60 research outputs found
Swallowing after Oral Oncological Treatment: A Five-Year Prospective Study
Background: Swallowing rehabilitation in curative treated patients with oral cancer is still
a challenge. Different factors may influence these patients’ swallowing function. The aim of this
study was to identify factors associated with swallowing function up to 5 years after cancer treatment.
Methods: Swallowing duration and frequency of 5 mL water and 15 mL applesauce were measured
in 123 patients treated for oral cancer. Mixed model analyses were performed to identify associated
factors. Results: Age influenced all measured swallowing outcomes. Assessment moment, gender,
tumor location, maximum tongue force, and tactile sensory function of the tongue were associated
with both water and applesauce swallowing duration, tumor classification was associated with water
swallowing duration, and alcohol consumption was associated with applesauce swallowing duration.
Assessment moment, cancer treatment, maximum tongue force, and tactile sensory function of the
tongue were associated with water and applesauce swallowing frequency. Conclusion: Patients who
are older at diagnosis, women, and patients who regularly consume alcohol before their treatment
may have poorer swallow functioning after curative oral cancer treatment. Patients that fit these
criteria should have their swallowing evaluated during clinical follow-ups and sent to swallowing
therapy when needed. During this therapy, optimizing tongue function needs attention to maintain
an optimal swallowing function
Effectiveness of Core Stability Exercises and Recovery Myofascial Release Massage on Fatigue in Breast Cancer Survivors: A Randomized Controlled Clinical Trial
The purpose of the present paper was to evaluate the effects of an 8-week multimodal program focused on core stability exercises and recovery massage with DVD support for a 6-month period in physical and psychological outcomes in breast cancer survivors. A randomized controlled clinical trial was performed. Seventy-eight (n = 78) breast cancer survivors were assigned to experimental (core stability exercises plus massage-myofascial release) and control (usual health care) groups. The intervention period was 8 weeks. Mood state, fatigue, trunk curl endurance, and leg strength were determined at baseline, after the last treatment session, and at 6 months of followup. Immediately after treatment and at 6 months, fatigue, mood state, trunk curl endurance, and leg strength exhibited greater improvement within the experimental group compared to placebo group. This paper showed that a multimodal program focused on core stability exercises and massage reduced fatigue, tension, depression, and improved vigor and muscle strength after intervention and 6 months after discharge
Exploring predictors of dysphagia in survivors of head and neck cancer: A cross‑sectional study
Purpose To evaluate the prevalence of dysphagia in survivors of head and neck cancer (sHNC) and to identify the predictors
contributing to the development of dysphagia.
Methods We enrolled 62 sHNC in a cross-sectional study to check the prevalence of dysphagia in sHNC and to evaluate
which factors were influencing the presence of this side effect. Besides dysphagia, sociodemographic and clinical characteristics,
oral symptoms, maximal mouth opening (MMO), sleep quality and physical condition were evaluated, and a linear
regression analysis was performed to verify which of these outcomes impact dysphagia.
Results Among all the sHNC, 85.5% presented dysphagia. The linear regression analysis confirmed that 44.9% of the variance
in dysphagia was determined by coughing, MMO and sleep quality, being MMO the most powerful predictor, followed
by coughing and sleep quality.
Conclusion Dysphagia affected the great majority of sHNC. Moreover, symptoms as coughing, reduced MMO and sleep
disorders may act as predictors contributing to the development of dysphagia. Our results emphasize the importance of an
early and proper identification of the symptoms as well as an adequate treatment strategy to address the cluster of symptoms
that sHNC undergo.Funding for open access publishing: Universidad de Granada/CBUA.Consejería de Salud, Junta
de Andalucía (PI-0187–2021 and PI-0171–2020)European Regional Development Fund (ERDF-FEDER
A Blended Learning System to Improve Motivation, Mood State, and Satisfaction in Undergraduate Students: Randomized Controlled Trial
Background: Smartphone-based learning, or mobile learning (m-learning), has become a popular learning-and-teaching strategy
in educational environments. Blended learning combines strategies such as m-learning with conventional learning to offer
continuous training, anytime and anywhere, via innovative learning activities.
Objective: The main aim of this work was to examine the short-term (ie, 2-week) effects of a blended learning method using
traditional materials plus a mobile app—the iPOT mobile learning app—on knowledge, motivation, mood state, and satisfaction
among undergraduate students enrolled in a health science first-degree program.
Methods: The study was designed as a two-armed, prospective, single-blind, randomized controlled trial. Subjects who met
the inclusion criteria were randomly assigned to either the intervention group (ie, blended learning involving traditional lectures
plus m-learning via the use of the iPOT app) or the control group (ie, traditional on-site learning). For both groups, the educational
program involved 13 lessons on basic health science. The iPOT app is a hybrid, multiplatform (ie, iOS and Android) smartphone
app with an interactive teacher-student interface. Outcomes were measured via multiple-choice questions (ie, knowledge), the
Instructional Materials Motivation Survey (ie, motivation), the Profile of Mood States scale (ie, mood state), and Likert-type
questionnaires (ie, satisfaction and linguistic competence).
Results: A total of 99 students were enrolled, with 49 (49%) in the intervention group and 50 (51%) in the control group. No
difference was seen between the two groups in terms of theoretical knowledge gain (P=.92). However, the intervention group
subjects returned significantly higher scores than the control group subjects for all postintervention assessed items via the motivation
questionnaire (all P<.001). Analysis of covariance (ANCOVA) revealed a significant difference in the confusion and bewilderment
component in favor of the intervention group (P=.01), but only a trend toward significance in anger and hostility as well as total
score. The intervention group subjects were more satisfied than the members of the control group with respect to five out of the
six items evaluated: general satisfaction (P<.001), clarity of the instructions (P<.01), clarity with the use of the learning method
(P<.001), enough time to complete the proposed exercises (P<.01), and improvement in the capacity to learn content (P<.001).
Finally, the intervention group subjects who were frequent users of the app showed stronger motivation, as well as increased
perception of greater gains in their English-language competence, than did infrequent users.Educational Innovation Unit of the University of Granada, Spain
16-54University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES
The effects of myofascial induction therapy in survivors of head and neck cancer: a randomized, controlled clinical trial
Purpose We aim to evaluate the effects of myofascial induction therapy (MIT) on the sequelae suffered by the survivors of
HNC (sHNC).
Methods We enrolled 46 sHNC in a randomized controlled trial (RCT), of whom 20 received a MIT protocol and 23 were
placed on a waitlist while receiving the recommended treatment for 6 weeks. The MIT protocol included a total of 18 sessions,
3 days a week on alternate days for 6 weeks. Maximal mouth opening, the presence of temporomandibular dysfunction,
cervical endurance, active range of motion (AROM), shoulder AROM, handgrip strength, and perceived physical fitness
were assessed.
Results Maximal mouth opening, temporomandibular dysfunction, cervical endurance, and AROM, affected shoulder abduction
and unaffected shoulder flexion and external rotation significantly improved (p < .05) after an MIT protocol, but only
cervical AROM and affected shoulder abduction changes were clinically meaningful. No statistically significant changes
were observed in the other shoulder AROM, handgrip strength, or physical fitness perception (p > .05).
Conclusion A 6-week MIT protocol improves mouth opening, TMD, cervical function (endurance and AROM), affected
shoulder abduction and unaffected shoulder flexion, and external rotation AROM in the sHNC. However, no changes were
observed in most of the shoulder AROM, muscular strength, or perceived physical fitness. Future studies should perform
longer follow-up designs, increase the sample size, and include multimodal treatments to address these sequelae in the sHNC.Fondos Estructurales de la Union Europea (FEDER)University of Granada, Excellence Actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES)Junta de Andalucia PI-0171-2020 CSy
Una sesión de Reiki en enfermeras diagnosticadas con síndrome de Burnout tiene efectos beneficiosos sobre la concentración de IgA salival y la presión arterial
This study aimed to investigate the immediate effects of the secretory immunoglobulin A (sIgA), α-amylase activity and blood pressure levels after the application of a Reiki session in nurses with Burnout Syndrome. A randomized, double-blind, placebo-controlled, crossover design was conducted to compare the immediate effects of Reiki versus control intervention (Hand-off sham intervention) in nurses with Burnout Syndrome. Sample was composed of eighteen nurses (aged 34-56 years) with burnout syndrome. Participants were randomly assigned to receive either a Reiki treatment or a placebo (sham Reiki) treatment, according to the established order in two different days. The ANOVA showed a significant interaction time x intervention for diastolic blood pressure (F=4.92, P=0.04) and sIgA concentration (F=4.71, P=0.04). A Reiki session can produce an immediate and statistically significant improvement in sIgA concentration and diastolic blood pressure in nurses with Burnout Syndrome.El objetivo fue investigar los efectos inmediatos en inmunoglobulina A salival (IgAs), actividad de α-amilasa y presión arterial de una aplicación de reiki en enfermeras sufriendo síndrome de Burnout. Se utilizó un ensayo preliminar placebo randomizado con cegamiento doble utilizando un diseño cruzado. Dieciocho enfermeras (edad 34-56) con síndrome de Burnout participaron en el estudio. Las participantes recibieron tratamiento con Reiki o Reiki fingido según el orden establecido por la randomización en dos días distintos. El test de ANOVA mostró un interacción significativa momento intervención para la presión arterial diastólica (F=4.92, P=0.04) a y la concentración de sIgA (F=4.71, P=0.04). Una sesión de Reiki de 30 minutos puede mejorar de manera inmediata la respuesta de IgAs y la presión arterial diastólica en enfermeras con síndrome de Burnout.O objetivo deste estudo foi investigar os efeitos imediatos na imunoglobulina A salivar (IgAs), na atividade de α-amilase e na pressão arterial, após uma aplicação de Reiki em enfermeiras que sofrem da síndrome de Burnout. Foi realizado ensaio clínico randomizado duplo-cego e placebo controlado, com desenho cruzado. Dezoito enfermeiras (idade entre 34 e 56 anos), com síndrome de Burnout, participaram do estudo. As participantes receberam tratamento com Reiki ou Reiki falso, de acordo com a ordem estabelecida, através da randomização em dois dias distintos. O teste de Anova mostrou interação significativa entre o momento da intervenção e a pressão arterial diastólica (F=4,92, p=0,04) e os níveis de sIgA (F=4,71, p=0,04). Conclui-se que uma sessão de Reiki de 30 minutos pode melhorar de forma imediata a resposta de IgAs e da pressão arterial diastólica em enfermeiras com síndrome de Burnout
Myofascial Induction Therapy Improves the Sequelae of Medical Treatment in Head and Neck Cancer Survivors: A Single-Blind, Placebo-Controlled, Randomized Cross-Over Study
Head and neck cancer (HNC) is the sixth most common cancer worldwide. Yet, less than
60% of HNC survivors receive adequate therapy for treatment-related sequelae. The objective of this
study was to determine the efficacy of myofascial induction therapy (MIT) in improving cervical and
shoulder pain and range of motion, maximal mouth opening, and cervical muscle function in HNC
survivors. This crossover, blinded, placebo-controlled study involved 22 HNC survivors (average
age 56.55 ± 12.71) of which 13 were males (59.1%) who received, in a crossover fashion, both a single
30-min session of MIT in the form of manual unwinding and simulated pulsed shortwave therapy
(placebo), with a 4-week washout interval between the two. Cervical and shoulder pain (visual
analogue scale) and range of motion (cervical range of motion device and goniometer), maximum
mouth opening (digital caliper), and cervical muscle function (deep cervical flexor endurance test)
were measured before and after the treatment and placebo sessions. A single session of MIT improved
cervical and affected side shoulder pain, cervical range of motion, maximum mouth opening, and
cervical muscle function. The associated effect sizes ranged from moderate to large. The present
study suggests that MIT, in the form of manual unwinding, improves cervical (−3.91 ± 2.77) and
affected-side shoulder (−3.64 ± 3.1) pain, cervical range of motion (flexion: 8.41 ± 8.26 deg; extension:
12.23 ± 6.55; affected-side rotation: 14.27 ± 11.05; unaffected-side rotation: 11.73 ± 8.65; affectedside lateroflexion: 7.95 ± 5.1; unaffected-side lateroflexion: 9.55 ± 6.6), maximum mouth opening
(3.36 ± 3.4 mm), and cervical muscle function (8.09 ± 6.96 s) in HNC survivors.European Regional Development Fund (ERDF) and the
“University of Granada, Excellence Actions: Units of Excellence; Unit of Excellence on Exercise
and Health (UCEES)” programUniversity of Granada: “Proyectos de Investigación Precompetitivos
para Jóvenes Investigadores. Plan Propio 2020” Code: PPJIA2020.15
Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study
Background: Patients often experience pain as a result of a stroke. However, the mechanism
of this pain remains uncertain. Our aim was to investigate the relationship between pressure pain
thresholds (PPTs) and disability pain in patients with hemiplegic shoulder pain (HSP). Methods:
Twenty-six post-stroke patients (age 53.35 +/- 13.09 years) and healthy controls (54.35 +/- 12.37 years)
participated. We investigated spontaneous shoulder pain, disability pain perception through the
shoulder pain and disability index (SPADI), and the PPTs over joint C5–C6, upper trapezius, deltoid,
epicondyle, second metacarpal, and tibialis anterior, bilaterally. Results: The analysis of variance
(ANOVA) showed significant differences in pain between groups (p < 0.001) and differences in the
SPADI (p < 0.001) between groups but not between sides for PPTs over deltoid (group: p = 0.007;
side: p = 0.750), epicondyle (group: p = 0.001; side: p = 0.848), and tibialis anterior (group: p < 0.001;
side: p = 0.932). Pain in the affected arm was negatively associated with PPTs over the affected
epicondyle (p = 0.003) and affected tibialis anterior (p = 0.009). Pain (SPADI) appeared negatively
correlated with PPTs over the affected epicondyle (p = 0.047), and disability (SPADI) was negatively
associated with PPTs over the affected tibialis anterior (p = 0.041). Conclusions: Post-stroke patients
showed a relationship between widespread pressure pain hypersensitivity with lower PPT levels and
pain disability perception, suggesting a central sensitization mediated by bilateral and symmetric
pain patterns
Therapeutic Benefits of Balneotherapy on Quality of Life of Patients with Rheumatoid Arthritis: A Systematic Review
This paper has external funding for publication from the "Catedra Hammam Al Andalus I + D + I en Bienestar Humano" (Hammam Al Andalus Chair in Human Well-being), University of Granada, Spain.Background: Rheumatoid arthritis (RA) is the most common inflammatory rheumatic
disease. RA symptoms make the disease disabling and strongly impact the quality of life of patients.
Among the available forms of treatment, balneotherapy seems to be one of the most common forms
of nonpharmacological treatment for rheumatic disease. The aim was to explore the effectiveness
of balneotherapy for improving the quality of life of patients with RA. Methods: Pubmed, Scopus,
Web of Science and The Cochrane library were searched for randomized or clinical controlled trials
published in English or Spanish until May 2021. Risk of bias of included articles were assessed using
the Cochrane tool. A total 535 records were retrieved, and seven met the inclusion criteria. All the
included studies showed statistically significant improvements in the quality of life of patients who
received balneotherapy treatment despite differences in treatment administration. Sessions should
be approximately 20 min long and use natural mineral waters enriched with elements, or mud, at
a water temperature between 35–38ºC. Conclusions: Balneotherapy benefits the quality of life of
people with RA. The obtained results show positive effects for both mineral bathing and immersion
in sand or mud on the quality of life of people who suffer from RA."Catedra Hammam Al Andalus I + D + I en Bienestar Humano" (Hammam Al Andalus Chair in Human Wellbeing), University of Granada, Spai
Upper body motor function and swallowing impairments and its association in survivors of head and neck cancer: A cross-sectional study
Background
Upper body motor function and swallowing may be affected after curative treatment for
head and neck cancer. The aims of this study are to compare maximum mouth opening
(MMO), temporomandibular dysfunction (TMD), cervical and shoulder active range of
motion (AROM) and strength, and swallowing difficulty between survivors of head and neck
cancer (sHNC) and healthy matched controls (HMC) and to examine the correlations
between these outcomes in sHNC.
Methods
Thirty-two sHNC and 32 HMC participated on the study. MMO, TMD, cervical and shoulder
AROM, cervical and shoulder strength, the SPADI shoulder pain and disability indices, the
Eating Assessment Tool (EAT-10) score, swallowing difficulty as determined using a visual
analogue scale (VAS), and the location of disturbances in swallowing, were recorded.
Results
MMO and cervical and shoulder AROM and strength were significantly lower in sHNC,
whereas FAI, SPADI score, EAT-10 and VAS were higher. The MMO, TMD, cervical and
shoulder AROM, and cervical shoulder strength values showed significant correlations
(some direct, others inverse) with one another. Swallowing difficulty was inversely associated with the MMO, cervical AROM and shoulder strength.
Conclusion
Compared with controls, sHNC present smaller MMO, lower cervical and shoulder AROM,
lower cervical and shoulder strength and higher perception of TMD, shoulder pain and disability and swallowing difficulty. sHNC suffer impaired swallowing related to lower MMO,
presence of TMD, cervical AROM and shoulder strength values. Improving these variables
via physiotherapy may reduce the difficulty in swallowing experienced by some sHNC.Fondos Estructurales de la Union Europea (FEDER)Unit of Excellence on Exercise and Health (UCEES), University of Granad
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