica Database (Embase), The Cochrane Library (Cochrane Central Register of Controlled Trials, CENTRAL), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang Database) were explored for randomized controlled trials (RCTs) published before February 2023. This study was reported based on the PRISMA 2020 statement. The Cochrane Collaboration's risk of bias assessment tool was used for methodological assessment, and the GRADE pro online assessment tool was used for evidence evaluation. The data were analyzed with the Review Manager 5.4 software.
RESULTS
Twelve studies involving 1047 patients were included. Meta-analysis showed that progressive muscle relaxation training plus routine nursing produced more positive effects than routine nursing in improving cancer-related fatigue [SMD = -1.06, 95 % CI -1.49, -0.62, P < 0.00001], anxiety [SMD = -1.09, 95 % CI -1.40, -0.77, P < 0.00001], depression [SMD = -1.43, 95 % CI -1.76, -1.10, P < 0.00001], and quality of sleep [MD = -1.41, 95 % CI -1.74, -1.08, P < 0.00001]. However, there was no significant difference in improving quality of life [SMD = 0.27, 95 % CI -0.62, 1.15, P = 0.55]. Progressive resistance exercise plus routine nursing improved cancer-related fatigue more than progressive muscle relaxation training plus routine nursing [SMD = 1.11, 95 % CI 0.43, 1.78, P = 0.001]. There was low certainty of evidence that progressive muscle relaxation training improved cancer-related fatigue and quality of sleep, and the evidence that improved quality of life, anxiety and depression was very low.
CONCLUSION
Current evidence suggested that progressive muscle relaxation training has the potential to improve cancer-related fatigue, anxiety, depression and quality of sleep in patients with cancer and is a low-load, simple exercise worthy of recommendation for cancer patients in fatigue state. Future research should focus on improving the methodological quality of randomized controlled trials to enhance the persuasive evidence of progressive muscle relaxation training efficacy.
Topics: Humans; Autogenic Training; Exercise; Fatigue; Neoplasms; Quality of Life
PubMed: 38281450
DOI: 10.1016/j.ijnurstu.2024.104694 -
Fatigue and Recovery Time Course After Female Soccer Matches: A Systematic Review And Meta-analysis.Sports Medicine - Open Jun 2022This study aimed to analyze the extent of fatigue responses after female soccer matches and the ensuing recovery time course of performance, physiological, and...
BACKGROUND
This study aimed to analyze the extent of fatigue responses after female soccer matches and the ensuing recovery time course of performance, physiological, and perceptual responses.
METHODS
Three databases (PubMed, Web of Science, and SPORTDiscus) were searched in October 2020 and updated in November 2021. Studies were included when participants were female soccer players, regardless of their ability level. Further, the intervention was an official soccer match with performance, physiological, or perceptual parameters collected pre- and post-match (immediately, 12 h, 24 h, 48 h, or 72 h-post).
RESULTS
A total of 26 studies (n = 465 players) were included for meta-analysis. Most performance parameters showed some immediate post-match reduction (effect size [ES] = - 0.72 to - 1.80), apart from countermovement jump (CMJ; ES = - 0.04). Reduced CMJ performance occurred at 12 h (ES = - 0.38) and 24 h (ES = - 0.42) and sprint at 48 h post-match (ES = - 0.75). Inflammatory and immunological parameters responded acutely with moderate-to-large increases (ES = 0.58-2.75) immediately post-match. Creatine kinase and lactate dehydrogenase alterations persisted at 72 h post-match (ES = 3.79 and 7.46, respectively). Small-to-moderate effects were observed for increased cortisol (ES = 0.75) and reduced testosterone/cortisol ratio (ES = -0.47) immediately post-match, while negligible to small effects existed for testosterone (ES = 0.14) and estradiol (ES = 0.34). Large effects were observed for perceptual variables, with increased fatigue (ES = 1.79) and reduced vigor (ES = - 0.97) at 12 h post-match, while muscle soreness was increased immediately post (ES = 1.63) and at 24 h post-match (ES = 1.00).
CONCLUSIONS
Acute fatigue exists following female soccer matches, and the performance, physiological, and perceptual parameters showed distinctive recovery timelines. Importantly, physical performance was recovered at 72 h post-match, whereas muscle damage markers were still increased at this time point. These timelines should be considered when planning training and match schedules. However, some caution should be advised given the small number of studies available on this population.
REGISTRATION
The protocol for this systematic review was pre-registered on the International Prospective Register of Systematic Reviews (PROSPERO, Registration Number: CRD42021237857).
PubMed: 35657571
DOI: 10.1186/s40798-022-00466-3 -
Acta Neurologica Belgica Apr 2022Multiple Sclerosis (MS) is a disease determined by inflammatory demyelination and neurodegeneration in the Central Nervous System (CNS). Despite the extensive... (Review)
Review
INTRODUCTION AND AIM
Multiple Sclerosis (MS) is a disease determined by inflammatory demyelination and neurodegeneration in the Central Nervous System (CNS). Despite the extensive utilization of Complementary and Alternative Medicine (CAM) in MS, there is a need to have comprehensive evidence regarding their application in the management of MS symptoms. This manuscript is a Systematic Literature Review and classification (SLR) of CAM therapies for the management of MS symptoms based on the International Classification of Functioning Disability and Health (ICF) model.
METHOD
Studies published between 1990 and 2020 IN PubMed, Science Direct, Scopus, Pro-Quest, and Google Scholar using CAM therapies for the management of MS symptoms were analyzed.
RESULTS
Thirty-one papers on the subject were analyzed and classified. The findings of this review clearly show that mindfulness, yoga, and reflexology were frequently used for managing MS symptoms. Moreover, most of the papers used mindfulness and yoga as a CAM therapy for the management of MS symptoms, which mostly devoted to mental functions such as fatigue, depression, cognition, neuromuscular functions such as gait, muscle strength, and spasticity, and sensory function such as balance, in addition to, reflexology is vastly used to management of mental functions of MS patients.
CONCLUSION
Evidence suggested that CAM therapies in patients with MS have the potential to target and enhancement numerous elements outlined in the ICF model. Although the use of CAM therapies in MS symptom management is promising, there is a need for strict clinical trials. Future research direction should concentrate on methodologically powerful studies to find out the potential efficacy of CAM intervention.
Topics: Complementary Therapies; Fatigue; Gait; Humans; Multiple Sclerosis; Muscle Strength
PubMed: 35060096
DOI: 10.1007/s13760-021-01847-3 -
The Cochrane Database of Systematic... Apr 2021Bronchiectasis is characterised by excessive sputum production, chronic cough, and acute exacerbations and is associated with symptoms of dyspnoea and fatigue, which... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Bronchiectasis is characterised by excessive sputum production, chronic cough, and acute exacerbations and is associated with symptoms of dyspnoea and fatigue, which reduce exercise tolerance and impair quality of life. Exercise training in isolation or in conjunction with other interventions is beneficial for people with other respiratory diseases, but its effects in bronchiectasis have not been well established.
OBJECTIVES
To determine effects of exercise training compared to usual care on exercise tolerance (primary outcome), quality of life (primary outcome), incidence of acute exacerbation and hospitalisation, respiratory and mental health symptoms, physical function, mortality, and adverse events in people with stable or acute exacerbation of bronchiectasis.
SEARCH METHODS
We identified trials from the Cochrane Airways Specialised Register, ClinicalTrials.gov, and the World Health Organization trials portal, from their inception to October 2020. We reviewed respiratory conference abstracts and reference lists of all primary studies and review articles for additional references.
SELECTION CRITERIA
We included randomised controlled trials in which exercise training of at least four weeks' duration (or eight sessions) was compared to usual care for people with stable bronchiectasis or experiencing an acute exacerbation. Co-interventions with exercise training including education, respiratory muscle training, and airway clearance therapy were permitted if also applied as part of usual care.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened and selected trials for inclusion, extracted outcome data, and assessed risk of bias. We contacted study authors for missing data. We calculated mean differences (MDs) using a random-effects model. We used the GRADE approach to assess the certainty of evidence.
MAIN RESULTS
We included six studies, two of which were published as abstracts, with a total of 275 participants. Five studies were undertaken with people with clinically stable bronchiectasis, and one pilot study was undertaken post acute exacerbation. All studies included co-interventions such as instructions for airway clearance therapy and/or breathing strategies, provision of an educational booklet, and delivery of educational sessions. The duration of training ranged from six to eight weeks, with a mix of supervised and unsupervised sessions conducted in the outpatient or home setting. No studies of children were included in the review; however we identified two studies as currently ongoing. No data were available regarding physical activity levels or adverse events. For people with stable bronchiectasis, evidence suggests that exercise training compared to usual care improves functional exercise tolerance as measured by the incremental shuttle walk distance, with a mean difference (MD) between groups of 87 metres (95% confidence interval (CI) 43 to 132 metres; 4 studies, 161 participants; low-certainty evidence). Evidence also suggests that exercise training improves six-minute walk distance (6MWD) (MD between groups of 42 metres, 95% CI 22 to 62; 1 study, 76 participants; low-certainty evidence). The magnitude of these observed mean changes appears clinically relevant as they exceed minimal clinically important difference (MCID) thresholds for people with chronic lung disease. Evidence suggests that quality of life improves following exercise training according to St George's Respiratory Questionnaire (SGRQ) total score (MD -9.62 points, 95% CI -15.67 to -3.56 points; 3 studies, 160 participants; low-certainty evidence), which exceeds the MCID of 4 points for this outcome. A reduction in dyspnoea (MD 1.0 points, 95% CI 0.47 to 1.53; 1 study, 76 participants) and fatigue (MD 1.51 points, 95% CI 0.80 to 2.22 points; 1 study, 76 participants) was observed following exercise training according to these domains of the Chronic Respiratory Disease Questionnaire. However, there was no change in cough-related quality of life as measured by the Leicester Cough Questionnaire (LCQ) (MD -0.09 points, 95% CI -0.98 to 0.80 points; 2 studies, 103 participants; moderate-certainty evidence), nor in anxiety or depression. Two studies reported longer-term outcomes up to 12 months after intervention completion; however exercise training did not appear to improve exercise capacity or quality of life more than usual care. Exercise training reduced the number of acute exacerbations of bronchiectasis over 12 months in people with stable bronchiectasis (odds ratio 0.26, 95% CI 0.08 to 0.81; 1 study, 55 participants). After an acute exacerbation of bronchiectasis, data from a single study (N = 27) suggest that exercise training compared to usual care confers little to no effect on exercise capacity (MD 11 metres, 95% CI -27 to 49 metres; low-certainty evidence), SGRQ total score (MD 6.34 points, 95%CI -17.08 to 29.76 points), or LCQ score (MD -0.08 points, 95% CI -0.94 to 0.78 points; low-certainty evidence) and does not reduce the time to first exacerbation (hazard ratio 0.83, 95% CI 0.31 to 2.22).
AUTHORS' CONCLUSIONS
This review provides low-certainty evidence suggesting improvement in functional exercise capacity and quality of life immediately following exercise training in people with stable bronchiectasis; however the effects of exercise training on cough-related quality of life and psychological symptoms appear to be minimal. Due to inadequate reporting of methods, small study numbers, and variation between study findings, evidence is of very low to moderate certainty. Limited evidence is available to show longer-term effects of exercise training on these outcomes.
Topics: Adult; Bias; Breathing Exercises; Bronchiectasis; Cough; Disease Progression; Dyspnea; Exercise; Exercise Tolerance; Hospitalization; Humans; Mental Health; Physical Endurance; Physical Functional Performance; Quality of Life; Respiration Disorders; Walk Test
PubMed: 33822364
DOI: 10.1002/14651858.CD013110.pub2 -
Respiratory Medicine 2023Exercise intolerance, muscle weakness, dyspnoea, and fatigue are frequent complications in symptomatic sarcoidosis patients. Pulmonary rehabilitation improves exercise... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exercise intolerance, muscle weakness, dyspnoea, and fatigue are frequent complications in symptomatic sarcoidosis patients. Pulmonary rehabilitation improves exercise capacity, symptoms, and quality of life in patients with chronic respiratory diseases. Our objective was to systematically determine the effects of pulmonary rehabilitation in patients with sarcoidosis.
METHODS
A systematic review was conducted in seven databases. Studies that applied pulmonary rehabilitation in patients with sarcoidosis were reviewed. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence.
RESULTS
Of the 406 reports returned by the initial search, five articles reporting on 184 patients were included in the data synthesis. Two studies included multi-component exercise, one inspiratory muscle training, one a physical activity incentivisation programme, and one a telerehabilitation program. In the intervention group (IG), we found significant improvement in exercise capacity (SMD 1.65, 95%CI 0.45, 2.86 points, p = 0.006). If we only analyse the studies that performed the 6-min walking test, the IG walked 40.3 (CI95% 20.3, 60.2) m higher than the control group (CG) (p < 0.001). Additionally, dyspnoea score was reduced (MD -0.42 95%CI -0.75, -0.10, p = 0.002). However, fatigue, quality of life and pulmonary function did not show any change.
CONCLUSION
Pulmonary rehabilitation could improve exercise capacity and dyspnoea perception in patients with sarcoidosis.
Topics: Humans; Quality of Life; Lung; Dyspnea; Sarcoidosis; Fatigue; Exercise Tolerance
PubMed: 37858728
DOI: 10.1016/j.rmed.2023.107432 -
Asian Pacific Journal of Cancer... Dec 2023Allogeneic hematopoietic cell transplantation (allo-HCT) serves as a potentially curative intervention for various hematologic disorders. However, its utility can be...
INTRODUCTION
Allogeneic hematopoietic cell transplantation (allo-HCT) serves as a potentially curative intervention for various hematologic disorders. However, its utility can be limited by the emergence of chronic graft-versus-host disease (cGVHD). The clinical manifestations of cGVHD result from a complex immune response characterized by the involvement of both B and T cells. Ibrutinib, a pharmacological agent, acts as an inhibitor of Bruton's tyrosine kinase (BTK) pathway, which becomes activated through the B-cell receptor and regulates B-cell survival. By exerting inhibitory effects on both BTK and inhibitor of interleukin-2 inducible T-cell kinase (ITK), ibrutinib exhibits promise as a therapeutic approach for managing cGVHD. Ibrutinib may be considered as a viable treatment option for active cGVHD in cases where patients exhibit an inadequate response to corticosteroid-based therapies. This systematic review seeks to assess the efficacy and safety of ibrutinib in the context of cGVHD patient management.
METHOD
We incorporated search engines from PubMed, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov. The study was performed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Assessing The Methodological Quality of Systematic Review (AMSTAR). We used Risk of Bias- 2 (RoB-2) tool for assess the risk of bias in randomized controlled studies (RCTs) and Newcastle Ottawa Scale (NOS) for observational and open-label studies.
RESULTS
A total of 7 studies were included in this study consisted of four open-label studies, two retrospective cohort studies, and one RCT study. These studies compared Ibrutinitib with standard therapies. Two studies investigated the pediatric population, and five studies investigated the adult population. Overall, these studies reported the overall response rate (ORR) of ibrutinib for cGVHD were 54%-78%. The results showed that in pediatric patients, the ORR were 54-78%. The results also showed that in adult patients, the ORR were 67%-76%. The most common adverse effects observed across the seven studies included pyrexia, diarrhea, abdominal pain, cough, nausea, stomatitis, vomiting, headache, bleeding and bruising, infection, muscle aches, fatigue, oral bleeding, elevated transaminases, lower gastrointestinal bleeding, persistent dizziness, sepsis, pneumonia, reduced platelet count, exhaustion, sleeplessness, peripheral edema, and fatigue.
CONCLUSION
The majority of studies have indicated that ibrutinib exhibits a high ORR and provides long-lasting responses, while also having manageable side effects.
Topics: Adult; Humans; Child; Bronchiolitis Obliterans Syndrome; Graft vs Host Disease; B-Lymphocytes; Fatigue
PubMed: 38156834
DOI: 10.31557/APJCP.2023.24.12.4025 -
Graefe's Archive For Clinical and... Dec 2022Ophthalmic surgery involves the manipulation of micron-level sized structures such as the internal limiting membrane where tactile sensation is practically absent. All... (Review)
Review
PURPOSE
Ophthalmic surgery involves the manipulation of micron-level sized structures such as the internal limiting membrane where tactile sensation is practically absent. All humans have physiologic tremors that are of low amplitude and not discernible to the naked eye; they do not adversely affect the majority of the population's daily functioning. However, during microsurgery, such tremors can be problematic. In this review, we focus on the impact of physiological tremors on ophthalmic microsurgery and offer a comparative discussion on the impact of such tremors on other surgical specialties.
METHODS
A single investigator used the MEDLINE database (via PubMed) to search for and identify articles for inclusion in this systematic review. Ten key factors were identified as potentially having an impact on tremor amplitude: beta-blockers, muscle fatigue, robotic systems, handheld tools/micromanipulators, armrests/wrist supports, caffeine, diet, sleep deprivation, consuming alcohol, and workouts (exercise). These key terms were then searched using the advanced Boolean search tool and operators (i.e., AND, OR) available on PubMed: (*keyword*) AND (surgeon tremor OR microsurgery tremor OR hand steadiness OR simulator score).
RESULTS
Ten studies attempted to quantify the baseline severity of operator physiologic tremor. Approximately 89% of studies accessing the impact of tremors on performance in regards to surgical metrics reported an improvement in performance compared to 57% of studies concluding that tremor elimination was of benefit when considering procedural outcomes.
CONCLUSIONS
Robotic technology, new instruments, exoskeletons, technique modifications, and lifestyle factors have all demonstrated the potential to assist in overcoming tremors in ophthalmology.
Topics: Humans; Tremor; Ophthalmology; Microsurgery; Robotics; Caffeine
PubMed: 35788893
DOI: 10.1007/s00417-022-05718-2 -
Human Movement Science Feb 2022Muscle fatigue is represented as a reduction in force production capability; however, fatigue does not necessarily result in performance impairments. As the distal upper...
Muscle fatigue is represented as a reduction in force production capability; however, fatigue does not necessarily result in performance impairments. As the distal upper limb serves as the end effector when interacting or manipulating objects, it is important to understand how muscle fatigue may impact motor functionality. The aim of this study was to systematically review the literature to identify how various aspects of motor performance of the distal upper limb are impaired following muscle fatigue. Four databases were searched using 23 search terms describing the distal upper limb, muscle fatigue, and various performance metrics. A total of 4561 articles were screened with a total of 28 articles extracted and critically appraised. Evidence extracted indicates that muscle fatigue results in unique impairments based on the type of motor performance being evaluated. Furthermore, much data suggests that muscle fatigue does not result in consistent, predictable performance impairments, particularly while performing submaximal tasks. Additionally, magnitude of fatigue does not directly correlate with reductions in performance outcomes at the hand and wrist. Fatiguing protocols used highlighted the importance of fatigue specificity. When fatiguing and performance tasks are similar, performance impairment is likely to be observed. The numerous muscles found in the hand and wrist, often considered redundant, play a critical role in maintaining task performance in the presence of muscle fatigue. The presence of motor abundance (e.g. multiple muscles with similar function) is shown to reduce the impairment in multiple performance metrics by compensating for reduced function of fatigued muscles. Continued exploration into various fatiguing protocols (i.e. maximal or submaximal) will provide greater insights into performance impairments in the distal upper limb.
Topics: Humans; Muscle Contraction; Muscle Fatigue; Muscle, Skeletal; Task Performance and Analysis; Upper Extremity; Wrist; Wrist Joint
PubMed: 34929434
DOI: 10.1016/j.humov.2021.102912 -
Diseases (Basel, Switzerland) Nov 2023Prolonged COVID is a persistent condition following the initial COVID-19 infection, which is characterized by a variety of symptoms that may include fatigue, muscle... (Review)
Review
Prolonged COVID is a persistent condition following the initial COVID-19 infection, which is characterized by a variety of symptoms that may include fatigue, muscle pain, sleep disturbances, "brain fog", respiratory, cardiovascular, digestive, neurological and dermatological symptoms. Physical therapy has been identified as a crucial aspect of the management of patients with long COVID, as it can help improve symptoms and overall physical function. The investigation of long COVID poses significant challenges due to the diversity and variability of symptoms, lack of clear diagnostic criteria, and limited understanding of the underlying mechanisms. The aim of this study is to conduct a systematic review of studies conducted in patients with long COVID in conjunction with interventions targeting respiratory function, particularly involving physical activity. To this end, we conducted a systematic review to analyze studies conducted on treatment programs for long COVID based on some form of physical activity. The protocol of the review was registered in the PROSPERO website, and the databases PubMed, Scopus, CINAHL and WOS were searched. Of the 62 initial articles, six were included in the review. The results obtained have positive implications for the advancement of physical activity as a therapeutic intervention for individuals with long COVID-19 and the conceptualization of evidence-based treatment protocols. Statistically significant results have been observed in studies of at least 6 weeks duration, in which inspiratory muscle training exercises are proposed. Further research is needed to better understand long COVID and develop effective treatment strategies.
PubMed: 37987274
DOI: 10.3390/diseases11040163