36 research outputs found
Characteristics of Frailty in Perimenopausal Women with Long COVID-19
The aim of this study was to compare the prevalence of risk factors for frailty between
perimenopausal women with long COVID-19 syndrome, women having successfully recovered from
COVID-19, and controls from the community. Women with a diagnosis of long COVID-19 and at
least one symptom related to the perimenopausal period, women who had successfully recovered
from COVID-19, and healthy women of comparable age were included in this study. Symptom
severity and functional disability were assessed with the COVID-19 Yorkshire Rehabilitation Scale,
and the presence of frailty was evaluated considering the Fried criteria. A total of 195 women were
included in the study, distributed over the three groups. The long COVID-19 group showed a higher
prevalence of perimenopausal symptoms and impact of COVID-19. Statistically significant differences
were found between the long COVID-19 group and the other two groups for the frailty variables.
When studying the associations between frailty variables and COVID-19 symptom impact, significant
positive correlations were found. Perimenopausal women with long COVID-19 syndrome present
more frailty-related factors and experience a higher range of debilitating ongoing symptoms. A
significant relationship is shown to exist between long COVID-19 syndrome-related disability and
symptoms and frailty variables, resulting in an increased chance of presenting disability.Formación Profesorado Universitario (FPU)
grant (FPU: 19/02609) from the Spanish Ministry of EducationFPU grant (FPU: 21/00451) for the training of university faculty from the University of
GranadaCollege of Physiotherapists of Andalucia,
(Project Ref: 06195/21D/MA
Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis
This research was funded by Ministerio de Ciencia, Innovacion y Universidades, grant number FPU: 19/02609, FPU: 17/00408 and FPU: 16/01531 and by University of Granada, grant number FPU: PP20/05.Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = -1.26, 95% CI = -1.65, -0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.University of Granada FPU: PP20/05Spanish Government FPU: 19/02609
FPU: 17/00408
FPU: 16/0153
Clinical Characteristics and Rehabilitation Strategies for the Stomatognathic System Disturbances in Patients with Stroke: A Systematic Review
Background: Understanding the stomatognathic system disturbances is key to diagnosing
them early and implementing rehabilitation approaches to promote functional recovery. The
objective of this study was to systematically review all published data that examined the assessment
and rehabilitation strategies for the stomatognathic system disturbances in patients with stroke.
Methods: Five databases (i.e., PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and
PEDro), were screened for manuscripts that included the assessment and rehabilitation strategies for
stomatognathic system disturbances. The methodological quality was evaluated using the Mixed
Methods Appraisal Tool. Results: Sixteen articles were included in this systematic review. The
most frequently reported symptoms in patients with stroke included stiffness and thickness of the
masseter muscle on the affected side and suprahyoid muscles; facial muscles’ asymmetry and weakness;
temporomandibular disorders; and a reduced maximum lip force, tongue pressure, and saliva
flow rate. The rehabilitation strategies more frequently reported included exercises directed to the
jaw, temporomandibular joint, tongue, and neck. The mean score for methodological quality was
85%. Conclusion: The stomatognathic system disturbances are frequently reported among patients
with stroke, leading to dysfunction in masticatory performance or swallowing. More studies on
interventions for stomatognathic system disturbances are required before conclusions may be drawn.
Key Practitioner Message: This systematic review has clinical implications for rehabilitation practices,
given that the results may help to develop early assessment and rehabilitation strategies for
stomatognathic disturbances in patients with stroke.German Research Foundation (DFG)
FPU: 20/2167
Effects of the COVID-19 Pandemic on Physical Activity in Chronic Diseases: A Systematic Review and Meta-Analysis
This work was supported by the Spanish Ministry of Education by a FPU ("Formacion Profesorado Universitario") grant for the authors Andres Calvache-Mateo and Laura Lopez-Lopez (grant number, FPU:19/02609, FPU:17/00408).The management of chronic diseases (CD) includes physical activity (PA). It is necessary to
determine the effects of COVID-19 restrictions in CD. The aim was to review the research related to
PA levels before and during the COVID-19 pandemic in people with CD. This review was designed
according to PRISMA guidelines and registered in PROSPERO: CRD42020218825. The search was
performed in CINAHL, Medline, Scopus, and Web of Science up to January 2021. The PICOS
recommendations were applied. The search was conducted by two reviewers, who completed the
data extraction of included articles. Methodological quality was assessed using the STROBE checklist,
and a meta-analysis was conducted. The literature search strategy identified 227 articles. Five studies
remained and were included. Only three studies were included in the meta-analysis. Two articles
used accelerometers to objectively compare PA levels before and during the pandemic. Three studies
made this comparison using an online survey. All articles showed a decrease in PA levels during
the COVID-19 pandemic. The meta-analysis showed a significant reduction in PA levels during
pandemic. PA levels during the COVID-19 pandemic have been reduced with respect to previous
levels of PA in patients with CD.German Research Foundation (DFG) FPU:19/02609
FPU:17/0040
Radiotherapy-Related Fatigue Associated Impairments in Lung Cancer Survivors during COVID-19 Voluntary Isolation
The author Alejandro Heredia Ciuro and the author Laura Lopez Lopez have received financial support through a FPU ("Formacion Profesorado Universitario") grant of the Spanish Ministry of Education (Spain), (FPU: 17/00408, and FPU: 20/01670).The main objective of this study was to investigate the impairments presented after
COVID-19 voluntary isolation by lung cancer survivors that experienced radiotherapy-related fatigue.
In this observational study, data were collected after COVID-19 voluntary isolation. Patients were
divided into two groups according to their fatigue severity reported with the Fatigue Severity Scale.
Health status was assessed by the EuroQol-5D, anxiety and depression by the Hospital Anxiety and
Depression Scale, and disability by theWorld Health Organization Disability Assessment Schedule
2.0. A total of 120 patients were included in the study. Patients with severe fatigue obtained higher
impairment results compared to patients without severe fatigue, with significant differences in all
the variables (p < 0.05). Lung cancer survivors who experienced severe radiotherapy-related fatigue
presented higher impairments after COVID-19 voluntary isolation than lung cancer patients who did
not experience severe radiotherapy-related fatigue, and showed high levels of anxiety, depression
and disability, and a poor self-perceived health status.FPU ("Formacion Profesorado Universitario") grant of the Spanish Ministry of Education (Spain) FPU: 17/00408
FPU: 20/0167
Cognitive impairment, nutritional status and clinical profile in chronic obstructive pulmonary disease
Introducción: La enfermedad pulmonar obstructiva
crónica (EPOC) es una enfermedad progresiva, cuya
prevalencia aumenta con la edad. Se caracteriza por su
elevado número de comorbilidades, entre ellas el deterioro
cognitivo, que ha ido adquiriendo gran relevancia
clínica en los últimos años. Factores como la función pulmonar,
la hipoxemia, la hipercapnia o las exacerbaciones
contribuyen al deterioro de las funciones cognitivas. Se
ha incluido el estado nutricional como un factor más que
presentándose en la EPOC, contribuya también al deterioro
de la funciones cognitivas.
Objetivo: Evidenciar la relación entre el deterioro cognitivo,
el estado nutricional y el perfil clínico de los pacientes
que ingresan por exacerbación aguda de EPOC
(EAEPOC).
Metodología: Ciento diez sujetos hospitalizados por
EAEPOC, divididos en dos grupos según su estado nutricional
y evaluación a su ingreso de deterioro cognitivo,
estado nutricional y perfil clínico.
Resultados: Diferencias significativas entre grupos de
estado nutricional en las variables antropométricas (sexo
e IMC), capacidad funcional (Índice de Barthel y escala
de Actividades de la Vida Diaria) calidad de vida (Euroqol-
5D y SGRQ), calidad de sueño (Pittsburgh), estado
de ánimo (HAD) y deterioro cognitivo (MoCa atención,
MoCa abstracción). (p<0.05).
Conclusión: Las funciones cognitivas se ven afectadas
en pacientes EPOC con un estado nutricional alterado,
en comparación con aquellos con un estado nutricional
normal. El deterioro nutricional es un factor que contribuye
al deterioro de las funciones cognitivas en este tipo
de pacientes; en concreto al deterioro de la atención y la
capacidad de abstracción.Introduction: Chronic Obstructive Pulmonary Disease
(COPD) is a progressive disease with a prevalence that
increases with the aging of the subject. It presents a high
prevalence of comorbidities, such as cognitive decline,
which is gaining great clinical relevance in recent years.
Factors such as pulmonary function, hypoxemia, hypercapnia
or exacerbations contribute to the decline of cognitive
functions. The nutritional status has been added to
these factors as contributing to cognitive function decline
when presenting in COPD.
Objective: To evidence the relationship between cognitive
decline, nutritional status and the clinical profile
of patients admitted because of an acute exacerbation of
COPD (AECOPD).
Methods: 110 subjects hospitalized because of COPD,
divided in two groups according to their nutritional status
and assessment of cognitive decline at admittance,
nutritional status and clinical profile.
Results: Significant differences between groups concerning
nutritional status in anthropometric variables
(sex and IMC), functional ability (Barthel index and
Daily Life Activities Scale), quality of life (Euroqol- 5D
y SGRQ), sleep quality (Pittsburgh), mood (HAD) and
cognitive decline (MoCa attention, MoCa abstraction).
(p<0.05).
Conclusion: Cognitive function is affected in COPD
patients with an altered nutritional status when compared
to those with a normal nutritional status. The nutritional
decline is a factor contributing to the impairment
of cognitive functions in this kind of patients, particularly
a decline in attention and abstraction ability
Trabajo colaborativo basado en embodied learning y experiencias reales para mejorar la adquisición de competencias clínicas en geriatría
Memoria de proyectos de innovación y buenas prácticas docente
A New Tool for Assessment of Professional Skills of Occupational Therapy Students
The assessment of the acquisition of professional skills is an essential process in occupational therapy students. Until now, there has been no standardized and validated instrument for
evaluating these skills in Spanish occupational therapy students. This study reports the development
and testing of the psychometric properties of the professional skills in students of occupational
therapy during their practical training. Methods: A new instrument was developed to assess the
professional skills of occupational therapy students, called CPTO. A total of 69 occupational therapists participated in evaluating 295 occupational therapy students from the University of Granada,
between the 2018 and 2021 academic years. Results: Of a total of 79 items, the factor analysis yielded a
final solution of 33 items, which explains 70.22% of the variance with the following three dimensions:
(1) self-appraisal and professional responsibility (α = 0.951); (2) communication skills and delivering intervention (α = 0.944); and (3) clinical reasoning for assessing and planning the intervention
(α = 0.947). The instrument allows students with low, medium, high and excellent clinical skills
to be differentiated according to the cutting points established by the quartiles. Conclusion: the
instrument has good psychometric properties, and is a useful tool to assess professional competencies
in occupational therapy students during their practice placement education.Unidad de Calidad Docente from University of Granad
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
Valoración e intervención de terapia ocupacional en patología neurodegenerativa
Los objetivos de esta Tesis Doctoral Internacional se clasifican en objetivo principal y objetivos secundarios. El objetivo
principal fue evaluar la efectividad de un programa de terapia ocupacional
en patología neurodegenerativa y los objetivos secundarios han sido
divididos por estudios.
Un estudio llevado a cabo en personas con diagnóstico de esclerosis
múltiple que tuvo como objetivos describir el perfil clínico de los
participantes , el deterioro motor y funcional en miembros superiores y
diseñar, implementar y evaluar la efectividad de un programa de terapia
ocupacional focalizado en la alteración motora y funcional de miembros
superiores en pacientes con esclerosis múltiple.
Un segundo estudio en personas con diagnóstico de enfermedad
de Parkinson que tuvo como objetivos describir el perfil clínico de los
participantes, el deterioro motor y funcional de los miembros superiores
y diseñar, implementar y evaluar la efectividad de un programa de terapia
ocupacional focalizado en el deterioro motor y funcional de los miembros
superiores en pacientes con enfermedad de Parkinson.Tesis Univ. Granada. Programa Oficial de Doctorado en: Medicina Clínica y Salud Públic