Patients with pacemakers need regular follow-ups which are demanding. Telemonitoring for pacemaker can provide a new opportunity to avoid follow-up visits. On the other hand, in-person visits could ...help patients with pacemakers to cope better with the anxiety linked to their condition and maintain better communication with their doctors than simple remote control of their device status. Therefore, our objective was to analyze the experiences and communication comparing telemonitoring (TM) versus conventional monitoring (CM) of patients with pacemakers. A single-center, controlled, non-randomized, non-blinded clinical trial was designed. Data were collected five years after implantation in a cohort of 89 consecutive patients assigned to two different groups: TM and CM. The 'Generic Short Patient Experiences Questionnaire' (GS-PEQ) was used to assess patients' experiences, and the Healthcare Communication Questionnaire (HCCQ) was used to measure the communication of patients with healthcare professionals. Additionally, an ad-hoc survey including items from the 'Telehealth Patient Satisfaction Survey' and a 'costs survey' was used. After five years, 55 patients completed the study (TM = 21; CM = 34). Participants' mean (±SD) age was 81 (±6.47), and 31% were females. No differences in baseline characteristics between groups were found. The comparative analyses TM versus CM showed some significant differences. According to GS-PEQ, TM users received adequate information about their diagnosis or afflictions (p = .035) and the treatment was better adapted to their situation (p = .009). Both groups reported negative experiences regarding their involvement in their treatment decisions, the waiting time before admission, and perceived a low-benefit. According to HCCQ, the TM group experienced poorer consultation management by the healthcare provider (p = .041). Participants reported positive overall communication experiences. The study provides insights into the experiences and communication in PM monitoring services as well as specific areas where users reported negative experiences such as the consultation management by clinicians. Trial registration: ClinicalTrials.gov NCT02234245.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Parkinson's disease (PD) is a neurodegenerative pathology classified as a movement disorder. Physical exercise within a physiotherapy program is an important element to improve postural stability, ...balance and mobility in order to reduce falls in people with PD. The aim of this work was to determine the efficacy of specific balance and trunk mobility exercises, as well as their benefits for and effects on patients with idiopathic PD. A systematic review and meta-analysis was conducted according to PRISMA standards. The search was performed in five databases: Cochrane Library, SciELO, PEDro, Scopus and PubMed, in February 2022 with the following descriptors: Parkinson's disease, trunk, exercise, therapy and physical therapy. The inclusion criteria were randomized controlled trials (RCTs) over the last ten years. A meta-analysis on static and dynamic balance was conducted with the software Review Manager. Nine articles met the objectives and inclusion criteria, with a total of 240 participants. The trials had moderate methodological quality according to the PEDro scale. The studies included differed with regard to intervention protocol and outcome measures. Finally, eight studies were included in a quantitative analysis in which it was shown that trunk-specific exercises interventions did not significantly improve static balance (SMD = -0.10, 95% CI = -0.29, 0.08;
= 0.28) or dynamic balance (SMD = 0.64 95% CI = -0.24, 1.52;
= 0.15). However, significant differences were found in static balance measured subjectively using the Berg Balance Scale (SMD = -0.52, 95% CI = -1.01, -0.02;
= 0.04). Although some differences were not significant, the studies included in this systematic review consider that specific trunk exercises or balance training combined with muscle strengthening in patients with idiopathic PD should be a complement to pharmacological treatment for improving balance dysfunction and postural instability, preventing falls and promoting wellness.
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease that, due to dyspnea, decreases patients’ physical function and quality of life. The aim of the research was to ...evaluate the effectiveness of water-based exercise (WE) in improving functional capacity and respiratory muscle strength in patients with COPD. It consisted of a systematic review and meta-analysis of eight randomized clinical trials (RCTs) from the last 10 years, found in PubMed, PEDro, Scopus and Web of Science databases. Methodological quality was analyzed using the PEDro scale and the Cochrane Collaboration Risk of Bias Tool. Regarding the evaluation of functional capacity, mainly assessed were lung function, respiratory muscle strength, and maximal or aerobic exercise. The results showed that WE improves functional capacity compared to a non-exercising control group (SMD: 73.42; IC 95%: 40.40 to 106.45; I2: 0%). There are no statistically significant differences between a WE treatment and a land exercise (LE) treatment (p = 0.24) in functional capacity, nor with respect to respiratory muscle strength (p = 0.97). These data should be interpreted with caution, as more RCTs with aquatic intervention in COPD patients are needed to elucidate whether there are differences between WE or LE according to patient characteristics and comorbidities.
The incidence of oropharyngeal dysphagia in Parkinson’s disease (PD) is very high. It is necessary to search for effective therapies that could prevent pneumonia. Previous results should be ...interpreted cautiously as there is a lack of evidence to support the use of compensatory or rehabilitative approaches to dysphagia. We reviewed the scientific literature to describe the treatments of dysphagia in PD. A systematic review was performed in PubMed, Scopus, Elsevier, and Medline according to PRISMA standards in 2018. The articles that did not mention dysphagia secondary to PD or used surgical treatment were excluded. Eleven articles met the criteria with information from 402 patients. The review relates to different protocols, such as training in expiratory muscle strength, postural techniques, oral motor exercises, video-assisted swallowing therapy, surface electrical stimulation, thermal stimulation, touch, compensatory interventions, training regime for swallowing, neuromuscular electrical stimulation, Lee Silverman voice treatment, swallow maneuver, airway protection, and postural compensation maneuvers. This review identifies the rationing interventions in each trial, if they are efficient and equitable. Several rehabilitative therapies have been successful. An improvement was seen in the degenerative function (coordination, speed, and volume), quality of life, and social relationships of people with PD. Further investigations concerning the clinical applicability of these therapies based on well-designed randomized controlled studies are needed. Larger patient populations need to be recruited to evaluate the effectiveness, long-term effects, and new treatment techniques.
Physical training at home by making individuals play active video games is a new therapeutic strategy to improve the condition of patients with cystic fibrosis (CF). We reviewed studies on the use of ...video games and their benefits in the treatment of CF. We conducted a systematic review with data from six databases (PubMed, Medline, Scopus, Web of Science, PEDro, and Cochrane library plus) since 2010, according to PRISMA standards. The descriptors were: "Cystic Fibrosis", "Video Game", "Gaming Console", "Pulmonary Rehabilitation", "Physiotherapy", and "Physical Therapy". Nine articles with 320 participants met the inclusion criteria and the study objective. Patients who played active video games showed a high intensity of exercise and higher ventilatory and aerobic capacity compared to the values of these parameters in tests such as the cardiopulmonary stress test or the six-minute walk test. Adequate values of metabolic demand in these patients were recorded after playing certain video games. A high level of treatment adherence and satisfaction was observed in both children and adults. Although the quality of the included studies was moderate, the evidence to confirm these results was insufficient. More robust studies are needed, including those on evaluation and health economics, to determine the effectiveness of the treatment.
The number of patients with post-COVID-19 syndrome continues to increase considerably, having serious healthcare, social and economic repercussions. The objective of this study is to describe the ...effectiveness of telerehabilitation to alleviate the symptoms of post-COVID-19 syndrome. A systematic review was conducted using the information available on four databases (PubMed, Medline, Scielo and PEDRo) on these patients until November 2022. The MeSH search terms were: Post-COVID syndrome, Post-COVID-19, Long COVID, Telerehabilitation, Physiotherapy, Rehabilitation, Virtual, Home care. Six articles were included which provided information on 140 patients, detailing their symptomatology, assessment, treatment and monitoring. The variables measured were dyspnea, fatigue, physical performance and quality of life. All studies included aerobic and anaerobic exercises. Most notable among the techniques used were rib cage expansion exercises, respiratory control and thoracic cage stretching, patient education, Mindfulness and virtual reality games to address physical, mental and relaxation aspects. The use of telerehabilitation could be an effective tool for the treatment of persistent symptoms after suffering from COVID-19. It has been shown in these studies that patients improve both their physical performance and their quality of life.
To compare home-based rehabilitation (RITH) and standard outpatient rehabilitation in a hospital setting, in terms of improving the functional recovery and quality of life of stroke patients.
This ...was a prospective cohort study in Andalusia (Spain).
One hundred and forty-five patients completed the outcome data.
Daily activities were measured by the Barthel index, Canadian Neurological Scale (to assess mental state), Tinetti scale (balance and gait), and Short Form Health Survey-36 (SF-36 to compare the quality of life).
No statistically significant differences were found between the two groups regarding the clinical characteristics of patients in the initial measurement, except for age and mental state (younger and with greater neurological impairment in the hospital group). After physical therapy, both groups showed statistically significant improvements from baseline in each of the measures. These improvements were better in RITH patients than in the hospital patients on all functionality scales with a smaller number of sessions.
Home rehabilitation is at least as effective as the outpatient rehabilitation programs in a hospital setting, in terms of recovery of functionality in post-stroke patients. Overall quality of life is severely impaired in both groups, as stroke is a very disabling disease that radically affects patients' lives.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Although the prevalence of gambling disorder (GD) and problem gambling has remained stable in recent years, the expansion of legalized gambling is considered a public health problem leading to ...significant personal, familial, and social impacts. This study aims to assess the effectiveness of various physiotherapy interventions on the symptoms of patients with GD. A systematic review following PRISMA guidelines was conducted in December 2022, using descriptors related to physiotherapy and GD in ten databases. Inclusion criteria were designed to identify clinical trials published in the last decade. Eight studies were identified, with a total of 357 patients, and the main variables measured were anxiety and depression symptoms, gambling craving, and gambling desire. The interventions included aerobic exercise, relaxation techniques, and non-invasive brain stimulation. Results suggest that physiotherapy may help with GD symptoms, although more research is needed to strengthen these findings. These findings highlight the potential of physiotherapy in treating GD and provide a basis for future research to better understand the effectiveness of these interventions.
The purpose of the study was to analyze homophobic trends and knowledge of sexual diversity among preschool education students in Chile in order to identify possible patterns of exclusion and ...discrimination towards the LGBTI community. Method. The research was quantitative, non-experimental, and cross-sectional. The sample consisted of 599 first to fifth-year students in preschool education training at 11 Chilean universities. Results. The results revealed that regarding knowledge of sex and gender (p < .001; moderate effect: 4.7%), data indicates that people with no religion or agnostics scored lower (6.75) compared to those who identify with a religion (7.60 and 7.98). The study's results show no significant differences in the variables of the questionnaire dimensions based on the type of university funding, the participants' education level, or the region where the university is located, but some significant differences were found in some variables. Discussion and conclusions. Regarding the differences found based on university funding, education level, and the participants' region of origin, it can be concluded that, in general, there are no major differences in the analyzed questionnaire dimensions. However, in some cases, a slight tendency towards the use of exclusionary language and the presence of hidden curricula of homophobia was observed, as well as the degree of knowledge about sexual identity and sex and gender.
La finalidad del estudio fue analizar las tendencias homofóbicas y los conocimientos sobre diversidad sexual en estudiantes de educación infantil en Chile, con el fin de identificar posibles patrones de exclusión y discriminación hacia la comunidad LGBTI. Método. La investigación fue de tipo cuantitativo, no experimental y de corte transversal. La muestra estuvo compuesta por 599 estudiantes de primer a quinto año de maestras en formación de educación infantil de 11 universidades chilenas. Resultados.Los resultados revelaron que en cuanto a los conocimientos sobre sexo y género (p<.001; efecto moderado: 4.7%), los datos indican que las personas sin religión o agnósticas obtuvieron puntuaciones más bajas (6.75) en comparación con las personas que se identifican con alguna religión (7.60 y 7.98). Los resultados del estudio muestran que no hay diferencias significativas en las variables de las dimensiones del cuestionario en función del tipo de financiación de las universidades, del nivel de estudios de los participantes ni de la región donde se encuentra la universidad, pero se encontraron algunas diferencias significativas en algunas variables. Discusión y conclusiones. En cuanto a las diferencias encontradas en función de la financiación de la universidad, el nivel de estudios y la región de origen de los encuestados, se puede concluir que, en general, no existen grandes diferencias en las dimensiones del cuestionario analizadas. Sin embargo, en algunos casos se observó una ligera tendencia en el uso de lenguaje excluyente y la presencia de currículum oculto de homofobia, así como en el grado de conocimiento sobre identidad sexual y sexo y género.