OBJECTIVE: To investigate feasibility of recruitment, tablet use in intervention delivery, and use of self-report outcome measures and to analyze the effect of Energy Conservation plus Problem-Solving Therapy versus Health Education interventions for individuals with heart failure-associated fatigue.METHODS: This feasibility study was a block-randomized controlled trial involving 23 adults, blinded to their group assignment, in a rural southern area in the United States. Individuals with heart failure and fatigue received the interventions for 6 weeks through videoconferencing or telephone. Participants were taught to solve their fatigue-related problems using energy conservation strategies and the process of Problem-Solving Therapy or educated about health-related topics.RESULTS: The recruitment rate was 23%. All participants completed the study participation according to their group assignment, except for one participant in the Energy Conservation plus Problem-Solving Therapy group. Participants primarily used the tablet (n=21) rather than the phone (n=2). Self-report errors were noted on Activity Card Sort (n=23). Reported fatigue was significantly lower for both the Energy Conservation plus Problem-Solving Therapy (p=0.03, r=0.49) and Health Education (p=0.004, r=0.64) groups. The Health Education group reported significantly lower fatigue impact (p=0.019, r=0.48). Participation was significantly different in low-physical demand leisure activities (p=0.008; r=0.55) favoring the Energy Conservation plus Problem-Solving Therapy group.CONCLUSION: The recruitment and delivery of the interventions were feasible. Activity Card Sort may not be appropriate for this study population due to recall bias. The interventions warrant future research to reduce fatigue and decrease participation in sedentary activities (Clinical Trial Registration number: NCT03820674).
Adult ; Bias (Epidemiology) ; Fatigue ; Feasibility Studies ; Health Education ; Heart Failure ; Heart ; Humans ; Leisure Activities ; Occupational Therapy ; Outcome Assessment (Health Care) ; Rehabilitation ; Telephone ; United States ; Videoconferencing

PURPOSE: Cancer patients are at a higher risk of being unemployed or facing difficulty in returning to work (RTW) than individuals without health concerns. The aim of this study is to identify and describe interventions developed specifically to assist cancer patients to RTW after treatment. METHODS: A comprehensive search was conducted from September to October 2018 in different international databases: PubMed, Medline, and Embase. Studies using qualitative, quantitative, or mixed designs were included if they satisfied the following criteria: (a) described an intervention to assist cancer patients to RTW during or after treatment; (b) conducted on patients aged 18 and over and diagnosed with cancer; (c) written in English; (d) published in peer-reviewed journals. RESULTS: Fourteen studies met the inclusion criteria. Counseling with physical activity intervention, behavioral training to reduce fatigue, and multi-disciplinary rehabilitation programs were found to be effective. CONCLUSION: Interventions adopting a multidisciplinary approach were effective for RTW in cancer patients. This literature review emphasizes the need for more tailored interventions based on survivors' needs and characteristics in the RTW field.
Counseling ; Fatigue ; Humans ; Motor Activity ; Rehabilitation ; Return to Work ; Survivors

BACKGROUND AND PURPOSE: This randomized controlled study examined the effect of repetitive transcranial magnetic stimulation (rTMS) on spasticity in patients with multiple sclerosis (MS). METHODS: This study included 16 patients with a history of MS and spasticity in the adductor hip muscles according to the Modified Ashworth Scale (MAS). The participants were randomized into the active group (n=10) and control group (n=6), in which active rTMS and sham rTMS were applied in 10 sessions, respectively. A physical therapy and rehabilitation program was applied along with rTMS sessions in both groups. The evaluation parameters were assessed at baseline and then 1 week and 1 month after applying rTMS. RESULTS: Statistical analyses with post-hoc correction revealed statistically significant improvements in the active group compared to the control group in the bilateral MAS score, Penn Spasm Frequency Scale score, patient satisfaction, amount of urine leakage, actual health status, perceived health status, energy and fatigue, role limitations due to physical problems, social function, overall quality of life, cognitive functioning, physical health composite score, mental health composite score, and total score on the Multiple Sclerosis Quality of Life-54 (MSQOL-54) (p<0.05). Statistically significant changes were detected in the MSQOL-54 social function and physical health composite scores of patients in the control group (p<0.05). CONCLUSIONS: Active rTMS combined with a physical therapy program reduced spasticity in MS patients compared to the control group that received only physical therapy. Further comprehensive and more advanced studies are needed to confirm the present findings.
Fatigue ; Hip ; Humans ; Mental Health ; Multiple Sclerosis ; Muscle Spasticity ; Muscles ; Patient Satisfaction ; Quality of Life ; Rehabilitation ; Social Problems ; Spasm ; Transcranial Magnetic Stimulation

Robot-assisted gait training (RAGT) is beneficial in effectively implementing repetitive, high-intensity gait training. Several studies have been conducted in different fields of RAGT; however, only a few have explored such training practices in patients with brain tumors. We conducted RAGT in 3 patients with primary brain tumors. They were treated with 30 minutes of Morning Walk® training, followed by 1 hour of conventional physiotherapy, 5 times a week for 3 weeks. At the end of RAGT, the outcomes revealed improved scores in all 3 patients on several assessments, such as the 10-meter walk test, Modified Barthel Index, Rivermead Mobility Index, Berg Balance Scale, and Karnofsky Performance Status Scale. However, the level of fatigue (Brief Fatigue Index) increased in all the patients. RAGT accompanied with conventional physiotherapy is beneficial for gait speed, mobility, and functional ambulation, but the level of fatigue is deteriorated at the same time in patients with brain tumors. The time, intensity, and protocol of RAGT accompanied with conventional physiotherapy need to be tailored to the level of fatigue expressed by patients with brain tumors to improving gait disturbances effectively.
Brain Neoplasms* ; Brain* ; Fatigue ; Gait* ; Humans ; Karnofsky Performance Status ; Rehabilitation ; Walking

OBJECTIVE: To evaluate the psychometric properties of the Fatigue Severity Scale (FSS), the Fatigue Impact Scale (FIS), and the Multidimensional Fatigue Inventory (MFI-20) in persons with late effects of polio (LEoP). More specifically, we explored the data completeness, scaling assumptions, targeting, reliability, and convergent validity. METHODS: A postal survey including FSS, FIS, and MFI-20 was administered to 77 persons with LEoP. Responders received a second survey after 3 weeks to enable test-retest reliability analyses. RESULTS: Sixty-one persons (mean age, 68 years; 54% women) responded to the survey (response rate 79%). Data quality of the rating scales was high (with 0%–0.5% missing item responses), the corrected item-total correlations exceeded 0.4 and the scales showed very little floor or ceiling effects (0%–6.6%). All scales had an acceptable reliability (Cronbach’s α≥0.95) and test-retest reliability (intraclass correlation coefficient, ≥0.80). The standard error of measurement and the smallest detectable difference were 7%–10% and 20%–28% of the possible scoring range. All three scales were highly correlated (Spearman’s correlation coefficient r(s)=0.79–0.80; p < 0.001). CONCLUSION: The FSS, FIS, and MFI-20 exhibit sound psychometric properties in terms of data completeness, scaling assumptions, targeting, reliability, and convergent validity, suggesting that these three rating scales can be used to assess fatigue in persons with LEoP. As FSS has fewer items and therefore is less time consuming it may be the preferred scale. However, the choice of scale depends on the research question and the study design.
Data Accuracy ; Fatigue* ; Humans ; Poliomyelitis* ; Postpoliomyelitis Syndrome ; Psychometrics* ; Rehabilitation ; Reproducibility of Results ; Weights and Measures*

This study suggested a new EMG-signal-based evaluation method for knee rehabilitation that provides not only fragmentary information like muscle power but also in-depth information like muscle fatigue in the field of rehabilitation which it has not been applied to. In our experiment, nine healthy subjects performed straight leg raise exercises which are widely performed for knee rehabilitation. During the exercises, we recorded the joint angle of the leg andEMGsignals from four prime movers of the leg: rectus femoris (RFM), vastus lateralis, vastus medialis, and biceps femoris (BFLH). We extracted two parameters to estimate muscle fatigue from the EMG signals, the zero-crossing rate (ZCR) and amplitude of muscle tension (AMT) that can quantitatively assess muscle fatigue from EMG signals. We found a decrease in the ZCR for the RFM and the BFLH in the muscle fatigue condition for most of the subjects. Also, we found increases in theAMT for the RFM and the BFLH. Based on the results, we quantitatively confirmed that in the state of muscle fatigue, the ZCR shows a decreasing trend whereas theAMT shows an increasing trend. Our results show that both the ZCR and AMT are useful parameters for characterizing the EMG signals in the muscle fatigue condition. In addition, our proposed methods are expected to be useful for developing a navigation system for knee rehabilitation exercises by evaluating the two parameters in two-dimensional parameter space.
Exercise ; Healthy Volunteers ; Joints ; Knee* ; Leg ; Methods ; Muscle Fatigue* ; Muscle Tonus ; Quadriceps Muscle ; Rehabilitation*

No abstract available.
Fatigue ; Humans ; Liver Transplantation ; Liver* ; Rehabilitation*

BACKGROUND: Balneotherapy, although not a well-established treatment, has been used for dermatologic diseases from ancient to modern times. However, there is little knowledge regarding the current awareness of balneotherapy in dermatologic patients and dermatologists. OBJECTIVE: To understand the current situation of balneotherapy, we first evaluated the utilization and awareness of balneotherapy among dermatology outpatients and dermatologists. METHODS: A written questionnaires were completed by 183 outpatients who visited the Department of Dermatology at a University Hospital. Online questionnaires were completed by 37 dermatologists. RESULTS: Only a small percentage of the outpatients used thermal springs/spas for therapeutic purposes. On the contrary, 93% of them used it for leisure and rest. Most outpatients thought the cleanliness of water is the most important factor in thermal springs/spas. Both outpatients (81%) and dermatologists (81%) regarded balneotherapy as a medically unestablished folk remedy. Though regarded as a folk remedy, almost all outpatients (98%) thought that balneotherapy helps improve general health problems, such as fatigue and skin diseases, or conditions related to blood circulation, pain, and joint/muscle. Participants thought that dermatology and rehabilitation medicine can be connected to balneotherapy. Although they thought that balneotherapy can improve general health, most dermatologists (70%) mentioned that it is difficult to judge the efficacy of balneotherapy owing to the lack of sufficient evidence. CONCLUSION: Although not yet considered as a confirmative therapeutic modality owing to the lack of medical verification, there is positive recognition and outlook for the effect of balneotherapy in Korea. To offer precise information to patients, more attention from dermatologists would be needed to confirm its actual efficacy.
Balneology* ; Baths ; Blood Circulation ; Dermatology ; Fatigue ; Humans ; Korea ; Leisure Activities ; Medicine, Traditional ; Outpatients* ; Rehabilitation ; Skin Diseases ; Water

PURPOSE: This study was to examine the effects of a footbath program on heart rate variability, blood pressure, body temperature and fatigue of stroke patients with stroke-induced hemiparesis. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 40 stroke patients, twenty for the footbath program and twenty for the control group, who were hospitalized in a long-term rehabilitation hospital in G city of Korea, from February to April 2014. The twenty participants in the experimental group received the intervention of footbaths and an educational program focused on the prevention of stroke complications; Collected data were analyzed by the IBM SPSS WIN 20.0 program using a t-test, chi2 test, Mann-Whitney U test and repeated measures ANOVA. RESULTS: Significant differences were found in heart rate variability, systolic blood pressure, hand and foot temperatures and fatigue between the two groups. But no significant differences were found in diastolic blood pressure, core temperatures, forehead temperatures, and hand temperatures between the two groups. CONCLUSION: The footbath program was an effective intervention for skin temperature change and fatigue reduction for stroke patients. Therefore, it is recommended that the footbath program can be utilized as an effective nursing intervention for stroke patients in long-term rehabilitation care hospitals.
Blood Pressure* ; Body Temperature* ; Fatigue* ; Foot ; Forehead ; Hand ; Heart Rate* ; Heart* ; Humans ; Korea ; Nursing ; Paresis ; Rehabilitation ; Skin Temperature ; Stroke*

OBJECTIVE: To compare and analyze the effects of cardiac rehabilitation (CR) in two groups based on the peak respiratory exchange ratio (RER(peak)) 1.1 values using the exercise tolerance test (ETT) results, and to investigate the reasons for early termination of ETT. METHODS: Patients with acute coronary syndrome who participated in CR exercise training were selected and all subjects underwent 6 weeks of CR exercise training. ETT was performed on a treadmill using a Modified Bruce Protocol before and after CR exercise training. According to the result of the first ETT, the subjects were divided into two groups: those with an RER(peak)≥1.1 (n=33) and those with an RER(peak)<1.1 (n=22). We investigated the reasons for ETT termination and compared the effect of CR between the groups. RESULTS: The reasons for the early termination of the first ETT in the RER(peak)<1.1 group were subjective dyspnea, abnormal cardiovascular responses, leg fatigue and other problems. After a 6-week CR, the peak oxygen consumption (VO2(peak)) and ETT time increased, and the rate of perceived exertion (RPE) and RPP (rate pressure product) at stage 3 decreased in both the RER(peak)<1.1 and RER(peak)≥1.1 groups. CONCLUSION: CR exercise training improved exercise capacity, not only in the RER(peak)≥1.1 group, but also in the RER(peak)<1.1 group. This means that patients with a lower exercise tolerance could also benefit from the effects of CR. Thoughtful consideration to identify the direct and indirect causes for the early termination of ETT would be necessary to improve the efficiency of CR.
Acute Coronary Syndrome ; Coronary Artery Disease* ; Coronary Vessels* ; Dyspnea ; Exercise Test ; Exercise Tolerance ; Fatigue ; Humans ; Leg ; Oxygen Consumption ; Rehabilitation*