1,721,004 research outputs found
Efficacy of exercise on depression: A systematic review
No full textOBJECTIVES: in the last 30 years, a number of studies have shown that physical activity may reduce depressive symptoms both in healthy populations and in patients diagnosed with MDD. A Decade and Half of Day Care Service for Persons with Psychiatric Disabilities: The RFS (I) Experience.
METHODS: the search of significant articles was carried out in PubMed/Medline with the following key words: “exercise”, “physical activity”, “physical fitness”, “depressive disorder”, “depression”, and “depressive symptoms”. Interval was set from January 2000 to December 2012.
RESULTS: 46 papers were retrieved by the search. Among the 14 included randomized controlled trials, treatment allocation was adequately conceived in 5 studies, intention-to-treat analysis was performed in 10 studies, and the main outcome assessment was blinded in all but three of the studies. We examined the results of all these trials, finding a small effect of exercise on depression, contaminated by the poor quality of the researches.
CONCLUSIONS: in the last 12 years, few progresses were done in showing the efficacy of exercise on depression, due in part to the persistent lack of high quality research, in part to the difficult to establish the real effectiveness of exercise on depressive symptoms. However, there are some promising findings on physical activity combined with antidepressants as an add-on strategy to manage depression, which may be probably more useful in clinical practice. © 2014 ADG, S.A. All Rights Reserved
Schizophrenia: from epidemiology to rehabilitation
No full textAbstract
PURPOSE/OBJECTIVE:
We discuss recent evidences about schizophrenia (frequency, onset, course, risk factors and genetics) and their influences to some epidemiological myths about schizophrenia diffuse between psychiatric and psychopathology clinicians. The scope is to evaluate if the new acquisitions may change the rehabilitation approaches to schizophrenia modifying the balance about the neurodevelopmental hypothesis of schizophrenia accepting that the cognitive deficits are produced by errors during the normal development of the brain (neurodevelopmental hypothesis) that remains stable in the course of illness and the neurodegenerative hypothesis according of which they derived from a degenerative process that goes on inexorably. RESEARCH METHOD/DESIGN: A review of the literature about epidemiology of schizophrenia has been performed and the contributions of some of these evidence to neurodevelopmental hypothesis and to rehabilitation has been described.
RESULTS:
It cannot be definitively concluded for or against the neurodevelopmental or degenerative hypothesis, but efforts in understanding basis of schizophrenia must go on. Until now, rehabilitation programs are based on the vulnerability-stress model: supposing an early deficit that go on stable during the life under favorable circumstances. So, rehabilitation approaches (as neuro-cognitive approaches, social skill training, cognitive-emotional training) are focused on the individual and micro-group coping skills, aiming to help people with schizophrenia to cope with environmental stress factors.
CONCLUSIONS/IMPLICATIONS:
Coping of cognitive deficits in schizophrenia may represents the starting-point for further research on schizophrenia, cohort studies and randomized trials are necessary to defined the range of effectiveness and the outcome of the treatments
Quality of life and psychiatric symptoms in wilson's disease: The relevance of bipolar disorders
No full textExergaming for Quality of Life in Persons Living with Chronic Diseases: A Systematic Review and Meta‐analysis
Full text linkObjective: To evaluate the evidence of effectiveness of exergame-based rehabilitative interventions
on health-related quality of life (HRQoL) in persons with chronic diseases.
Type: Systematic review and meta-analysis.
Literature survey: Randomized and non-randomized controlled trials of exergame rehabilitation
interventions in populations with chronic diseases reporting HRQoL outcomes were identified by
searching PubMed, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central Register
of Controlled Trials (CENTRAL), and Google Scholar, using keywords and MeSH terms for papers
published between January 2005 and March 2019.
Methodology: Risk of bias was assessed by using the PEDro scale. The GRADE system was used
to score the quality of evidence. Pooled effects were reported as standardized mean differences
(SMDs) or weighted mean difference (MDs) and 95% confidence intervals (CIs), using a randomeffects
model. Heterogeneity was weighted by inconsistency I2 tests.
Synthesis: Thirty-four trials were identified (1,594 participants). Overall, the evidence was low
quality. Exergames significantly improved HRQoL in populations with chronic diseases, with a
small effect size (32 studies; 1,544 participants; SMD 0.24; 95% CI 0.1 to 0.4; I2 = 27%) and
specifically in people with neurological disorders (20 studies, 956 participants, SMD 0.22; 95% CI
0.2 to 0.4; I2 = 49%), rheumatologic diseases (four studies, 210 participants, SMD 0.39; 95% CI 0.1
to 0.7; I2 = 4%), and cardiorespiratory and chronic metabolic conditions (five studies, 309
participants, SMD 0.23; 95% CI 0.0 to 0.5; I2 = 0%). Exergaming interventions in health care
settings demonstrated similarly small but positive effects (22 studies, 905 participants, SMD 0.30;
95% CI 0.1 to 0.5; I2 = 41%), whereas those carried out in home-based contexts did not.
Conclusions: Exergame-based rehabilitative interventions performed in health care settings led to
small but statistically significant improvements in HRQoL in persons with chronic diseases
Psychiatric comorbidity in Wilson’s disease
Full text linkWilson’s disease (WD) is a relatively rare autosomal recessive inherited disorder causing copper accumulation in different organs, mainly the liver and brain. Psychiatric disturbances represent a diagnostic and therapeutic issue in WD. A search for relevant articles was carried out on PubMed/Medline, Scopus, and Google Scholar, for papers focused on psychiatric disorders in WD published between 1985–2016. Ninety-two articles were included in this review, showing the findings from 35 observational and case-control studies and 57 case reports. This study discussed the findings on the prevalence of psychiatric symptoms in WD, their impact on the life of those diagnosed, and the efficacy of available treatments on the psychiatric outcomes of WD. Psychiatric disorders are confirmed frequent in WD, with a high prevalence of mood disorders, and contribute to worse Quality-of-Life and psychosocial outcomes. Because specific therapies for WD lead to a good life expectancy, adherence to medicaments and clinical monitoring should be warranted by a multidisciplinary approach, including a hepathologic, neurologic, and psychiatric careful evaluation and education of those affected and their relatives
Active exergames to improve cognitive functioning in neurological disabilities: a systematic review and meta-analysis
Full text linkINTRODUCTION: Exergames represent a way to perform physical activity through active video games, serving as potentially useful tool in the field of neurorehabilitation. However, little is known regarding the possible role of exergames in improving cognitive functions in persons suffering from neurological disabilities.
EVIDENCE ACQUISITION:
A search for relevant articles was carried out on PubMed/Medline, Scopus, PEDro, and Google Scholar. Only randomized controlled studies and non-randomized but controlled studies were retained. The following additional inclusion criteria were applied: studies focused on physical activity interventions carried out by means of exergames; populations targeted were affected by neurological disabilities; and reported results were related to cognitive outcomes. We calculated standardized mean differences (SMD) and pooled results using a random effects meta-analysis.
EVIDENCE SYNTHESIS:
Of 520 abstracts screened, thirteen studies met the criteria to be included yielding a total of 465 participants, 233 randomized to exergames, and 232 allocated to the alternative or no intervention. The included studies varied in terms of studied populations (e.g., multiple sclerosis, post-stroke hemiparesis, Parkinson's disease, dementia, dyslexia, Down syndrome), type and duration of interventions, and cognitive outcome measures. Exergames significantly improved executive functions (SMD=0.53, p=0.005; 8 studies, n=380) and visuo-spatial perception (SMD=0.65, p<0.0001; 5 studies, n=209) when compared to the alternative or no intervention. There were no significant differences for attention (SMD=0.57, p=0.07; 7 studies, n=250) and global cognition (SMD=0.05, p=0.80; 6 studies, n=161).
CONCLUSIONS:
Exergames are a highly-flexible tool for rehabilitation of both cognitive and motor functions in adult populations suffering from various neurological disabilities and developmental neurological disorders. Additional high-quality clinical trials with larger samples and more specific cognitive outcomes are needed to corroborate these preliminary findings.
CLINICAL REHABILITATION IMPACT:
Exergames could be considered either as a supplemental treatment to conventional rehabilitation, or as strategy to extend benefits of conventional programs at home
Quality of life, cortisol blood levels and exercise in older adults: results of a randomized controlled trial
No full textIntroduction: Cortisol plays a central role in the stress response; while high stress can determine physical and psychological impairment, moderate stress, with a mild increase in cortisol level, may have a positive effect on coping and physical performance. This trial attempted to determine whether cortisol levels were associated with Quality of Life (QoL) in a sample of elderly subjects undertaking an exercise program. Methods:42 subjects aged ≥65 years were randomlyassigned in a 1:1 fashion either to a vigorous physical activity (VAG: N=21) or to a postural gimnastic group (PGG: N=21). Differences between the two groups in QoL (on SF-12), and blood cortisol levels were assessed by ANOVA at different times. Results:In both the VAG and PGG, cortisol levels rose at the end of the trial, with statistically significant differences as compared to the baseline. QoL at the end of the trial was higher than in the national normative sample. Cortisol and QoL in both groups decreased slightly 12 weeks after the end of the trial (T2); however, only in the VAG did the difference from the initial level remain statistically significant. At T1 and T2, subjects with higher SF-12 scores were found in subsamples in both groups with cortisol levels moderately increased (between 200 and 300 mg/ml). Conclusion:In a sample of elderly subjects undergoing two different kinds of exercise, a better perception of Quality of Life was associated with a moderate, non-pathological increase in cortisol. The results need to be confirmed by trials on larger samples
Impact of direct-acting antiviral drugs for chronic hepatitis C on mood: Preliminary results from a longitudinal study
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