Effects on Sleep Quality of Physical Exercise Programs in Older Adults: A Systematic Review and Meta-Analysis

Exercise; Older adults; Sleep qualityEjercicio; Adultos mayores; Calidad de sueñoExercici; Adults grans; Qualitat del sonBackground: Given the beneficial effects of exercise in different populations and the close relationship between healthy ageing and sleep quality, our objective was to determine if physical exercise delivered through a structured program improves sleep quality in older adults. Methods: Embase, PubMed/MEDLINE, Web of Science, and Cochrane Register of Clinical Trials (CENTRAL) were searched to 15 January 2023. Studies that applied physical exercise programs in older adults were reviewed. Two independent reviewers analysed the studies, extracted the data, and assessed the quality of evidence. Results: Of the 2599 reports returned by the initial search, 13 articles reporting on 2612 patients were included in the data synthesis. The articles used interventions based on yoga (n = 5), multicomponent exercise (n = 3), walking (n = 2), cycling (n = 1), pilates (n = 1), elastic bands (n = 1), and healthy beat acupunch (n = 1). In the intervention group, we found significant improvement in Pittsburgh sleep quality index of −2.49 points (95% CI −3.84 to −1.14) in comparison to the control group (p = 0.0003) and sleep efficiency measured with objective instruments (MD 1.18%, 95% CI 0.86 to 1.50%, p < 0.0001). Conclusion: Our results found that physical exercise programs in older adults improve sleep quality and efficiency measured with objective instruments

Completeness of reporting acupuncture interventions for chronic obstructive pulmonary disease : Review of adherence to the STRICTA statement

The completeness of reporting of acupuncture interventions is critical to ensure the applicability and reproducibility of acupuncture clinical trials. In the past, different publications have evaluated the completeness of reporting of acupuncture interventions for different clinical situations, such as knee osteoarthritis, neurological diseases or cancer. However, this has not been done for acupuncture trials for chronic obstructive pulmonary disease (COPD). To assess the completeness of reporting of acupuncture interventions in trials for COPD. A total of 11 English and Chinese databases were screened up until May 2019 for randomised or quasi-randomised control trials of acupuncture for COPD. The STRICTA checklist was used to determine the quality of the reporting of acupuncture interventions. A total of 28 trials were included in our review. Out of the 16 STRICTA checklist subitems analysed, only 4 were considered appropriately reported in more than 70% of the trials, while 7 were correctly reported in less than 30%. The adherence to STRICTA guidelines of acupuncture trials for COPD is suboptimal, and future efforts need to be addressed to improve the completeness of reporting

Quality of reporting acupuncture interventions for chronic obstructive pulmonary disease : Review of adherence to the STRICTA statement

The quality of reporting of acupuncture interventions is critical to ensure the applicability and reproducibility of acupuncture clinical trials. In the past, different publications have evaluated the quality of reporting of acupuncture interventions for different clinical situations, such as knee osteoarthritis, neurological diseases or cancer. However, this has not been done for acupuncture trials for chronic obstructive pulmonary disease (COPD). To assess the quality of reporting of acupuncture interventions in trials for COPD. A total of 11 English and Chinese databases were screened up until May 2019 for randomised or quasi-randomised control trials of acupuncture for COPD. The STRICTA checklist was used to determine the quality of the reporting of acupuncture interventions. Results: A total of 28 trials were included in our review. Out of the 16 STRICTA checklist subitems analysed, only 3 were considered appropriately reported in more than 70% of the trials, while 7 were correctly reported in less than 40%. The adherence to STRICTA guidelines of acupuncture trials for COPD is suboptimal, and future efforts need to be addressed to improve the quality of reporting

Effectiveness of home-based exercise delivered by digital health in older adults : a systematic review and meta-analysis

regular physical exercise is essential to maintain or improve functional capacity in older adults. Multimorbidity, functional limitation, social barriers and currently, coronavirus disease of 2019, among others, have increased the need for home-based exercise (HBE) programmes and digital health interventions (DHI). Our objective was to evaluate the effectiveness of HBE programs delivered by DHI on physical function, health-related quality of life (HRQoL) improvement and falls reduction in older adults. systematic review and meta-analysis. community-dwelling older adults over 65 years. exercises at home through DHI. physical function, HRQoL and falls. twenty-six studies have met the inclusion criteria, including 5,133 participants (range age 69.5 ± 4.0-83.0 ± 6.7). The HBE programmes delivered with DHI improve muscular strength (five times sit-to-stand test, −0.56 s, 95% confidence interval, CI −1.00 to −0.11; P = 0.01), functional capacity (Barthel index, 5.01 points, 95% CI 0.24-9.79; P = 0.04) and HRQoL (SMD 0.18; 95% CI 0.05-0.30; P = 0.004); and reduce events of falls (odds ratio, OR 0.77, 95% CI 0.64-0.93; P = 0.008). In addition, in the subgroup analysis, older adults with diseases improve mobility (SMD −0.23; 95% CI −0.45 to −0.01; P = 0.04), and balance (SMD 0.28; 95% CI 0.09-0.48; P = 0.004). the HBE programmes carried out by DHI improve physical function in terms of lower extremity strength and functional capacity. It also significantly reduces the number of falls and improves the HRQoL. In addition, in analysis of only older adults with diseases, it also improves the balance and mobility

Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study

The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals’ competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.info:eu-repo/semantics/publishedVersio

Professional competences to promote healthy ageing across the lifespan: a scoping review

As societies age, the development of resources and strategies that foster healthy ageing from the beginning of life become increasingly important. Social and healthcare professionals are key agents in this process; therefore, their training needs to be in agreement with societal needs. We performed a scoping review on professional competences for social and health workers to adequately promote healthy ageing throughout life, using the framework described by Arksey and O’Malley and the Joanna Briggs Institute Guidelines. A stakeholder consultation was held in each of the participating countries, in which 79 experts took part. Results show that current literature has been excessively focused on the older age and that more attention on how to work with younger population groups is needed. Likewise, not all disciplines have equally refected on their role before this challenge and interprofessional approaches, despite showing promise, have not been sufciently described. Based on our results, health and social professionals working to promote healthy ageing across the lifespan will need sound competences regarding person-centred communication, professional communication, technology applications, physiological and pathophysiological aspects of ageing, social and environmental aspects, cultural diversity, programs and policies, ethics, general and basic skills, context and self-management-related skills, health promotion and disease prevention skills, educational and research skills, leadership skills, technological skills and clinical reasoning. Further research should contribute to establishing which competences are more relevant to each discipline and at what level they should be taught, as well as how they can be best implemented to efectively transform health and social care systems.info:eu-repo/semantics/publishedVersio

Effectiveness of acupuncture as a nonpharmacological intervention in the treatment of chronic obstructive pulmonary disease

Antecedents: La malaltia pulmonar obstructiva crònica (MPOC) és una afecció d'alta prevalença que afecta el 12% de la població mundial; és causada per una inflamació crònica de les vies respiratòries i els pulmons. Aquesta malaltia té un impacte important en la qualitat de vida del pacient a causa de la dispnea progressiva, tos crònica i producció d'esput, sibilàncies, opressió al pit i poca capacitat d'exercici. Encara que s'utilitzen diverses estratègies de tractament farmacològic i no farmacològic per als pacients amb MPOC, el maneig dels símptomes és insatisfactori en molts pacients i per tant, es necessiten noves estratègies. En els últims anys, s'han publicat diversos estudis que suggereixen que les tècniques d'acupuntura podrien ser beneficioses per als pacients amb MPOC; però l'evidència encara no és clara. A més, s'han trobat limitacions en la qualitat de la informació de les intervencions d'acupuntura en estudis anteriors en diferents afectacions com la artrosis de genoll, malalties neurològiques o càncer. Per tant, és important avaluar la qualitat de la informació dels assajos d'acupuntura sobre la MPOC per garantir una adequada avaluació, reproducció i implementació dels resultats dels assajos clínics. Mètodes: Aquest treball costa de tres publicacions incloent dues revisions sistemàtiques, que avaluen l'efectivitat de les tècniques d'acupuntura més comunament utilitzades, i una avaluació de la qualitat de la informació d'intervencions d'acupuntura en assajos de MPOC. Resultats: Les nostres dues revisions sistemàtiques van revelar beneficis d'algunes tècniques d'acupuntura en el maneig de el tractament de la MPOC. L'evidència suggereix beneficis de l'acupuntura amb agulla filiforme per a la dispnea, la capacitat d'exercici i la qualitat de vida i possiblement la acupressió per a la dispnea, la qualitat de vida i l'ansietat. No obstant això, l'evidència actual està limitada pel risc de biaix, l'heterogeneïtat i el baix nombre d'assaigs existents. Pel que fa a la qualitat de la informació de les intervencions d'acupuntura, observem una informació subòptima en diversos elements de la llista de verificació STRICTA, inclosa la profunditat d'inserció de l'agulla, el tipus d'agulla, el nombre de sessions de tractament, el entorn i el context de el tractament, la descripció de l'acupuntura i la justificació del control. Discussió: La investigació sobre les tècniques d'acupuntura comparteix algunes de les dificultats d'altres intervencions no farmacològiques, inclòs el baix nombre de participants, l'heterogeneïtat de la seva pràctica i les dificultats en el procés de cegament. Els investigadors han de ser conscients d'aquestes limitacions al dissenyar assajos futurs i triar els tipus d'intervenció i control més adequats d'acord amb la seva pregunta de recerca específica. Les deficiències en la qualitat de la informació és un altre tema que s'ha de millorar, tant pel que fa a la metodologia dels assajos com a la descripció de la intervenció. Aquesta manca d'informació no només dificulta l'avaluació de el risc de biaix de l'assaig, sinó que també dificulta l'avaluació i reproducció adequades de la de l'assaig. Conclusions: Hi ha alguna evidència que l'acupuntura mitjançant agulla filiforme i la acupressió podrien ser útils en el tractament de la MPOC. Per altres intervencions, l'evidència és incerta. Calen investigacions futures de més qualitat amb millores en la qualitat de la informació per tenir estimacions més fiables dels efectes de la tècnica d'acupuntura en pacients amb MPOC i permetre una recomanació sòlida pel que fa a l'ús de l'acupuntura.Antecedentes: La enfermedad pulmonar obstructiva crónica (EPOC) es una afección de alta prevalencia que afecta al 12% de la población mundial y està causada por una inflamación crónica de las vías respiratorias y los pulmones. Esta enfermedad tiene un impacto importante en la calidad de vida del paciente al causar disnea progresiva, tos crónica y producción de esputo, sibilancias, opresión en el pecho y poca capacidad de ejercicio. Aunque se utilizan varias estrategias de tratamiento farmacológico y no farmacológico para los pacientes con EPOC, el manejo de los síntomas es insatisfactorio en muchos pacientes y por tanto, se necesitan nuevas estrategias. En los últimos años, se han publicado varios estudios que sugieren que las técnicas de acupuntura podrían ser beneficiosas para los pacientes con EPOC; sin embargo, la evidencia aún no es clara. Además, se han encontrado limitaciones en la calidad de la información de las intervenciones de acupuntura en estudios anteriores en diferentes afecciones clínicas como la artrosis de rodilla, enfermedades neurológicas o cáncer. Por lo tanto, es importante evaluar la calidad de la información de los ensayos de acupuntura en EPOC para garantizar una adecuada evaluación, reproducción e implementación de los resultados de los estudios. Métodos: Este trabajo costa de tres publicaciones incluyendo dos revisiones sistemáticas que evalúan la efectividad de las técnicas de acupuntura más comúnmente utilizadas, y una evaluación sobre la calidad de la información de intervenciones de acupuntura en ensayos de EPOC. Resultados: Nuestras dos revisiones sistemáticas revelaron beneficios de algunas técnicas de acupuntura en el manejo del tratamiento de la EPOC. La evidencia sugiere beneficios de la acupuntura con aguja filiforme para la disnea, la capacidad de ejercicio y la calidad de vida y posiblemente la acupresión para la disnea, la calidad de vida y la ansiedad. Sin embargo, la evidencia actual está limitada por el riesgo de sesgo, la heterogeneidad y el bajo número de ensayos existentes. Con respecto a la calidad de la información de las intervenciones de acupuntura, observamos una información subóptima en varios elementos de la lista de verificación STRICTA, incluida la profundidad de inserción de la aguja, el tipo de aguja, el número de sesiones de tratamiento, el entorno y el contexto del tratamiento, la descripción del acupunturista y la justificación del control. Discusión: La investigación sobre las técnicas de acupuntura comparte algunas de las dificultades de otras intervenciones no farmacológicas, incluido el bajo número de participantes, la heterogeneidad de su práctica y las dificultades en el proceso de cegamiento. Los investigadores deben ser conscientes de esas limitaciones al diseñar ensayos futuros y elegir los tipos de intervención y control más adecuados de acuerdo con su pregunta de investigación específica. Las deficiencias en la calidad de la información es otro tema que debe mejorarse, tanto en lo que respecta a la metodología de los ensayos como a la descripción de la intervención. Esta falta de información no solo dificulta la evaluación del riesgo de sesgo del ensayo, sino que también dificulta la evaluación y reproducción adecuadas de la del ensayo. Conclusiones: Existe alguna evidencia de que la acupuntura mediante aguja filiforme y la acupresión podrían ser útiles en el tratamiento de la EPOC. Para otras intervenciones, la evidencia es incierta. Se necesitan investigaciones futuras de mayor calidad con mejoras en la calidad de la información para tener estimaciones más confiables de los efectos de la técnica de acupuntura en pacientes con EPOC y permitir una recomendación sólida con respecto al uso de la acupuntura.Background: Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition, affecting 12% of the global population; it is caused by chronic airway and lung inflammation. This disease has an important impact on patient quality of life by causing progressive dyspnoea, chronic cough and sputum production, wheezing, chest tightness and poor exercise capacity. Although several pharmacological and non-pharmacological treatment strategies are used for COPD patients, they only aim to reduce the progression of the disease and control symptoms as much as possible. However, symptom management is till unsatisfactory in many patients and therefore new strategies are needed. Acupuncture is a therapeutic technique that originated from traditional Chinese medicine. It uses several stimulation methods, most of them non-pharmacologic, and has been traditionally used to treat multiple diseases, including respiratory conditions such as COPD. In recent years, several studies have been published suggesting that acupuncture techniques could be beneficial to COPD patients; however, the evidence is still not clear. Moreover, limitations on the completeness of reporting of acupuncture interventions have been found in past trials in different clinical health conditions, such as knee osteoarthritis, neurological diseases or cancer. Therefore, it is important to assess the current completeness of reporting of acupuncture trials on COPD to ensure the proper assessment, replication and implementation of the results of clinical trials. Methods: This work resulted in three publications on this topic, including two systematic reviews assessing the effectiveness of the most common used acupuncture techniques and an assessment on the completeness of reporting of acupuncture interventions in COPD trials. Results: Our two systematic reviews revealed benefits for some acupuncture techniques in the management of COPD treatment. Evidence suggests benefits of filiform needle acupuncture for dyspnoea exercise capacity and quality of life and possibly for acupressure for dyspnoea, quality of life and anxiety. However, the current evidence is limited by the risk of bias, heterogeneity and low number of existing trials. Regarding the completeness of reporting of acupuncture interventions, we observed suboptimal reporting in several items of the STRICTA checklist, including needling insertion depth, needle type, number of treatment sessions, setting and context of the treatment, description of the acupuncturist and control rationale. Discussion: Although acupuncture techniques have been used for decades in China to treat lung diseases such as COPD, current evidence regarding its efficacy is still limited. Research into acupuncture techniques share some of the difficulties of other non-pharmacological interventions, including low number of participants, the heterogeneity of its practice and difficulties in the blinding process. Researchers must be aware of those limitations when designing future trials, and choose the most adequate intervention and control types according to their specific research question. Deficiencies in acupuncture publications reporting is another issue that needs to be improved, both regarding the trials methodology and the intervention description. This lack of information does not only stifle the assessment of the trial&#8217;s risk of bias, but also hinders the adequate assessment and reproduction of acupuncture research. Reporting guidelines such as CONSORT and STRICTA must be used to guarantee proper reporting in the published papers. Conclusions: There is some evidence that filiform needle acupuncture and acupressure could be helpful in the treatment of COPD. For other interventions, the evidence is unclear. Future large high-quality research with better reporting is needed to have more reliable estimates of acupuncture technique effects in COPD patients to allow solid recommendation regarding acupuncture use.Universitat Autònoma de Barcelona. Programa de Doctorat en Metodologia de la Recerca Biomèdica i Salut Públic

Acupoint transcutaneous electrical nerve stimulation in hospitalized COPD patients with severe dyspnoea: study protocol for a randomized controlled trial

Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of hospital admissions and dyspnoea is its main symptom. Some studies have concluded that a new modality of acupuncture, called acupoint transcutaneous electrical nerve stimulation (acuTENS), could reduce dyspnoea in patients with COPD by increasing β-endorphin levels. However, those trials have been conducted mainly on patients in stable condition. This study aims to determine whether the administration of acuTENS can reduce dyspnoea in patients hospitalized for AECOPD. Methods A multicentre randomized control trial with blinding of participants and assessors will be conducted. A sample of 60 patients will be randomly assigned to receive 45 min of either real acuTENS or sham acuTENS treatment once a day for five consecutive days. The trial will be conducted at the “Hospital del Mar” in Barcelona (Spain) and the “Hospital Sant Joan de Déu de Manresa” in Manresa (Spain). The Borg scale at baseline and days 1 to 5 will be the primary outcome. Secondary outcomes will be the duration of the hospitalization, quantity of drugs administrated, expiratory peak flow adverse effects and mortality and readmissions at 3 months. Discussion AcuTENS is a non-pharmacological, non-invasive and inexpensive intervention. This trial will help to elucidate the potential role of acuTENS in the treatment of AECOPD

Acupoint Transcutaneous Electrical Nerve Stimulation in Hospitalized COPD Patients with Severe Dyspnoea: A Randomized Controlled Trial

Objective To evaluate the effect of acupuncture transcutaneous electrical nerve stimulation (acuTENS) on the reduction of dyspnoea during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A multicentric randomized control trial with masked patients and evaluators was carried out. During hospitalization, AECOPD patients received 45 min of acuTENS (experimental group) or sham acuTENS (controls) daily on 5 consecutive days. The trial was conducted at the Hospital del Mar, Barcelona, and Hospital Sant Joan de Déu, Manresa (both in Spain). Dyspnoea and peak expiratory flow were measured daily from the first to fifth days. Length of stay, readmissions at 3 months and adverse events were also analysed. Results Finally, 19 patients with moderately to severely exacerbated COPD were included. Although some tendencies in dyspnoea during day 1 and length of hospital stay were found favouring acupuncture, no significant differences were shown between groups. Conclusions The acuTENS intervention was feasible#well tolerated in AECOPD patients and no important side effects were reported

Interventions across the retirement transition for improving well-being: a scoping review protocol

Introduction The work-to-retirement transition involves a process of psychologically and behaviourally distancing oneself from the workforce that is often accompanied by other social changes. The person is confronted with new social roles, expectations, challenges and opportunities that can influence lifestyle and well-being. In the scientific literature, we find recent reports of interventions aimed at improving health and well-being in people at retirement age. However, there is still a gap of knowledge on how different interventions during retirement might improve health status. We intend to conduct a scoping review with the aim of describing interventions for improving wellbeing across the retirement transition. Methods and analysis The methodological framework described by Arksey and O’Malley; the Joanna Briggs Institute guidelines as well as the Preferred Reporting Items for scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols statements will be followed. Eligibility criteria comprise of: (a) all type of original studies, review articles or reports published on journals as well as grey literature; (b) describing interventions to improve the well-being in adults across their retirement transition; (c) including participants before, during and after retirement; (d) all publications must describe variables associated with participants’ physical and/or psychological and/or social well-being and/or perceived quality of life related to these; (e) no language restriction and (f) published from January 2000 to March 2019. The main findings will be summarised using a narrative descriptive synthesis approach and grouped following the population, concept and context principles. A stakeholder meeting will be held to provide feedback on the findings and to develop next steps in research and practice. Ethics and dissemination Approval from a research ethics committee is not required, as no personal information will be collected. We plan to disseminate our research findings at different levels: scientific community, clinical and social arenas, as well as to healthcare leaders and policymakers and general population. The project has been registered at Open Science Framework with the name TRANSITS: work to retirement transition project