115 research outputs found

    Several submaximal exercise tests reliable, valid and acceptable in patients with chronic pain, fibromyalgia or chronic fatigue: a systematic review.

    Get PDF
    Question: Are submaximal and maximal exercise tests reliable, valid and acceptable in people with chronic pain, fibromyalgia and fatigue disorders? Design: Systematic review of studies of the psychometric properties of exercise tests. Participants: People older than 18 years with chronic pain, fibromyalgia and chronic fatigue disorders. Intervention: Studies of the measurement properties of tests of physical capacity in people with chronic pain, fibromyalgia or chronic fatigue disorders were included. Outcome measures: Studies were required to report: reliability coefficients (intraclass correlation coefficient, alpha reliability coefficient, limits of agreements and Bland-Altman plots); validity coefficients (intraclass correlation coefficient, Spearman's correlation, Kendal T coefficient, Pearson's correlation); or dropout rates. Results: Fourteen studies were eligible: none had low risk of bias, 10 had unclear risk of bias and four had high risk of bias. The included studies evaluated: Ă…strand test; modified Ă…strand test; Lean body mass-based Ă…strand test; submaximal bicycle ergometer test following another protocol other than Ă…strand test; 2-km walk test; 5-minute, 6-minute and 10-minute walk tests; shuttle walk test; and modified symptom-limited Bruce treadmill test. None of the studies assessed maximal exercise tests. Where they had been tested, reliability and validity were generally high. Dropout rates were generally acceptable. The 2-km walk test was not recommended in fibromyalgia. Conclusion: Moderate evidence was found for reliability, validity and acceptability of submaximal exercise tests in patients with chronic pain, fibromyalgia or chronic fatigue. There is no evidence about maximal exercise tests in patients with chronic pain, fibromyalgia and chronic fatigue

    Hyperbaric Oxygen Therapy: Solution for Difficult to Heal Acute Wounds? Systematic Review

    Get PDF
    Hyperbaric oxygen therapy (HBOT) is used to treat various wound types. However, the possible beneficial and harmful effects of HBOT for acute wounds are unclear. We undertook a systematic review to evaluate the effectiveness of HBOT compared to other interventions on wound healing and adverse effects in patients with acute wounds. To detect all available randomized controlled trials (RCTs) we searched five relevant databases up to March 2010. Trial selection, quality assessment, data extraction, and data synthesis were conducted by two of the authors independently. We included five trials, totaling 360 patients. These trials, with some methodologic flaws, included different kinds of wound and focused on different outcome parameters, which prohibited meta-analysis. A French trial (n = 36 patients) reported that significantly more crush wounds healed with HBOT than with sham HBOT [relative risk (RR) 1.70, 95% confidence interval (CI) 1.11-2.61]. Moreover, there were significantly fewer additional surgical procedures required with HBOT (RR 1.60, 95% CI 1.03-2.50), and there was significantly less tissue necrosis (RR 1.70, 95% CI 1.11-2.61). In one of two American trials (n = 141) burn wounds healed significantly quicker with HBOT (P <0.005) than with routine burn care. A British trial (n = 48) compared HBOT with usual care. HBOT resulted in a significantly higher percentage of healthy graft area in split skin grafts (RR 3.50, 95% CI 1.35-9.11). In a Chinese trial (n = 145) HBOT did not significantly improve flap survival in patients with limb skin defects. HBOT, if readily available, appears effective for the management of acute, difficult to heal wound

    Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury:A systematic review

    Get PDF
    Objective: To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Methods: Cochrane, MEDLINE, EM BASE, CINAHL, PEDro, DocOnline were searched and identified studies were assessed for eligibility and methodological quality and described regarding population, training protocol, and effects on walking ability, activities of daily living and quality of life. A descriptive and quantitative synthesis was conducted. Results: Eighteen articles (17 studies) were included. Two randomized controlled trials showed that subjects with injuries of less than one year duration reached higher scores on the locomotor item of the Functional Independence Measure (range 1-7) in the over-ground training group compared with the body weight-supported treadmill training group. Only for persons with an American Spinal Injury Association Impairment Scale C or D was the mean difference significant, with 0.80 (95% confidence interval 0.04-1.56). No differences were found regarding walking velocity, activities of daily living or quality of life. Conclusion: Subjects with subacute motor incomplete spinal cord injury reached a higher level of independent walking after over-ground training, compared with body weight-supported treadmill training. More randomized controlled trials are needed to clarify the effectiveness of body weight-supported gait training on walking, activities of daily living, and quality of life for subgroups of persons with an incomplete spinal cord injury

    The implementation of a physical activity counseling program in rehabilitation care:findings from the ReSpAct study

    Get PDF
    Purpose: This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients? physical activity outcomes. Methods: This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ?70) and patients (n?=?1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients? physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. Results: 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. Conclusion: After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity)

    The current implementation status of the integration of sports and physical activity into Dutch rehabilitation care

    Get PDF
    Purpose: To describe the current status of the nationwide implementation process of a sports and physical activity stimulation programme to gain insight into how sports and physical activity were integrated into Dutch rehabilitation care. Methods: The current implementation status of a sports and physical activity stimulation programme in 12 rehabilitation centres and 5 hospitals with a rehabilitation department was described by scoring fidelity and satisfaction. Seventy-one rehabilitation professionals filled out a questionnaire on how sports and physical activity, including stimulation activities, were implemented into rehabilitation care. Total fidelity scores (in %) were calculated for each organization. Professionals’ satisfaction was rated on a scale from 1 to 10. Results: In most organizations sports and physical activity were to some extent integrated during and after rehabilitation (fidelity scores: median = 54%, IQR = 23%). Physical activity stimulation was not always embedded as standard component of a rehabilitation treatment. Professionals’ satisfaction rated a median value of 8.0 (IQR = 0.0) indicating high satisfaction rates. Conclusions: The fidelity outcome showed that activities to stimulate sports and physical activity during and after rehabilitation were integrated into rehabilitation care, but not always delivered as standardized component. These findings have emphasized the importance to focus on integrating these activities into routines of organizations.Implications for Rehabilitation Components of an evidence-based programme to stimulate sports and physical activity during and after rehabilitation can be used to measure the current status of the integration of sports and physical activity in rehabilitation care in a structural and effective way. The method described in the current study can be used to compare the content of the rehabilitation care regarding the integration of sports and physical activity among organizations both on a national and international level. Sports and physical activity are seen as important ingredients for successful rehabilitation care in The Netherlands

    Landslide Detection in the Himalayas Using Machine Learning Algorithms and U-Net

    Get PDF
    Event-based landslide inventories are essential sources to broaden our understanding of the causal relationship between triggering events and the occurring landslides. Moreover, detailed inventories are crucial for the succeeding phases of landslide risk studies like susceptibility and hazard assessment. The openly available inventories differ in the quality and completeness levels. Event-based landslide inventories are created based on manual interpretation, and there can be significant differences in the mapping preferences among interpreters. To address this issue, we used two different datasets to analyze the potential of U-Net and machine learning approaches for automated landslide detection in the Himalayas. Dataset-1 is composed of five optical bands from the RapidEye satellite imagery. Dataset-2 is composed of the RapidEye optical data, and ALOS-PALSAR derived topographical data. We used a small dataset consisting of 239 samples acquired from several training zones and one testing zone to evaluate our models’ performance using the fully convolutional U-Net model, Support Vector Machines (SVM), K-Nearest Neighbor, and the Random Forest (RF). We created thirty-two different maps to evaluate and understand the implications of different sample patch sizes and their effect on the accuracy of landslide detection in the study area. The results were then compared against the manually interpreted inventory compiled using fieldwork and visual interpretation of the RapidEye satellite image. We used accuracy assessment metrics such as F1-score, Precision, Recall, and Mathews Correlation Coefficient (MCC). In the context of the Nepali Himalayas, employing RapidEye images and machine learning models, a viable patch size was investigated. The U-Net model trained with 128 × 128 pixel patch size yields the best MCC results (76.59%) with the dataset-1. The added information from the digital elevation model benefited the overall detection of landslides. However, it does not improve the model’s overall accuracy but helps differentiate human settlement areas and river sand bars. In this study, the U-Net achieved slightly better results than other machine learning approaches. Although it can depend on architecture of the U-Net model and the complexity of the geographical features in the imagery, the U-Net model is still preliminary in the domain of landslide detection. There is very little literature available related to the use of U-Net for landslide detection. This study is one of the first efforts of using U-Net for landslide detection in the Himalayas. Nevertheless, U-Net has the potential to improve further automated landslide detection in the future for varied topographical and geomorphological scenes

    The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study

    Get PDF
    Purpose: This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients’ physical activity outcomes. Methods: This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ±70) and patients (n = 1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients’ physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. Results: 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. Conclusion: After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity).Implications for rehabilitation Physical activity counseling after rehabilitation is important to support people with disabilities in making the step from rehabilitation-based physical activities to community-based physical activities. Establishing “Physical Activity Counseling Centers” is a promising “disability-overarching” strategy to promote physical activity after rehabilitation. Although the actual received counseling (dosage) varied among patients, this did not coincide with large differences in physical activity outcomes. The training in Motivational Interviewing, the financial incentives, and the advisory support were considered as important or essential ingredients for a successful implementation of the counseling program in rehabilitation practice

    Nonexercise Interventions for Prevention of Musculoskeletal Injuries in Armed Forces: A Systematic Review and Meta-Analysis

    Get PDF
    Context: This study evaluates the effect of nonexercise interventions on the reduction of risk for musculoskeletal injuries in armed forces. Evidence acquisition: A database search was conducted in PubMed/MEDLINE, Embase, Cochrane Library, CINAHL, SPORTdiscus, Greylit, Open Grey, the WHO trial registry, and the reference lists of included articles up to July 2019. RCTs and cluster RCTs evaluating nonexercise interventions for the prevention of musculoskeletal injuries in armed forces compared with any other intervention(s) or no intervention were eligible for inclusion. Data extraction and risk of bias assessment were done by 2 authors independently, followed by meta-analysis and Grading of Recommendations Assessment, Development,

    Test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities

    Get PDF
    The current study determined the test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities. Before filling in the Adapted-SQUASH twice with a recall period of 2 weeks, participants wore the Actiheart activity monitor up to 1 week. For the test-retest reliability (N = 68), Intraclass correlation coefficients (ICCs) were 0.67 (p <0.001) for the total activity score (min x intensity/week) and 0.76 (p <0.001) for the total minutes of activity (min/week). For the concurrent validity (N = 58), the Spearman correlation coefficient was 0.40 (p = 0.002) between the total activity score of the first administration of the Adapted-SQUASH and activity energy expenditure from the Actiheart (kcals kg min ). The ICC was 0.22 (p = 0.027) between the total minutes of activity assessed with the first administration of the Adapted-SQUASH and Actiheart. The Adapted-SQUASH is an acceptable measure to assess self-reported physical activity in large populations of adults with disabilities but is not applicable at the individual level due to wide limits of agreement. Self-reported physical activity assessed with the Adapted-SQUASH does not accurately represent physical activity assessed with the Actiheart in adults with disabilities, as indicated with a systematic bias between both instruments in the Bland-Altman analysis

    Food Acceptability in Field Studies with US Army Men and Women: Relationship with Food Intake and Food Choice After Repeated Exposures

    Get PDF
    Laboratory data with single exposures showed that palatability has a positive relationship with food intake. The question addressed in this study is whether this relationship also holds over repeated exposures in non-laboratory contexts in more natural environments. The data were collected in four field studies, lasting 4–11 days with 307 US Army men and 119 Army women, and comprised 5791 main meals and 8831 snacks in total. Acceptability was rated on the nine point hedonic scale, and intake was registered in units of 1/4, 1/2, 3/4, or 1 or more times of the provided portion size. Correlation coefficients between individual acceptability ratings and intakes varied from 0.22 to 0.62 for the main meals (n=193–2267), and between 0.13 and 0.56 for the snacks (n=304–2967). The likelihood of choosing a meal for the second time was positively related to the acceptability rating of the meal when it was consumed for the first time. The results reinforce the importance of liking in food choice and food intake/choice behavior. However, the magnitude of the correlation coefficients between acceptability ratings and food intake suggest that environmental factors also have an important role in determining intake and choice
    • …
    corecore