RESUMEN
PURPOSE: Quality of life in women receiving adjuvant endocrine therapy for breast cancer (BC) may be impaired by hot flushes and night sweats. The cool pad pillow topper (CPPT) is a commercial product, promoted to improve quality of sleep disrupted by hot flushes. This study aimed to identify if the CPPT reduces severity of sleep disturbance by minimising effects of hot flushes. METHODS: This randomised phase II trial, recruited women with BC, on adjuvant endocrine therapy, experiencing hot flushes and insomnia. Participants were randomised (stratified by baseline sleep efficiency score (SES) and menopausal status) to the intervention arm (CPPT + standard care) or control arm (standard care). Participants completed Hospital Anxiety and Depression Scale and Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaires and fortnightly sleep/hot flush diaries (where responses were averaged over 2-week periods). The primary endpoint was change in average SES from -2 to 0 weeks to 2 to 4 weeks. RESULTS: Seventy-four pre- (68.9 %) and post-menopausal (31.1 %) women were recruited. Median age was 49.5 years. Endocrine therapies included tamoxifen (93.2 %). Median SES at weeks 2 to 4 improved in both arms but the increase on the intervention arm was almost twice that on the control arm (p = 0.024). There were significantly greater reductions in hot flushes and HADS depression in the intervention arm (p = 0.09 and p = 0.036, respectively). There were no significant differences in FACT-B or HADS anxiety. CONCLUSION: This study supports the use of the CPPT as an aid to reduce sleep disturbance and the frequency/severity of hot flushes.
Asunto(s)
Ropa de Cama y Ropa Blanca , Neoplasias de la Mama/complicaciones , Crioterapia/instrumentación , Sofocos/terapia , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Adulto , Antineoplásicos Hormonales/efectos adversos , Ansiedad , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/psicología , Crioterapia/métodos , Depresión , Femenino , Sofocos/inducido químicamente , Sofocos/psicología , Humanos , Persona de Mediana Edad , Calidad de Vida , Trastornos del Inicio y del Mantenimiento del Sueño/inducido químicamente , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Encuestas y Cuestionarios , Sudoración , Tamoxifeno/efectos adversos , Resultado del TratamientoRESUMEN
OBJECTIVES: To evaluate the oxygen cost of gait and measure physical activity profiles, including time spent sedentary, in people with rheumatoid arthritis (RA) and matched controls. METHOD: We recruited 19 people with RA and 19 controls matched for age, sex, and body mass index (BMI). Demographic details and clinical characteristics of the RA population were recorded. Oxygen uptake per metre walked (oxygen cost) was measured in the laboratory using a portable gas analyser. Activity profiles including the number of steps per day, time spent sedentary (sitting or lying down), and intensity of walking were recorded over 5 days using an activity monitor, from which physical activity was classified by intensity categories. Levels of pain, fatigue, anxiety, and depression were recorded. RESULTS: People with RA walked with a slower self-selected gait speed (p < 0.001) than controls but there was no difference in the oxygen cost of walking (p = 0.992) between the groups. People with RA took fewer steps (p < 0.001), had increased sedentary time (p = 0.029) and lower time walking at cadences commensurate with moderate to vigorous physical activity (MVPA) compared to controls (p < 0.001). Pain, fatigue, and depression were higher in the RA group (all p < 0.001). CONCLUSIONS: The oxygen cost of walking in this cohort of people with RA was similar to that of matched controls but there was an increase in time spent sedentary and a reduction in time spent at cadences commensurate with MVPA. Clinical symptoms such as depression, pain, and fatigue may explain the changes in activity/sedentary behaviours in people with RA and require further investigation.
Asunto(s)
Artritis Reumatoide/fisiopatología , Actividad Motora/fisiología , Consumo de Oxígeno/fisiología , Conducta Sedentaria , Caminata/fisiología , Adulto , Anciano , Ansiedad/diagnóstico , Ansiedad/fisiopatología , Ansiedad/psicología , Artritis Reumatoide/psicología , Índice de Masa Corporal , Estudios Transversales , Depresión/diagnóstico , Depresión/fisiopatología , Depresión/psicología , Fatiga/fisiopatología , Fatiga/psicología , Femenino , Marcha/fisiología , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Índice de Severidad de la EnfermedadRESUMEN
PURPOSE: The evidence base to support therapeutic exercise for people with multiple sclerosis (MS) is improving; however few studies have considered the patients' perspective. This study aimed to explore the experiences and views of people moderately affected with MS following participation in a 12-week exercise programme. METHOD: Twenty people with MS participated in a group exercise class. Subsequently, four men and ten women took part in one of two focus groups. Semi-structured questions were used to elicit participants' views on the exercise class, outcomes from exercise and the exercise class and any perceived facilitators or barriers to exercise. Data were analysed using a general inductive method. RESULTS: Benefits to participating in exercise for those with MS included social support and symptom improvement. Psychosocial factors, symptoms and lack of service emerged as exercise barriers. Three inter-related themes emerged; (1) The exercise class developed as a bridge to allow participants to realise, (2) the benefits of the class, helping them to overcome and (3) barriers to exercise. CONCLUSION: Taking part in an exercise class was a positive experience for people with MS. Healthcare professionals should work with exercise professionals to provide feasible exercise opportunities to help those with MS benefit from therapeutic exercise.