The impact of physical exercises on intensity of chronic pain and functional ability of terminally ill patients

Background. The main goal of palliative care is to alleviate pain, as well as improving the quality of life. Pain treatment should be interdisciplinary, including physical aspect-pharmacology and physical exercises, as well as psychological and spiritual. Material and methods. The aim of the study was to establish the impact of exercising on intensity of chronic pain and functional condition at patients terminally ill. During one month, a group of 30 patients (18 women and 12 men), suffering of chronic pain, caused by cancer, circulatory and neuro-muscular diseases, participated in physical treatment, which included strengthening and stretching exercises of large group of muscles (dorsal, abdominal and lower limb), respiratory exercises and vertical position. The intensity of pain was verified by a questionnaire, including pain scales. Second method was modified Barthel’s index, which evaluated patient's functional condition. Also the quantity and form of drugs were estimated. Results. Studies are showing the reduction of pain level after exercising. The low intensity of pain before exercising are described by 3.3% of patients, the moderate - by 30.0% and intense - by 66.7% of patients. The intensity of pain after exercising, described as low was by 33.3% of patients, the moderate - by 43.3% and intense - by 34.4% of patients. The mean of points in Barthel's index initially was 14.6 for whole group, at the end of study - 28.0. The mean of physical condition initially was 24.0%, after study came to 46.7% (100% = 60 points in Barthel's index).The average dose of analgesic decreased. Initially it was 130 mg, the final dose was 114 mg. Conclusion. 1.Studies prove the significant decrease of chronic pain intensity. 2. Pain was the main factor limiting patient's daily activity. 3. Exercising caused over double increase of physical condition. 4. Doses of analgesics decreased in a significant amount of patients.Background. The main goal of palliative care is to alleviate pain, as well as improving the quality of life. Pain treatment should be interdisciplinary, including physical aspect-pharmacology and physical exercises, as well as psychological and spiritual. Material and methods. The aim of the study was to establish the impact of exercising on intensity of chronic pain and functional condition at patients terminally ill. During one month, a group of 30 patients (18 women and 12 men), suffering of chronic pain, caused by cancer, circulatory and neuro-muscular diseases, participated in physical treatment, which included strengthening and stretching exercises of large group of muscles (dorsal, abdominal and lower limb), respiratory exercises and vertical position. The intensity of pain was verified by a questionnaire, including pain scales. Second method was modified Barthel’s index, which evaluated patient's functional condition. Also the quantity and form of drugs were estimated. Results. Studies are showing the reduction of pain level after exercising. The low intensity of pain before exercising are described by 3.3% of patients, the moderate - by 30.0% and intense - by 66.7% of patients. The intensity of pain after exercising, described as low was by 33.3% of patients, the moderate - by 43.3% and intense - by 34.4% of patients. The mean of points in Barthel's index initially was 14.6 for whole group, at the end of study - 28.0. The mean of physical condition initially was 24.0%, after study came to 46.7% (100% = 60 points in Barthel's index).The average dose of analgesic decreased. Initially it was 130 mg, the final dose was 114 mg. Conclusion. 1.Studies prove the significant decrease of chronic pain intensity. 2. Pain was the main factor limiting patient's daily activity. 3. Exercising caused over double increase of physical condition. 4. Doses of analgesics decreased in a significant amount of patients

Influence of metabolic risk factors of cardiovascular diseases on cognitive impairment in elderly patients

Wstęp. Zaburzenia funkcji poznawczych występujące u osób starszych obniżają jakość życia i wpływają na stan zdrowia tych pacjentów. Celem pracy jest ocena zaburzeń poznawczych u osób starszych, ustalenie związku między stopniem tych zaburzeń i metabolicznymi czynnikami ryzyka chorób sercowo-naczyniowych. Materiał i metody. U 93 starszych pacjentów przeprowadzono test MMSE, na podstawie którego utworzono następujące grupy: 1 &#8212; kontrolna (bez zaburzeń poznawczych), 2 &#8212; pacjenci z zaburzeniami poznawczymi oraz podgrupy: 2a &#8212; osoby z łagodnymi zaburzeniami, 2b &#8212; chorzy z zaburzeniami średniozaawansowanymi i głębokimi. Oceniono zależność pomiędzy stopniem zaburzeń poznawczych i stężeniem frakcji lipidowych. Na podstawie kryteriów klinicznych, takich jak: I &#8212; obecność cukrzycy, II &#8212; zwężenia tętnic szyjnych > 50%, III &#8212; współistnienie obu tych czynników, IV &#8212; występowanie zespołu metabolicznego, wyodrębniono 4 grupy. Wyniki. Uzyskano dodatnią korelację MMSE i stężenia cholesterolu frakcji HDL (HDL-C), ujemną korelację: MMSE i LDL/HDL, brak korelacji: MMSE i stężenia cholesterolu całkowitego (TC), cholesterolu frakcji LDL (LDL-C) i triglicerydów (TG), istotne różnice stężeń frakcji lipidowych TG, HDL-C i LDL/HDL pomiędzy grupą 1 i 2; różnice te zwiększają się przy porównaniu grupy 1 i podgrupy 2b. Uzyskano niższy wynik MMSE u chorych na cukrzycę i u pacjentów z zaawansowanymi zmianami w tętnicach szyjnych; wartość ta jest jeszcze mniejsza, jeśli oba stany współistnieją. Zespół metaboliczny wiąże się z istotnie niższym wynikiem MMSE (p < 0,0004). Wnioski. Zaburzeniom poznawczym i otępieniu u osób w podeszłym wieku towarzyszy niskie stężenie cholesterolu frakcji HDL, wysoka wartość wskaźnika LDL/HDL oraz wysokie stężenie TG. Stężenie cholesterolu frakcji HDL koreluje dodatnio, a wartość LDL/HDL ujemnie ze stopniem zaburzeń poznawczych. Zmiany miażdżycowe bez istotnego zwężenia tętnic szyjnych nie wpływają na funkcje poznawcze pacjentów. Zaburzenia poznawcze są większe u chorych na cukrzycę typu 2, z zaawansowanymi zmianami tętnic szyjnych i pogłębiają się przy współistnieniu obu stanów. Zespół metaboliczny wiąże się z bardzo wysokim ryzykiem osłabienia funkcji poznawczych.Background. Cognitive impairment in older people diminishes their quality of life and interferes with their state of health. The aim of the study is the assessment of cognitive functions in elderly people, the evaluation of the correlation between cognitive impairment and metabolic risk factors of cardiovascular diseases. Material and methods. 93 patients over 60 years old completed the Mini-Mental State Examination (MMSE), as a consequence, the following the groups were established: Group 1 &#8212; control group without cognitive impairment, group 2 &#8212; presence of cognitive impairment: 2a &#8212; mild impairment, 2b &#8212; moderate or severe dementia. The interdependence of the MMSE score and serum concentration of fractionated lipids was evaluated, and it was examined whether cognitive impairment was connected with diabetes type 2, carotid arteries stenosis or with the coexistence of the first two and finally with the metabolic syndrome. Results. The following results were obtained: a positive correlation between MMSE score and HDL-C concentration, negative correlation between MMSE score and LDL/HDL index, no correlation between MMSE score and TC, LDL-C and TG concentration. In patients of group 2, the HDL-C concentration was significantly lower, the TG concentration higher, and the LDL/HDL index was higher than in group 1, these tendencies increased when both groups, 1 and 2b were compared. In patients with diabetes or with carotid stenosis, the MMSE score was low, the results decreased in patients with the coexistence of both. Patients with metabolic syndrome revealed significantly lower MMSE scores compared to patients without the syndrome (p < 0.0004). Conclusion. Low HDL-C concentration, high value of LDL/HDL coefficient and high TG concentration are connected with cognitive impairment in elderly people. HDL-C concentrations correlate positively, and values of LDL/HDL coefficients correlate negatively, with the degree of cognitive dysfunction. Cognitive impairment is connected with diabetes type 2 and carotid stenosis, and it intensifies in patients suffering from both. Metabolic syndrome gives a very high risk of cognitive impairment

Interactive Video Games as a Method to Increase Physical Activity Levels in Children Treated for Leukemia

Despite the beneficial effect of exercise, children treated for cancer do not engage in sufficient physical activity. It is necessary to search for attractive forms of physical activity, including interactive video games (IVGs). The aim of this study was to verify the effectiveness of the rehabilitation model developed by the authors based on the use of IVGs in children undergoing leukemia treatment. The study included a group of 21 children aged 7&ndash;13 years (12 boys, 9 girls) undergoing treatment for acute lymphoblastic leukemia (ALL) (n = 13) and acute myeloid leukemia (AML) (n = 8). The children were randomly assigned to an intervention group and a control group. To assess the level of cardiorespiratory fitness (CRF), each child participated in a Cardiopulmonary Exercise Test. Daily physical activity was assessed using the HBSC questionnaire. The study also used the Children&rsquo;s Effort Rating Table Scale (CERT) to assess the intensity of physical effort. The children in the intervention group participated in 12 sessions of. The study participants managed to complete all stages of a progressive training program, which confirmed the feasibility of such physical effort by patients with cancer. Pediatric patients reported that the IVG training required a light to moderate physical effort despite high values of energy expenditure (EE)

Interactive Video Games as a Method to Increase Physical Activity Levels in Children Treated for Leukemia

Despite the beneficial effect of exercise, children treated for cancer do not engage in sufficient physical activity. It is necessary to search for attractive forms of physical activity, including interactive video games (IVGs). The aim of this study was to verify the effectiveness of the rehabilitation model developed by the authors based on the use of IVGs in children undergoing leukemia treatment. The study included a group of 21 children aged 7–13 years (12 boys, 9 girls) undergoing treatment for acute lymphoblastic leukemia (ALL) (n = 13) and acute myeloid leukemia (AML) (n = 8). The children were randomly assigned to an intervention group and a control group. To assess the level of cardiorespiratory fitness (CRF), each child participated in a Cardiopulmonary Exercise Test. Daily physical activity was assessed using the HBSC questionnaire. The study also used the Children’s Effort Rating Table Scale (CERT) to assess the intensity of physical effort. The children in the intervention group participated in 12 sessions of. The study participants managed to complete all stages of a progressive training program, which confirmed the feasibility of such physical effort by patients with cancer. Pediatric patients reported that the IVG training required a light to moderate physical effort despite high values of energy expenditure (EE)

Peak Oxygen Uptake and Exercise Capacity of Children Undergoing Leukemia Treatment

The aim of the study was to assess the exercise capacity (VO2peak) of children undergoing leukemia treatment and to compare the results with healthy children. Furthermore, we assessed the influence of treatment methods on the level of exercise capacity and the increase in sedentary behaviors. The study comprised 21 children (12 boys and 9 girls) undergoing treatment for acute lymphoblastic leukemia (ALL) (n = 13) and acute myeloid leukemia (AML) (n = 8). The subjects were aged 7&ndash;13 years (mean age 10.7, SD 2.0 years). Cardiorespiratory fitness was assessed by using the ergospirometry test. Progressive Godfrey protocol was performed. The level of physical activity was assessed by using the questions from the Health Behavior in School-Aged Children (HBSC 2018) questionnaire. The study results showed that children undergoing leukemia treatment were characterized by a reduced level of exercise capacity. The measured value of VO2peak in the group of treated children was, on average, 22.16 mL&middot;kg&minus;1&middot;min&minus;1. The mean values of VO2peak predicted for this age group were 45.48 mL&middot;kg&minus;1&middot;min&minus;1 (SD, 3.8). The measured value of VO2peak in the study group with the division into age groups was, on average, 21.21 mL&middot;kg&minus;1&middot;min&minus;1 in the group of children aged 7&ndash;10 years. In the group of children aged 11&ndash;13 years, this parameter was 22.64 mL&middot;kg&minus;1&middot;min&minus;1. Lack of physical activity and failure to meet the standards for the minimum level of weekly physical activity (MVPA index&mdash;moderate-to-vigorous physical activity) probably contribute to the deterioration in exercise capacity level of cancer-treated children

Does Daily Physical Activity Level Determine the Physical Efficiency of Children After Treatment of Leukemia?

The aim of the study was to assess daily physical activity level and its influence on the physical efficiency of children after the treatment of leukemia. The study was comprised of 34 children (23 boys and 11 girls) after the treatment of acute lymphoblastic leukemia or myeloid leukemia (mean age of 11.29 &plusmn; 2.81 years, mean body height of 146.88 &plusmn; 16.11 cm, and mean body weight of 43.68 &plusmn; 13.93 kg). The mean time since treatment completion was 3.09 &plusmn; 1.80 years. The level of physical activity was assessed with the Health Behavior in School-Aged Children questionnaire (HBSC). Physical efficiency was assessed based on the palant ball throw (assessment of strength, coordination, and upper limb speed), the long jump (assessment of jumping ability, speed and coordination) and the 60 m run (assessment of speed). Measurements of motor skills were normalized, classified according to age and sex, and converted into grades. The mean values obtained in the run and the ball throw showed low pass grades in the study group. In the case of the long jump, satisfactory grades were obtained. A correlation of r = 0.512 was found between vigorous physical activity (HBSC 3) and the grade in the run. A correlation of r = &minus;0.437 was observed between the duration of computer use in leisure time (HBSC 6) and the grade in the long jump, whereas correlations of r = &minus;0.482 and &minus;0.485 were noted between the number hours per week spent on games (HBSC 5) and the duration of computer use in leisure time (HBSC 6) and the grade obtained in the ball throw, respectively. In addition, different levels of physical activity and physical efficiency were demonstrated depending on the time elapsed since treatment completion. Supervised programs promoting daily physical activity should include children after the treatment of leukemia. These programs should also be aimed at improving their physical efficiency

The relationship between sagittal spinal curvatures and isokinetic trunk muscle endurance after aquatic exercise training in survivors of breast cancer

Assessment of the impact of aquatic exercises on the relationship between sagittal spinal curvatures and isokinetic trunk muscle endurance against standard land exercises in women after breast cancer treatment. Methods: 40 women post breast cancer divided into two groups: a study group (n = 20) participated in the aquatic exercises and a control group (n = 20) performed the land exercises. Data collection occurred both before and after the 8 week intervention. Measurements were taken from the SG and CG performing antagonistic movements (flexions/extensions) to assess the endurance (120 °/s) in isokinetic conditions and a photogrammetric examination to define sagittal spinal curvatures. Results: A significant improvement ( p < 0.05) in total work and average power was found among women after the aquatic exercises irrespective of the muscle group under examination. There were no significant changes in any examined parameters after the land exercises. In the study group, there was a significant association of gamma angle decrease and an increase of all examined functional parameters of total work and average power of both the extensor muscles (r = –0,49 to –0.51) and the trunk flexors (r = –0.48 to –0.51). In the control group, a similar tendency of functional-postural changes was observed only for the extensor muscles of the trunk (r = –0.54 to –0.58). Conclusions: General exercises performed in water, as opposed to those performed on land, are more effective in terms of the functional-postural retations in women after breast cancer

Cardiac rehabilitation for hemodynamic parameters and heart function of a patient with low left ventricle ejection fraction after myocardial infarction – a case report

Wstęp. Właściwie dobrany trening rehabilitacyjny powoduje zmniejszenie zapotrzebowania na tlen, zwolnienie spoczynkowej i wysiłkowej czynności serca oraz zwiększenie objętości wyrzutowej serca, wpływa na polepszenie funkcji śródbłonka, poprawę ukrwienia mięśni szkieletowych oraz wzrost siły mięśniowej. Celem niniejszej pracy było określenie wpływu rehabilitacji kardiologicznej na parametry hemodynamiczne i badanie echokardiograficzne serca chorego po zawale mięśnia sercowego z niską frakcją wyrzutową lewej komory. Opis przypadku i program rehabilitacji. Pacjent po przebytym zawale mięśnia sercowego z rozpoznaną przewlekłą obturacyjną chorobą płuc w stadium GOLD II/A. W badaniu EKG wykryto niedokrwienne upośledzenia funkcji skurczowej lewej komory serca dużego stopnia. U pacjenta stwierdzono kardiomiopatię niedokrwienną w fazie kompensacji krążenia w klasie według NYHA II. W 2014 r. przeszedł zawał mięśnia sercowego ściany przedniej STEMI. W maju 2014 r. wszczepiono ICD-VR SJM. Po próbie wysiłkowej pacjent zaczął rehabilitację, na którą składały się trening na cykloergometrze, ćwiczenia na sali cardiofitness oraz ogólnousprawniające na sali gimnastycznej. Treningi odbywały się 3 razy w tygodniu po 2 godziny dziennie. Obciążenie początkowe na cykloergometrze wynosiło 60 watów i wzrastało co 4 minuty o 5 watów. Po kontroli lekarskiej pół roku po podjęciu rehabilitacji przeprowadzono badanie testem spiroergometrycznym i na podstawie dobrych wyników utrzymano decyzję o kontynuacji leczenia zachowawczego. Pacjent nadal jednak zgłaszał duszność wysiłkową w klasie czynnościowej NYHA II. Podsumowanie. Po 6 miesiącach regularnego treningu rehabilitacyjnego o umiarkowanym obciążeniu zaobserwowano poprawę wydolności u pacjenta oraz zwiększenie frakcji wyrzutowej lewej komory serca. Systematyczne treningi i samodyscyplina chorego pozytywnie wpłynęły na poprawę stanu jego zdrowia i dalsze leczenie.Background. Properly selected rehabilitation training reduces the need for oxygen, slows down the resting and exertional activity of the heart and increases the ejection volume of the heart, improves the endothelial function, improves the blood circulation of skeletal muscles and increases muscle strength. The aim of this study was to determine the impact of cardiac rehabilitation on haemodynamic parameters and echocardiographic examination of the patient's heart after myocardial infarction with low left ventricle ejection fraction. Case description and rehabilitation program. Patient after myocardial infarction and diagnosed with chronic obstructive pulmonary disease in the GOLD II / A stage. ECG revealed a high degree of ischemic impairment of left ventricular systolic function. The patient was diagnosed with ischemic cardiomyopathy in the NYHA II class of circulatory compensation. In 2014, he underwent myocardial infarction of the front wall of STEMI. In May 2014 ICD-VR SJM was implanted. After the stress test the patient started rehabilitation, which consisted of training on a cycloergometer, cardiofitness exercises and general exercises in the gym. Trainings were held 3 times a week for 2 hours a day. The initial load on the cycloergometer was 60 Watt and increased by 5 Watt every 4 minutes. After the medical check-up, six months after the rehabilitation, the spiro-ergometric test was carried out and the decision to continue conservative treatment was maintained on the basis of good results. However, the patient still reported exercise dyspnoea in the NYHA II functional class. Conclusions. After six months of regular rehabilitation training with moderate load, an improvement in the patient's performance and an increase in the left ventricle ejection fraction can be observed. Systematic training and self-discipline of the patient positively influenced the improvement of health and further treatment