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A Randomized Study of Yoga for Fatigue and Quality of Life in Women with Breast Cancer Undergoing (Neo) Adjuvant Chemotherapy.
Jong, MC, Boers, I, Schouten van der Velden, AP, Meij, SV, Göker, E, Timmer-Bonte, ANJH, van Wietmarschen, HA
Journal of alternative and complementary medicine (New York, N.Y.). 2018;(9-10):942-953
Abstract
OBJECTIVES To compare the effectiveness of yoga added to standard care (SC) versus SC only, in women with breast cancer during chemotherapy. DESIGN A multicenter pragmatic, randomized controlled study. SETTINGS/LOCATION Three hospitals in the Netherlands. SUBJECTS Women with stage I-III breast cancer undergoing chemotherapy. INTERVENTIONS Women were randomized either to a program based on Dru Yoga, once a week yoga sessions for 12 weeks (N = 47), or SC only (N = 36). OUTCOME MEASURES Primary outcome fatigue (Multidimensional Fatigue Inventory [MFI]; general fatigue) and secondary outcomes fatigue (MFI, Fatigue Quality List [FQL]), quality of life (30-item Quality of Life Questionnaire-C of the European Organization for Research and Treatment of Cancer [EORTC-QLQ-C-30]) and psychological distress (Hospital Anxiety Depression Scale [HADS], Impact of Events Scale [IES]) were measured at baseline (T0), 3 months (T1), and 6 months (T2) and analyzed on observed cases. Other outcomes were adequate relief, reintegration to work, and adverse events. RESULTS No significant differences were found in general fatigue at T1 (MFI: yoga; 14.6 ± 4.5 vs. SC; 14.2 ± 4.2, p = 0.987). Similar findings were observed for other fatigue (sub)scales of MFI and FQL and functional domains of EORTC. With respect to EORTCs symptom scales, women in the yoga group reported significantly less nausea and vomiting compared with SC at T2 (p = 0.004), but not at T1 (p = 0.807). Depressive symptoms were significantly lower with yoga at T1 (HADS: yoga; 4.7 ± 4.1 vs. SC; 5.1 ± 4.2, p = 0.031). More women in the yoga group experienced adequate relief compared with SC at T1 (yoga; 51% vs. SC; 19%) and had returned to work at T2 (yoga; 53% vs. SC; 23%). No adverse events were reported with yoga. CONCLUSIONS A Dru-based yoga program failed to demonstrate a significant beneficial effect on fatigue. Possible favorable effects of the yoga program on nausea and vomiting and early return to work in breast cancer survivors warrant further research.
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The Influence of Post-Exercise Cold-Water Immersion on Adaptive Responses to Exercise: A Review of the Literature.
Broatch, JR, Petersen, A, Bishop, DJ
Sports medicine (Auckland, N.Z.). 2018;(6):1369-1387
Abstract
Post-exercise cold-water immersion (CWI) is used extensively in exercise training as a means to minimise fatigue and expedite recovery between sessions. However, debate exists around its merit in long-term training regimens. While an improvement in recovery following a single session of exercise may improve subsequent training quality and stimulus, reports have emerged suggesting CWI may attenuate long-term adaptations to exercise training. Recent developments in the understanding of the molecular mechanisms governing the adaptive response to exercise in human skeletal muscle have provided potential mechanistic insight into the effects of CWI on training adaptations. Preliminary evidence suggests that CWI may blunt resistance signalling pathways following a single exercise session, as well as attenuate key long-term resistance training adaptations such as strength and muscle mass. Conversely, CWI may augment endurance signalling pathways and the expression of genes key to mitochondrial biogenesis following a single endurance exercise session, but have little to no effect on the content of proteins key to mitochondrial biogenesis following long-term endurance training. This review explores current evidence regarding the underlying molecular mechanisms by which CWI may alter cellular signalling and the long-term adaptive response to exercise in human skeletal muscle.
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The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: A randomized controlled clinical trial.
Seyedi Chegeni, P, Gholami, M, Azargoon, A, Hossein Pour, AH, Birjandi, M, Norollahi, H
Complementary therapies in clinical practice. 2018;:64-70
Abstract
OBJECTIVE To assess the effect of progressive muscle relaxation (PMR) on fatigue and sleep quality of patients with chronic obstructive pulmonary disease (COPD) stages 3 and 4. MATERIALS AND METHODS The pretest posttest clinical trial recruited 91 patients COPD grades 3 and 4. Following random assignment of subjects, the treatment group (n = 45) performed PMR for eight weeks and the control group (n = 46) received routine cares. At baseline and after the intervention, fatigue and sleep quality was assessed. Data obtained were analyzed in SPSS. RESULTS It was determined that PMR decreased patients' fatigue level and improved some sleep quality subscales including subjective sleep quality, sleep latency, sleep duration and habitual sleep efficiency, but no improvement was found in global sleep quality and other sleep subscales. CONCLUSION An eight-week home-based PMR program can be effective in reducing fatigue and improving certain subscales of sleep quality in patients with COPD stages 3,4. (IRCT2016080124080N3).
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Long-term effects of prolonged-release fampridine in cognitive function, fatigue, mood and quality of life of MS patients: The IGNITE study.
Bakirtzis, C, Konstantinopoulou, E, Langdon, DW, Grigoriadou, E, Minti, F, Nikolaidis, I, Boziki, MK, Tatsi, T, Ioannidis, P, Karapanayiotides, T, et al
Journal of the neurological sciences. 2018;:106-112
Abstract
BACKGROUND Studies have reported conflicting results regarding the potential benefit of prolonged release (PR) fampridine in other domains besides walking. Moreover, only a small number of studies have explored long- term effects of PR fampridine. The aim of this study was to assess cognitive function, quality of life, mood and fatigue in MS patients treated with fampridine after 6 and 12 months of treatment. METHODS IGNITE was an observational, open label study. Subjects were examined with the timed 25-ft walk (T25FW) and the BICAMS battery and were asked to complete the Multiple Sclerosis Impact Scale (MSIS-29), Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory-II (BDI-II) and MS International Quality-of-Life questionnaire (MUSIQOL) at baseline and at weeks 24 and 48. Patients were sub-grouped into responders (n:40) and non-responders (n:20) according to T25FW performance after 2 weeks on treatment. RESULTS After 6 months, statistically significant improvement was observed on T25FW (p < .001), SDMT (p < .001) and MSIS29 (p < .001), for responders. After 1 year on treatment, statistically significant improvement was observed in T25FW (p < .001), MSIS29 (p = .004), SDMT (p < .001) and MUSIQOL (p = .03) for responders. There were no statistically significant improvements for the non-responders. CONCLUSIONS PR Fampridine may have a beneficial effect on information processing speed though not on memory. Study data provide some evidence that fampridine treatment may reduce the impact of MS on daily activities and improve quality of life but has no effect on subjective fatigue and mood.
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Validation of Gait Characteristics Extracted From Raw Accelerometry During Walking Against Measures of Physical Function, Mobility, Fatigability, and Fitness.
Urbanek, JK, Zipunnikov, V, Harris, T, Crainiceanu, C, Harezlak, J, Glynn, NW
The journals of gerontology. Series A, Biological sciences and medical sciences. 2018;(5):676-681
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Abstract
BACKGROUND Data collected by wearable accelerometry devices can be used to identify periods of sustained harmonic walking. This report aims to establish whether the features of walking identified in the laboratory and free-living environments are associated with each other as well as measures of physical function, mobility, fatigability, and fitness. METHODS Fifty-one older adults (mean age 78.31) enrolled in the Developmental Epidemiologic Cohort Study were included in the analyses. The study included an "in-the-lab" component as well as 7 days of monitoring "in-the-wild" (free living). Participants were equipped with hip-worn Actigraph GT3X+ activity monitors, which collect raw accelerometry data. We applied a walking identification algorithm and defined features of walking, including participant-specific walking acceleration and cadence. The association between these walking features and physical function, mobility, fatigability, and fitness was quantified using linear regression analysis. RESULTS Acceleration and cadence estimated from "in-the-lab" and "in-the-wild" data were significantly associated with each other (p < .05). However, walking acceleration "in-the-lab" was on average 96% higher than "in-the-wild," whereas cadence "in-the-lab" was on average 20% higher than "in-the-wild." Acceleration and cadence were associated with measures of physical function, mobility, fatigability, and fitness (p < .05) in both "in-the-lab" and "in-the-wild" settings. In addition, "in-the-wild" daily walking time was associated with fitness (p < .05). CONCLUSIONS The quantitative difference in proposed walking features indicates that participants may overperform when observed "in-the-lab." Also, proposed features of walking were significantly associated with measures of physical function, mobility, fatigability, and fitness, which provides evidence of convergent validity.
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Prolonged uninterrupted sitting increases fatigue in type 2 diabetes.
Dempsey, PC, Dunstan, DW, Larsen, RN, Lambert, GW, Kingwell, BA, Owen, N
Diabetes research and clinical practice. 2018;:128-133
Abstract
Fatigue is a prevalent, costly and disabling clinical complaint among those with type 2 diabetes. In a randomized crossover trial, prolonged uninterrupted sitting increased fatigue by 29% relative to days when sitting was regularly interrupted by brief activity-breaks. This may have implications for diabetes-related quality of life, occupational productivity and self-care.
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Could exercise improve mental health and cognitive skills for surgeons and other healthcare professionals?
Parry, DA, Oeppen, RS, Amin, MSA, Brennan, PA
The British journal of oral & maxillofacial surgery. 2018;(5):367-370
Abstract
Workplace-related illness is common in the UK, and in healthcare more than five million working days over 10years have been lost as a result. Occupational stress is well known and can affect clinicians at any stage, yet many healthcare professionals continue to work with this or other psychological problems (including anxiety, chronic fatigue, and burnout) as they do not wish to let their colleagues down. Mental health issues might be dismissed, particularly in surgery, because there is a misconception that surgeons can cope better with stress than those working in other specialties, and are better protected from clinical burnout. The benefit of exercise on physical health is clear, but its role in the maintenance of good mental health and well-being should not be underestimated. As society adopts an increasingly sedentary lifestyle, exercise for many has a lower priority than other activities. In this article we give an overview of the mental health issues that might affect doctors and surgeons, and explore how exercise can benefit our well-being and clinical performance.
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Enhancing daily well-being at work through lunchtime park walks and relaxation exercises: Recovery experiences as mediators.
Sianoja, M, Syrek, CJ, de Bloom, J, Korpela, K, Kinnunen, U
Journal of occupational health psychology. 2018;(3):428-442
Abstract
Only few studies so far have examined recovery from work during workday breaks. In this intervention study, based on the effort-recovery model and the conservation of resources theory, we examined how to enhance recovery during lunch breaks. More specifically, we examined the within-person effects of lunchtime park walks and relaxation exercises on employees' levels of concentration, strain, and fatigue experienced at the end of a working day. We moreover tested whether detachment from work and enjoyment experienced during lunch breaks transmitted the effects of these activities to well-being outcomes. Participants in the park walk (n = 51) and relaxation (n = 46) groups were asked to complete a 15-min exercise during their lunch break on 10 consecutive working days. Afternoon well-being, lunchtime detachment, and lunchtime enjoyment were assessed twice a week before, during, and after the intervention, altogether for 5 weeks. Multilevel analysis results showed that park walks at lunchtime were related to better concentration and less fatigue in the afternoon through enjoyment. Relaxation exercises were related to better concentration in the afternoon via detachment. In addition, relaxation exercises were directly linked to lower levels of strain and fatigue in the afternoon. Our study suggests that on days on which employees engage in recovering activities during lunch breaks, they experience higher levels of well-being at the end of a working day. These results add to the theory-based knowledge on recovery during workday breaks and highlight the importance of breaks for organizational practices. (PsycINFO Database Record
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Effect of Lavender cream with or without footbath on sleep quality and fatigue in pregnancy and postpartum: a randomized controlled trial.
Effati-Daryani, F, Mohammad-Alizadeh-Charandabi, S, Mirghafourvand, M, Taghizadeh, M, Bekhradi, R, Zarei, S
Women & health. 2018;(10):1179-1191
Abstract
Sleep disturbance and fatigue are frequent complaints during pregnancy and postpartum. We assessed the effectiveness of Lavender cream and footbath on sleep quality and fatigue in pregnancy and postpartum. In this trial, 141 women with sleep disturbance at 25-28 weeks gestation were recruited from public health centers in Tabriz, Iran, from May 2013 until January 2014 and randomized into one of three groups receiving: Lavender and footbath, Lavender alone, or placebo cream. Sleep quality was assessed using the Pittsburgh sleep quality index at the 4th and 8th weeks after intervention and the 6th week postpartum. Fatigue was assessed with the multidimensional assessment of fatigue scale at the 6th week after intervention and the 6th week postpartum. Repeated measures ANOVA and ANCOVA were used. Compared with the placebo group, the global sleep quality score post-intervention in pregnancy and the postpartum were significantly lower in the Lavender and footbath and the Lavender cream only groups. Fatigue in both intervention groups was significantly improved only at the 6th week postpartum. No statistically significant differences were observed between the two intervention groups. Lavender cream with or without footbath may improve sleep quality in pregnancy and postpartum.
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Rationale and design of technology assisted stepped collaborative care intervention to improve patient-centered outcomes in hemodialysis patients (TĀCcare trial).
Roumelioti, ME, Steel, JL, Yabes, J, Vowles, KE, Vodovotz, Y, Beach, S, Rollman, B, Weisbord, SD, Unruh, ML, Jhamb, M
Contemporary clinical trials. 2018;:81-91
Abstract
Most hemodialysis (HD) patients experience symptoms of depression, pain and fatigue that impair their health-related quality of life (HRQOL) significantly. These symptoms are associated with increased hospitalization and mortality, mediated by behavioral factors (e.g. non-adherence to medication and dialysis) and biological factors (e.g. inflammatory cytokines). Prior interventions to alleviate symptoms and improve HRQOL showed limited effectiveness in HD patients and their effect on bio-behavioral mediators is lacking evidence. It is imperative to improve patient-centered dialysis care and to address call from Kidney Disease Improving Global Outcomes (KDIGO) guidelines for integration of symptom assessment and management in routine HD-care. Technology-Assisted stepped Collaborative Care (TĀCcare) is a multi-center randomized controlled trial (RCT) of 150 diverse HD patients from Pennsylvania and New Mexico, designed to compare the effectiveness of a 12-week stepped collaborative care intervention (cognitive behavioral therapy, CBT) with an attention control arm of technology-delivered health education. Collaborative care provides an integrated multi-disciplinary structured management plan. Furthermore, a stepped approach to pharmacotherapy and/or CBT allows for individualization of treatment according to patients' clinical status, preferences and treatment response. To simplify the delivery of CBT and to minimize patient and provider burden, we will use live video-conferencing with patients in dialysis units. We will examine the effect of these interventions on patient symptoms, HRQOL, treatment adherence and inflammatory biomarkers. This RCT tests a readily implementable intervention that can be integrated in routine HD-care and will generate novel and meaningful insights on strategies to alleviate common symptoms and improve HRQOL in HD.