Clinical practice guidelines for the management of brain tumours: A rehabilitation perspective

Objective: To critically appraise published clinical practice guidelines (CPGs) for brain tumours, and to synthesize evidence-based recommendations from a rehabilitation perspective. Methods: A comprehensive literature search included: health science databases, CPG clearinghouse/developer websites, and grey literature up to March 2018. All brain tumour CPGs that reported systematic methods for evidence search, and clearly defined recommendations supporting evidence for rehabilitation interventions were included. Three authors independently selected potential CPGs and assessed their methodological quality using the Appraisal of Guidelines, Research and Evaluation (AGREE-II) Instrument. Recommendations from included CPGs were categorized from a rehabilitation perspective. Results: Of the 11 CPGs identified, only 2, developed by the National Institute for Health and Clinical Excellence (NICE) and the Australian Cancer Network (ACN), included rehabilitation components for the management of brain tumours. Both CPGs were of moderate quality. The recommendations reported were generic, and only the ACN guidelines provided detailed recommendations for rehabilitation interventions. Both guidelines recommend a comprehensive multi-disciplinary care approach. Detailed comparison, however, was not possible due to inconsistent recommendations, making it difficult to summarize rehabilitative care. Conclusion: Despite rehabilitation being an integral component of the management of brain tumours, only a limited number of CPGs have incorporated recommendations for specific rehabilitation interventions. In order to improve clinical outcomes in this population future CPGs should incorporate rehabilitation interventions

Physical activity in multiple sclerosis: meeting the guidelines at the time of COVID-19 pandemic

Background and Purpose: Regular physical activity (PA) helps to reduce the severity of physical and mental symptoms and improves quality of life in people with multiple sclerosis (PwMS). Based on current evidence and expert opinion, the recent MS guidelines recommend at least 150 min/week of PA. This study presents the results of a survey analysing whether and how PwMS met the guidelines before and during pandemic. Methods: We developed and disseminated an international online survey between December 2020 and July 2021, investigating changes in self-reported PA type, duration, frequency and intensity due to the COVID-19 outbreak in PwMS with differing disability levels. Results: Among respondents (n=3810), 3725 were eligible. The proportion of those who conducted at least one activity decreased with increasing disability level at both time-points (pre and during). Overall 60% of respondents met the guidelines before the pandemic (mild: 64.43%; moderate: 51.53%; severe: 39.34%; X2(2)=109.13, p<0.01); a reduction of ~10% occurred during pandemic in all disability groups (mild: 54.76%; moderate: 42.47%; severe: 29.48%; X2(2)=109.67, p<0.01). Respondents with higher disability participated more in physical therapy and less in walking, cycling and running at both time-points. Most respondents reported practicing PA at a moderate intensity at both time-points; frequency and duration of sessions decreased as disability level increased. Discussion and Conclusions: The percentage of those meeting the guidelines reduced with increasing disability level and during the pandemic. PA type and intensity varied widely across the disability categories. Interventions accounting for disability level are required to enable more PwMS to reap the benefits.  https://journals.lww.com/jnpt/pages/default.aspxinpressinpres

The impact of the COVID-19 pandemic on physical activity and associated technology use in persons with multiple sclerosis: an international RIMS-SIG Mobility survey study.

From Elsevier via Jisc Publications RouterHistory: accepted 2022-06-05, issued 2022-06-26Article version: AMPublication status: AcceptedObjective To investigate the impact of the COVID-19 pandemic on physical activity (PA) in persons with multiple sclerosis (PwMS). Design and Setting A multi-centre international online survey study was conducted within 11 participating countries. Each country launched the survey using online platforms from May to July 2021. Participants This was an electronic survey study targeting PwMS. Intervention Not applicable. Outcome measures The survey ascertained PA performance and its intensity, the nature of the activities conducted and the use of technology to support home-based physical activity before and during the pandemic. Results 3725 respondents completed the survey. Pre-pandemic, the majority (83%) of respondents reported being physically active, and this decreased to 75% during the pandemic. This change was significant for moderate and high intensity activity (p<.0001). Activities carried out in physiotherapy centres, gyms or pools decreased the most. Walking was the most frequently performed activity pre-pandemic (27%) and increased during the pandemic (33%). 24% of those inactive during the pandemic had no intention of changing their PA behaviour post-pandemic. 58% of the respondents did not use technology to support PA during the pandemic. Of those who did use technology, wearables were most used (24%). Of those currently non-active (25%) expressed a preference for an in-person format to conduct PA post-pandemic. Conclusion PA performance, especially activities at moderate and high intensities, decreased during the pandemic in PwMS compared to pre-pandemic. Walking and using wearables gained popularity to stay active. As we move towards an endemic-COVID-19, a call for action to develop interventions focused on walking programmes, with specific emphasis on increasing PA of persons with MS is proposed

Changes in physical activity participation during the COVID-19 pandemic in people with Multiple Sclerosis: an international survey study [Letter to the editor]

Marietta van der Linden - ORCID: 0000-0003-2256-6673 https://orcid.org/0000-0003-2256-6673Item is restricted in this repository until 12 months after publication date.in pressinpres