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Objective: To examine the effects of an empowerment-based interprofessional lifestyle intervention program among people at risk of type 2 diabetes on knowledge, skills, and confidence in self-management, health, psychological well-being, and lifestyle characteristics, and to explore the participants' perceptions of participating in the intervention. Design and methods: In line with the Medical Research Council complex interventions research methods framework, we conducted a randomized controlled trial with embedded qualitative interviews in primary healthcare clinics in Norway between 2019–2021. Of the patients at risk (The Finnish Diabetes Risk Score Calculator (FINDRISC) ≥15 or Body Mass Index (BMI) ≥30) 142 accepted the invitation, and 14 participants from the intervention group participated in individual interviews after the 12-month follow-up. Our primary outcome was the Patient Activation Measure (PAM-13). Secondary outcomes were EQ-5D-5L, EQ-VAS, WHO-Overall health, WHO-Overall QOL, weight, height, waist circumference, and regularity of physical activity. We used thematic analysis to analyse the qualitative data. Results: There was no clinically relevant differences of neither the primary nor the secondary endpoints between intervention and control group. As to the qualitative data, we identified two distinct features: 'Meaningful perspectives on lifestyle changes' and 'Lifestyle change is not a linear process due to challenges faced along the way' putting ownership of their choices in life into picture. Conclusion: The negative results of the RCT stand in contrast to the findings given by the participants voices, perceiving the intervention as a key eye opener placing their health challenges in perspective. How to interpret these seemingly conflicting findings of participants being seen, heard, and understood, helping them to take more conscious ownership of their choices in life, and at the same time demonstrating no improvements in symptoms or measures, is a dilemma that needs further exploration. We should be careful to implement interventions that do not demonstrate any effects on the quantitative outcomes. [ABSTRACT FROM AUTHOR]

To evaluate the impact of depressive symptom severity on opioid use and treatment retention in individuals with prescription-type opioid use disorder (POUD). We analyzed data from a multi-centric, pragmatic, open-label, randomized controlled trial comparing buprenorphine/naloxone to methadone models of care in 272 individuals with POUD. Opioid use was self-reported every two weeks for 24 weeks using the Timeline Followback. Depressive symptom severity was self-reported with the Beck Depression Inventory at baseline, week 12 and week 24. Baseline depressive symptom severity was not associated with opioid use nor treatment retention. At week 12, moderate depressive symptoms were associated with greater opioid use while mild to severe depressive symptoms were associated with lowered treatment retention. At week 24, moderate depressive symptoms were associated with greater opioid use. Ongoing depressive symptoms lead to poorer outcomes in POUD. Clinicians are encouraged to use integrative approaches to optimize treatment outcomes. This study was registered in ClinicalTrials.gov (NCT03033732) on January 27th, 2017, prior to participants enrollment. [ABSTRACT FROM AUTHOR]

Despite recent calls for more peer support initiatives aimed at promoting mental health in postsecondary institutions, those initiatives remain scarce. In this study, a multisite randomized controlled trial was designed to assess the effect of an online peer support intervention based on acceptance and commitment therapy using mental health and school indicators. Undergraduate students were recruited in three Canadian universities and randomly assigned to an intervention (n = 54) or a wait-list control group (n = 53). Compared to control participants, those who took part in the program self-reported reduced psychological inflexibility, stress, anxiety and depression, and increased psychological flexibility and well-being. The intervention had no effect on academic satisfaction and engagement. These results were found both in completer and intent-to-treat samples. The findings provide evidence that peer support may be a beneficial adjunct to mental health interventions offered to college and university students. [ABSTRACT FROM AUTHOR]

Background: Personalized Normative Feedback (PNF) aims to modify misperceptions about peer consumption that influence one's drinking. PNF is usually a component in Brief Interventions delivered to university students. Despite this, whether PNF contributes to improving the effect of brief interventions is unclear. Objectives: This randomized controlled trial aimed to determine the role of PNF as an active ingredient in a face-to-face motivational brief intervention. Results: Participants were students from an Argentinian university (n=806; M=20.14; SD=3.17; 63.2% women) who presented at least one binge drinking episode in the last 12 months. Students were randomly assigned to 1) a Brief Intervention, 2) a Brief Intervention with PNF, or 3) an evaluation-only control group. The follow-up was three months later. After controlling sex and age, General Linear Models showed that both the brief intervention and the brief intervention with PNF reduced the quantity and frequency of alcohol consumption, binge drinking, and alcohol problems compared to the control condition. No differences were found between the brief intervention and the brief intervention with PNF. Also, treating eight students with brief intervention and 10 with brief intervention with PNF was necessary to benefit one student. Conclusions: In conclusion, this study demonstrates that brief intervention reduces alcohol consumption among Latin American university students and that PNF might not be an active ingredient of its effectiveness in this population. However, PNF could benefit students with specific characteristics, like those who overestimate their peers' drinking, highlighting the need to study moderators of effectiveness further. [ABSTRACT FROM AUTHOR]

The purpose of this randomized controlled trial (Trial registration ID: redacted) was to examine the feasibility, acceptability, and efficacy of the Step One program, an SMS-based alcohol intervention for same-sex attracted women (SSAW). Ninety-seven SSAW who scored ≥8 on the Alcohol Use Disorders Identification Test (AUDIT) were randomly allocated to receive the Step One program (n = 47; mean age = 36.79) or a weekly message containing a link to a website with health information and support services for LGBT individuals (n = 50; mean age = 34.08). Participants completed questionnaires on alcohol use, wellbeing, and help-seeking at baseline (T1), intervention completion (T2; 4 wk after baseline) and 12 wk post-intervention (T3). In addition, participants in the intervention condition completed feasibility and accessibility measures at T2, and a subsample (n = 10) was interviewed about acceptability at T3. Across conditions, participants significantly reduced their alcohol intake and improved their wellbeing and help-seeking over time. However, there were no significant differences between the intervention and control condition. Furthermore, frequency of help-seeking was low; only four intervention group participants and three control group participants began accessing support between T1 and T3. Overall, our findings indicate the intervention would benefit from revision prior to implementation. Our approach was consistent with best practice in the development of an ecologically valid intervention; however, this intervention, in its current form, lacks the complexity desired by its users to optimally facilitate alcohol reduction among SSAW. Keywords: Alcohol intervention; Intervention mapping framework; Randomized controlled trial (RCT); Same-sex attracted women; Short-message service (SMS). [ABSTRACT FROM AUTHOR]

This randomized controlled trial examined the effects of fictive kin interaction on the physical health and psychological well-being of older adults living in a shared site nursing home in China. The results revealed that depression levels significantly decreased and self-efficacy and flourishing levels significantly increased among the participants who engaged in additional one-to-one pair activities with kindergartners, with the effect size ranging from medium to large. The research findings indicated that one-to-one fictive kinship interactions between older adults and young children can promote the self-perceived physical health and psychological well-being of older adults in a Chinese context. [ABSTRACT FROM AUTHOR]

Transcranial direct current stimulation (tDCS) seems to be a potential tool to optimize the long-term effects of multimodal physical training (MPT) on fitness components in post-stroke patients. We investigated the effects of cortical tDCS combined with MPT on motor function reflected by strength, motor performance, and cardiorespiratory capacity in chronic stroke patients. This double-blind randomized controlled trial included 18 volunteers (55 ± 10 y, 72 ± 13 kg), who underwent MPT preceded by either sham stimulation (SHAM) or 2 mA bi-hemispheric tDCS. MPT consisted of 24 sessions of 60–70 min performed 2 d/wk within 12–16 weeks, with individualized intensity. Outcomes were Fugl-Meyer scores for lower limbs (FM-LL), and total (FM-Total); speed in the 10-m walk test (10MWT); oxygen uptake and work output at maximal effort (VO2max and Wmax), and gas exchange threshold (VO2-GET and W-GET); peak torque of isokinetic knee extension (PT-EXT) and flexion (PT-FLEX) of paretic and non-paretic limbs; bilateral strength deficit during knee extension (DS-EXT) and flexion (DS-FLEX). Pre- vs. post-intervention improvements were detected in tDCS vs. SHAM (p < 0.05) for FM-total (29.6% vs. 15.9%; effect size [ES] = 0.78), FM-LL (35.9% vs. 9.0%; ES = 1.23), 10MWT (10.6% vs. 3.8%; ES = 0.67), Wmax (75.0% vs. 4.3%; ES = 1.68), W-GET (91.6% vs. 12.4%; ES = 1.62), PT-EXT (25.6% vs. −6.5%; ES = 1.94) and PT-FLEX (26.3% vs. 9.8%; ES = 0.65) of the paretic limb, and DS-EXT (−13.7% vs. 2.5; ES = 1.43). Bi-hemispheric cortical tDCS optimized the effects of MPT performed with moderate volume and intensity upon muscle strength, motor function, and cardiorespiratory performance in stroke hemiparetic survivors. (Registration number RBR-22rh3p). [ABSTRACT FROM AUTHOR]

Objective: Performance of Cognitive Refocusing Treatment for Insomnia (CRT-I) relative to stimulus control treatment (SCT) remains unknown among college students. This pilot trial compared single-session, electronic-based, peer-led CRT-I to SCT, and as well as awareness-based (AC) and no-treatment (NTC) controls. Participants: College students (N = 82; Mage=18.59 [SD = 0.78]; 58% female; 61% White; 16% Hispanic) with insomnia symptoms were randomly assigned to CRT-I (n = 12), SCT (n = 14), and AC (n = 14) conditions, or non-randomly recruited to NTC (n = 42). Methods: All participants completed baseline and one-month follow-up surveys, and reported daily task enactment (except NTC). Results: Feasibility ratings were comparable across conditions. Within-group treatment effects revealed greater improvements in (a) insomnia symptom severity among CRT-I (d = 1.13) and SCT (d = 1.66) groups relative to AC (d = 0.90) and (b) pre-sleep cognitive arousal among CRT-I (d = 0.94) and SCT (d = 1.42) groups relative to AC (d = 0.75). Conclusions: Brief, electronic-based, peer-led CRT-I and SCT interventions appear feasible and potentially efficacious for college insomnia. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the effect of integrating custom-designed hand therapy video games (HTVG) with contralaterally controlled functional electrical stimulation (CCFES) therapy. Methods: Fifty-two stroke survivors with chronic (>6 months) upper limb hemiplegia were randomized to 12 weeks of CCFES or CCFES + HTVG. Treatment involved self-administration of technology-mediated therapy at home plus therapist-administered CCFES-assisted task practice in the lab. Pre- and post-treatment assessments were made of hand dexterity, upper limb impairment and activity limitation, and cognitive function. Results: No significant between-group differences were found on any outcome measure, and the average magnitudes of improvement within both groups were small. The incidence of technical problems with study devices at home was greater for the CCFES + HTVG group. This negatively affected adherence and may partially explain the absence of effect of HTVG. At end-of-treatment, large majorities of both treatment groups had positive perceptions of treatment efficacy and expressed enthusiasm for the treatments. Conclusion: This study makes an important contribution to the research literature on the importance of environmental factors, concomitant impairments, and technology simplification when designing technology-based therapies intended to be self-administered at home. This study failed to show any added benefit of HTVG to CCFES therapy. Clinicaltrials.gov (NCT03058796). IMPLICATIONS FOR REHABILITATION: Contralaterally controlled functional electrical stimulation (CCFES) is an emerging therapy for upper limb rehabilitation after stroke that is designed, in part, to be self-administered at home. While movement-soliciting video games have shown promise in rehabilitation, this study failed to show a significant added benefit of integrating CCFES with hand therapy video games. For technology-based therapies intended to be self-administered at home, this study brings to light the importance of making every component of rehabilitation technology as user friendly and trouble-free as possible. For technology-based therapies intended to be self-administered at home, this study brings to light the importance of assuring that the home environment is conducive to home-based therapy. [ABSTRACT FROM AUTHOR]

This trial was carried out to investigate the effect of forced air warming in various body areas of women on hypothermia during cesarean delivery. The patients in the study groups (n = 76) were assigned to the full-body warming group, upper-extremity warming group, lower-extremity warming group, and control groups. The intervention groups received forced-air warming 30 min before the surgery and continued until 30 min after surgery. The incidence of hypothermia was significantly higher in the control group than in the other groups at the 60th minute of the operation (p < 0.01). The intervention and control groups showed significant differences in the frequency of shivering at the entrance to the PACU (p = 0.001). Thermal comfort scores have significant difference between the control group and all of the intervention groups (p<.001). It is said that the full-body forced-air warming technique prevents hypothermia, shivering, and thermal discomfort in women Cesarean Section (CS). [ABSTRACT FROM AUTHOR]

Objective: The benefits of mindfulness-training and mentoring for college students have yet to be investigated. We aimed to provide an exploratory and descriptive account of their potential benefits during the COVID-19 pandemic. Participants: In February 2020, 49 undergraduates (M = 20.51 years-old; 94% female) participated in a randomized trial of 12-week mentoring + mindfulness or mentoring-as-usual. After five weekly mentoring-sessions, programs were interrupted by COVID-19; mentoring continued online. Methods: Undergraduates completed questionnaires about mental health, behaviors, and regulatory processes in February and July 2020, with additional COVID-19-related questions at follow-up. Results: Participants reported moderate COVID-19-related perceived stress, but mental health, health behaviors, and regulatory processes did not diminish over time, with no condition differences. Undergraduates described using contemplative practices and social support to cope with COVID-19-stress. Conclusions: Undergraduates showed stable mental health/health behaviors despite moderate COVID-19-related-stress. Future research on mentoring with a mindfulness component among a larger and more heterogeneous sample will be necessary. [ABSTRACT FROM AUTHOR]

We conducted a parallel-group randomized controlled trial in three HIV clinics in Mexico to evaluate a user-centred habit-formation intervention to improve ART adherence among MSM living with HIV. We randomized 74 participants to the intervention group and 77 to the control group. We measured adherence at one, four, and ten months through medication possession ratio and self-reported adherence. Additionally, we measured viral load, CD4 cell count, major depression disorder symptoms, and alcohol and substance use disorder at baseline, fourth and tenth months. We found no statistically significant effect on adherence between groups. However, the intervention demonstrated positive results in major depression disorder symptoms (21% vs. 6%, p = 0.008) and substance use disorder (11% vs. 1%, p = 0.018) in the fourth month. The latter is relevant because, in addition to its direct benefit, it might also improve the chances of maintaining adequate adherence in the long term. This trial was retrospectively registered at ClinicalTrials.gov (trial number NCT03410680) on 8 January 2018. Trial registration: ClinicalTrials.gov identifier: NCT03410680. [ABSTRACT FROM AUTHOR]

This pilot randomized controlled trial aimed to evaluate the feasibility and potential outcomes of an innovative 16-session multicomponent intervention model to improve cognitive abilities in older adults with mild cognitive impairment (MCI) by promoting healthy lifestyle, cognitive skills, tai chi and mindfulness practices. This study was a multicentre, randomized controlled, two-arm, parallel-group, unblinded trial in Hong Kong. 57 Chinese older adults with MCI recruited from three local elderly centers were randomly assigned to either the control or intervention group. The study results support the feasibility and efficacy of the multicomponent intervention, and recommend future larger-scale randomized control trials. [ABSTRACT FROM AUTHOR]

To verify the effectiveness of experimental occupational therapy plus intensive standard rehabilitation compared to intensive standard rehabilitation alone on the reintegration to social activities of complex patients three months after hospital discharge. Patients with a score ≥ 9 on the Rehabilitation Complexity Scale at admission to an intensive rehabilitation ward were randomized to the control or experimental group. Both groups received intensive multidisciplinary rehabilitation aimed at recovering independence in the basic activities of daily life (ADL). The experimental group also received experimental occupational therapy services to address goals identified through the administration of the Canadian Occupational Performance Measure (COPM). Experimental occupational therapy began during the in-hospital phase and continued in the home-based setting. It consisted of teaching strategies, recommending aids, and providing personalized information regarding available community support. Ninety-two individuals with a mean age of 65 years (female 44.6%) were enrolled. The experimental group significantly improved participation measured by the Reintegration to Normal Living Index (mean changes 8.61, 95% CI: 1–16.23, p = 0.027). The performance and satisfaction scores of the COPM, both during hospitalization and after discharge, and independence in ADL also improved. No differences in mood disturbances were found. Early post-discharge occupational therapy integrated with multidisciplinary rehabilitation improves the social participation of complex patients. Future research should investigate the concrete feasibility of implementing this complex intervention cost-effectively and in different contexts. ClinicalTrials.gov Identifier NCT03668938 (first posted date 13/09/2018) Early post-discharge rehabilitation assists patients' transition from hospital to home by improving the management of problems they encounter. In complex patients, occupational therapy initiated during hospitalization and extended to the early post-discharge phase improves social participation, independence in basic and instrumental daily activities, and performance and satisfaction when carrying out relevant occupational activities. The strong partnership between the Occupational Therapist and the patient improves compliance to treatment, enhancing the chances of success of rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Mobile health applications (mHealth apps) may lead to health benefits. In recent years, the use of apps in multiple sclerosis (MS) has increased. Apps to train and improve dexterity in MS are scarce. This study investigated the effectiveness of a tablet app-based home-based training to improve dexterity in individuals with MS. In a randomized controlled trial, two standardized 4-week home-based interventions focussing on different aspects of dexterity and upper limb function were compared. Assessments were done at baseline, post-intervention and 12-week follow-up. The primary endpoint was the Arm Function in Multiple Sclerosis Questionnaire, a dexterity-related measure of patient-reported activities of daily living. Secondary endpoints were dexterous function, grip strength and health-related quality of life. Forty-eight individuals were randomly assigned to a tablet app-based program (n = 26) or a control strengthening exercise program (n = 22). No significant differences were found for the primary endpoint (p = 0.35). Some significant differences in favour of the app-group were found in fine coordinated finger movements and strength. No significant differences were found at the 12-week follow-up for all endpoints. Adherence in both groups was above 90%. App-based training was not superior compared to a control strengthening exercise program concerning the arm- and hand function from the participant's perspective. However, app-based training was found to be effective in improving specific dimensions (finger movements and strength), and can easily be applied at home. Therefore, individuals living with MS with impaired dexterity should consider app-based training. Clinicaltrials.gov NCT03369470. This study provides initial evidence for the effectiveness of a home-based app-based program for improving dexterous function in individuals living with multiple sclerosis through the implementation of a tablet app-based dexterity training. App-based training was not superior compared to a control strengthening exercise program concerning the arm- and hand function from the participant's perspective. Patients attending the app-based dexterity program showed some statistically significant improvements in fine coordinated finger movements and strength. [ABSTRACT FROM AUTHOR]

Coaches influence athletes' body image, but often feel ill-equipped to address body image concerns and inadvertently perpetuate harmful body ideals. No evidence-based, empirically-tested body image intervention for coaches exists. This study evaluated the acceptability and preliminary efficacy of a novel web-based intervention (body confident coaching [BCC]), comprising five self-led 20-min modules. A pilot randomized controlled trial was conducted with 97 coaches of adolescent girls (Mage = 36.6yrs, SD = 10.4; 70% women). Coaches were randomized into the intervention (n = 52) or waitlist control condition (n = 45). Intervention condition participants completed baseline self-assessments (demographics, target outcomes), took part in BCC over two weeks, and completed post-intervention self-assessments (target outcomes, acceptability, adherence). Waitlist control participants completed baseline (demographics, target outcomes) and post-intervention self-assessments (target outcomes), after which they received unmonitored access to the intervention. Intervention condition participants who completed post-intervention assessments (n = 16) finished all five modules and 75% reported engaging with the additional resources. Coaches found the intervention easy to follow, appropriate, useful, and enjoyable. Preliminary efficacy analyses indicated that the intervention condition reported higher levels of self-efficacy toward body image (ηp2 =.19), and lower levels of fat phobia (ηp2 =.39) and gender essentialist beliefs (ηp2 =.20) at post-intervention, compared to the waitlist condition. A limitation of this study is the small sample size and high attrition rate (51%), which may bias results. Following modifications to the intervention and trial protocol, BCC will be evaluated in a large-scale randomized controlled effectiveness trial. Lay summary: Body dissatisfaction is common among girls in sport, but coaches are unprepared and unskilled to address these concerns, and few resources for coaches exist. A new education program was found to be appropriate, useful, and enjoyable for coaches and improved their ability to recognize and address athletes' body image concerns. It is important for sport organizations to understand and recognize the relationship between athletes' body image and their broader mental health and sport performance, as well as coaches' influence on, and responsibility to address, body image concerns among their athletes and to promote body positive sport environments. BCC can increase coaches' self-efficacy to identify and address athletes' body image concerns, as well as reduce coaches' fat phobia and gender essentialist beliefs. BCC: a pilot randomized controlled trial evaluating the acceptability of a web-based body image intervention for coaches of adolescent girls Trial Registration: This trial has been registered with ClinicalTrials.gov, a database of privately and publicly funded studies conducted around the world. Registration date: 7 April 2022; Registration ID: NCT05316558. . [ABSTRACT FROM AUTHOR]

In vitro fertilisation is a stressful process for women. Hypnofertility is a method that can be used to relieve stress during in vitro fertilisation. It is based on an effective and strong body-mind interaction, as well as balancing the brain and body via positive words and thoughts. This study aimed to investigate the effects of hypnofertility on fertility preparedness, stress, and coping with stress in women undergoing in vitro fertilisation. This study was conducted with a randomised controlled trial design. Hypnofertility-based relaxation, visualisation, imagination, and affirmation techniques were applied to the intervention group at four stages, and no initiative was applied to the women in the control group. The Clinical Trial Registration number of the study is NCT04755270. After the hypnofertility method, the mean score of the intervention group in the positive feelings and thoughts subscale of the Fertility Preparedness Scale was higher than that of the control group (p < 0.05). The hypnofertility method caused a significant decrease in the level of infertility stress in the intervention group, and the intervention group used the active-confronting and passive-avoidance methods more than control group did (p < 0.05). The hypnofertility method increased the levels of preparedness for fertility, reduced stress levels and provided effective strategies to cope with stress. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) and chronic low back pain (CLBP) are frequently co-morbid. Some research suggests that PTSD and CLBP may share common neurobiological mechanisms related to stress. Traditional biomedical education may be ineffective for PTSD and CLBP, especially when co-morbid. The purpose of this study is to determine if pain neuroscience education (PNE) is more effective than traditional education in reducing PTSD, disability, pain, and maladaptive beliefs in patients with CLBP. Participants with CLBP and possible PTSD/PTSD-symptoms were recruited for this study. Participants were randomly allocated to a PNE group or a traditional education group. The intervention included 30 minutes of education followed by a standardized exercise program once a week for 4-weeks with a 4 and 8-week follow-up and healthcare utilization assessed at 12-months. Forty-eight participants consented for this research study with 39 allocated to treatment (PNE n = 18, traditional n = 21). PNE participants were more likely to achieve a clinically meaningful reduction in PTSD symptoms and disability at short-term follow-up. At 12-months, the PNE group utilized healthcare with 76% lower costs. In participants with CLBP, PNE may reduce hypervigilance toward pain and improve PTSD symptoms. Participants who received PNE were more confident body-tissues were safe to exercise. These beliefs about pain could contribute to a decrease in perceived disability and healthcare consumption for CLBP. [ABSTRACT FROM AUTHOR]

Sexual dysfunction caused by opioids is one of the serious problems of drug misusers. This study aimed to evaluate and compare the effect of continuous low-dose sildenafil treatment alongside psychological training on the sexual function of methadone-treated patients. This randomized clinical trial was conducted on methadone-treated men with sexual dysfunction. Patients were randomly divided into two treatment groups: sildenafil 25 mg and psychological training. Sexual Quality of Life-Men, Sexual Self-Efficacy Scale–Erectile, and the International Index of Erectile Function were used before and 4 weeks after the end of the intervention. A total of 67 couples were included in the study (34 psychological interventions vs. 33 sildenafil group). After 4 weeks of treatment, the mean of male erectile function (33.73 ± 8.114 and 27.62 ± 6.238, p = 0.003) and sexual self-efficacy score (78.36 ± 12.713 and 69.62 ± 14.940, p < 0.0001) in the sildenafil group were statistically significant compared to the psychological group, however, the sexual quality score of the two groups was not statistically significant (31.48 ± 9.216 and 31.71 ± 11.333, p = 0.342). The sexual function of methadone-treated men in both groups was significantly improved, yet this difference was significantly greater in the pharmaceutical treatment group than the trainings. As a result, due to the high need for treatment, any type of intervention (medication or psychotherapy) will be effective in these patients. [ABSTRACT FROM AUTHOR]

After a total knee arthroplasty (TKA), ensuring rehabilitation is continued at home is essential for a successful recovery. The aim of this randomized clinical trial (NCT04155957) was to demonstrate the safety and efficacy of an interactive telerehabilitation system (ReHub®) to guide and provide feedback during exercise in the postoperative period of a fast-track TKA program. Fifty-two patients who underwent TKA were randomized to intervention (N = 26) or control (N = 26). Upon discharge, they followed a 4-week plan of 5 daily exercises and up to 10 physiotherapy home visits. The intervention group performed exercises with ReHub® autonomously, control did not use any auxiliary device. Data were collected 1) on the day of discharge, 2) after 2 weeks and 3) after 4 weeks. Telerehabilitation patients showed higher adherence to exercise (p = 0.002) and greater quadriceps strength (p = 0.028). No significant differences between groups were found in other outcomes. Only 1 adverse event was linked to ReHub®. Patients gave the platform high System Usability Scale scores (83/100). Interactive telerehabilitation with ReHub® during a post-TKA exercise program is effective, safe, and well-received by patients. It provides real-time performance feedback and ensures communication. Quadriceps strength and adherence to the exercise plan are improved with ReHub®. Telerehabilitation platforms can be introduced into fast-track total knee arthroplasty protocols to monitor home-based exercise programmes without compromising efficacy and safety. Telerehabilitation and remote patient monitoring contribute to obtaining high levels of adherence to exercise plans, which is a current challenge faced by rehabilitation professionals. Real-time biofeedback on exercise performance facilitates correct exercise performance and motivates the patient. This technology allows professionals to monitor and adjust the patient's therapy remotely and avoid unnecessary travel. [ABSTRACT FROM AUTHOR]

In this study, we investigated the effects of mirror therapy (MT) combined with contralaterally controlled functional electrical stimulation (CCFES) on upper limb motor function, activities of daily life, and corticospinal excitability in post-stroke patients. Sixty post-stroke patients were randomly divided into four groups: CCFES, MT, MT combined with CCFES, and control. All the patients underwent routine rehabilitation. Those in the MT, CCFES, MT combined with CCFES, and control groups received MT, CCFES, MT combined with CCFES, and routine rehabilitation alone, respectively. Upper limb motor function, activities of daily living, and corticospinal excitability were evaluated before and after a 3-week intervention period. MT combined with CCFES demonstrated a significantly greater therapeutic effect on motor function of the paretic wrist than CCFES, MT, or routine rehabilitation alone. However, there was no significant difference in the overall motor function of the affected upper limb, activities of daily life, or corticospinal excitability between the MT combined with CCFES group and the other three groups. MT combined with CCFES may be a potential adjuvant therapy to promote motor function in paretic wrist after stroke. The combined therapy of mirror therapy (MT) and contralaterally controlled functional electrical stimulation (CCFES) may be a potential adjuvant therapy to promote motor function in paretic wrists after stroke. MT combined with CCFES could be incorporated into rehabilitation programs for post-stroke patients with impaired upper limb motor function. Exploring the potential benefits of combining different rehabilitation therapies could inform the development of more effective interventions. [ABSTRACT FROM AUTHOR]

Increasing physical activity in daily life (PADL) in chronic obstructive pulmonary disease (COPD), mainly in short-term training programs, is still a challenge. The combination of functional exercises with aerobic and resistance training may be a strategy to improve PADL and limitations in activities of daily living (ADL) in COPD. To evaluated the short- and medium-term effects of the combination of functional exercises with aerobic and resistance training. Seventy-six patients were randomized into (1) functional training group who performed resistance and aerobic and functional exercises; (2) conventional training group (CTG) who performed resistance and aerobic exercise; or (3) usual care group who performed respiratory physiotherapy. Patients were evaluated for PADL (activity monitor), ADL limitations (London Chest Activity of Daily Living scale [LCADL]), functional exercise capacity (6-minute walk test [6MWT]), and peripheral muscle strength before and after eight weeks. Medium-term effects were evaluated 12 weeks after the training. There were no changes or differences between groups in PADL and in 6MWT post-intervention and 12 weeks post-training. Only CTG showed a reduction in the total score on LCADL scale after the intervention and increase at follow-up (score: 20 ± 8; 17 ± 6; 19 ± 8, pre-intervention, post-intervention, and 12 weeks post-training, respectively, p = 0.001), without differences between groups (p = 0.375). There were increases in the muscle strength of knee flexors (p = 0.016) and extensors (p < 0.001) after the intervention only in CTG. Combined aerobic and resistance training with functional exercises failed to improve PADL and ADL limitations in COPD. Eight weeks of conventional training improved ADL. This, however, was not superior to the results from the other groups and was not sustained at medium-term 12 weeks post-training. [ABSTRACT FROM AUTHOR]

This study aimed to verify the effects of 4 weeks of high-intensity interval training (HIIT), heavy (HRT) and explosive (ERT) resistance training on aerobic, anaerobic and neuromuscular parameters and performance of well-trained runners. Twenty-six male athletes were divided into HIIT (n = 10), HRT (n = 7) and ERT (n = 9) groups. Maximal oxygen uptake ($V{O_2}\max $ V O 2 max) and the corresponding velocity ($vV{O_2}\max $ vV O 2 max), anaerobic threshold (AT), running economy (RE), oxygen uptake kinetics, lower-body strength (1RM) and power (CMJ), and the 1500m and 5000m time-trial (TT) were determined. Improvements were observed in $vV{O_2}\max $ vV O 2 max (mean difference (Δ): 2.6%; effect size (ES): 0.63) with HIIT, while AT was incresead in ERT (Δ: 4.3%; ES: 0.73) and HRT (Δ: 6.9%; ES: 0.72) groups. The CMJ performance was increased in ERT (Δ: 13.8%; ES: 1.03), HRT (Δ: 6.9%; ES: 0.55) and HIIT (Δ: 5.4%; ES: 0.34), whereas 1RM increase in HRT (Δ: 38.1%; ES: 1.21) and ERT (Δ: 49.2%; ES: 0.96) groups. HIIT improved the 1500m (Δ: −2.3%; ES: −0.62) and both HRT (Δ: −1.6%; ES: −0.32) and ERT (Δ: −1.7%; ES: −0.31) the 5000m TT. Despite performance adaptations were dependent on the training characteristics, both RT and HIIT model constitute an alternative for training periodization. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy of environment-based intervention on participation outcomes and parent efficacy in autistic children. Twenty-one autistic children 6–10 years old and their parents were randomized to environment-based intervention (n = 11) or usual care (n = 10). The environment-based intervention targets individualized participation goals in leisure and community activities through changing environment and activity demands. The study outcomes were Canadian Occupational Performance Measure (COPM), Goal attainment scaling (GAS), and Parent Empowerment and Efficacy Measure (PEEM). Assessments included baseline, 12 weeks (post-test), and 24 weeks (follow-up). Mixed ANOVAs were used to examine within-group and between-group effects in outcome variables. The COPM performance and satisfaction scores and GAS T-scores increased after environment-based intervention from baseline to 12 weeks and 24 weeks (p < 0.001) but did not significantly differ from usual care. The medium to large effect sizes of COPM performance and GAS T-scores favored the environment-based intervention. For the PEEM scores, no significant differences were found. Environment-based intervention may support school-age autistic children to participate in self-chosen activities over time. The intervention effects on participation goals and parent efficacy, however, were inconclusive and need further research. Environmental barriers are important attributes to participation restriction in autistic children. Interventions focusing on modifying the task and environment is viable in supporting the participation of autistic children. The environment-based intervention appears to improve the participation goals in leisure and community-based activities over time. The environment-focused strategies may include providing social support, enabling access to a sensory-friendly environment, finding inclusive programs, adapting task demands, and managing routines. [ABSTRACT FROM AUTHOR]

To evaluate the immediate and 4-week effects of compression garments (CG) on balance using a force platform during 8 different visual, static, and dynamic conditions in hypermobile Ehlers-Danlos Syndrome (hEDS) patients. Thirty-six participants were randomly assigned to a group: physiotherapy alone (PT, n = 19) or physiotherapy and daily CG wearing for 4 weeks (PT + CG, n = 17). Both attended 12 physiotherapy sessions (strengthening, proprioception, and balance exercises) for 4 weeks. Primary outcome: sway velocity of the centre of pressure (COP) measured before, immediately with the CG, and at 4 weeks. Secondary outcomes: ellipse area, Romberg quotient, and pain. Sway velocity in dynamic conditions decreased immediately with the CG. After 4 weeks of intervention, sway velocity (95% CI 4.36–39.23, effect size 0.93) and area (95% CI 146–3274, effect size 0.45) on the laterally oscillating platform with eyes-closed improved more in the PT + CG group than the PT group. Romberg quotient on foam cushion improved more in the PT + CG than the PT group. Pain decreased in both groups after 4 weeks with no between-group difference. CG combined with physiotherapy improved dynamic balance measured with COP variables significantly more than physiotherapy alone in people with hEDS. NCT03359135 Compression garments immediately improve balance in people with hypermobile Ehlers-Danlos Syndrome (hEDS) Compression garments combined with regular physiotherapy improve balance in people with hEDS after 4 weeks of treatment Compression garments could compensate for proprioceptive impairment in hEDS [ABSTRACT FROM AUTHOR]

Given the prevalence of motor deficits post-stroke, a large proportion of stroke rehabilitation interventions are directed toward motor recovery. The purpose of this study is to present a detailed investigation of the methodological characteristics in the stroke rehabilitation literature with respect to randomized controlled trials (RCTs) designed to facilitate upper extremity motor recovery. This review was conducted following guidelines from the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA) statement. English articles of RCTs were eligible if they were published before April 1, 2021 and applied an intervention to the hemiparetic upper extremity of individuals post stroke as the primary objective of the study, or recorded at least one upper extremity related outcome measure. The number of RCTs for upper extremity rehabilitation interventions post stroke has been increasing, with over three quarters of RCTs published in the last decade. In total, 1,307 RCTs met inclusion criteria for which the mean sample size (start/finish) was 45.8 (SD 55.4)/41.8 (SD 49.7). The median sample size (start/finish) was 30 (IQR 20–48)/29 (IQR 19–44). The mean PEDro score was 6.12 (SD 1.55). 251 RCTs (19%) were multi-centered trials. Key methodological measures of quality remain low including the blinding of assessors (59%), intention to treat analyses (42%) and concealed allocation (37%). There is a large number of RCTs evaluating stroke rehabilitation upper extremity interventions. Research quality continues to be a challenge (low percentage of key quality indicators, small percentage of multicentred trials, small sample sizes) but is slowly improving. [ABSTRACT FROM AUTHOR]

The main aim of this study was to investigate the effects of circuit resistance training (CRT) on post-exercise appetite and energy intake in chronic hemiparetic stroke patients. A secondary aim was to evaluate the reproducibility of these effects. Seven participants met the eligibility criteria and, in a randomized order, participated in a non-exercise control session (CTL) and two bouts of CRT. The CRT involved 10 exercises with 3 sets of 15-repetition maximum per exercise, performed using a vertical loading approach, with each set interspersed with 45s of walking. Expired gases were carried out to calculate the net energy cost of the exercise and the relative energy intake post-CTL/CRT. Hunger, fullness, desire to eat, and energy intake were assessed at baseline and for 12 h after CTL and CRT. Compared to CTL, hunger, desire to eat (P <.001), and relative energy intake (P <.05) were significantly lower after CRT, whereas the perception of fullness was significantly higher (P <.001). Significant differences between CTL and CRT were observed only for the first 9 h of the post-exercise period for hunger, fullness, and desire to eat (P <.05). No significant differences in appetite or relative energy intake were observed between the two bouts of CRT. A bout of CRT elicited decreased post-exercise appetite and relative energy intake in chronic hemiparetic stroke patients. Decreased appetite perceptions lasted for around 9 h and were reproducible. [ABSTRACT FROM AUTHOR]

Developing self-care behaviors is a fundamental yet challenging strategy to prevent the complications of diabetes. This three-arm randomized controlled trial aimed to compare the effectiveness of combined mindfulness and self-regulation-based intervention with self-regulation-based intervention on self-care behaviors of Iranian older adults with diabetes in 2021–2022. Three public diabetic clinics were randomly assigned to three study groups and then 45 participants were randomly recruited from every clinic. 24-week educational interventions via WhatsApp included a self-regulation-based intervention (SRIP), a combined mindfulness and self-regulation intervention (CMSRIP), and routine care with training on COVID-19 prevention were performed in two intervention groups and a control group respectively. Data were collected at baseline and four and 16 weeks using a Mindfulness-based questionnaire (MSCS) and a summary of the diabetes self-care activities scale (SDSCA). The SPSS software (V. 22) was used to analyze data through ANOVA test, chi-square tests, one-way ANOVA, Levene's test, and Repeated measures MANCOVA at a significance level of less than 0.05. The total scores of MSCS and SDSCA in four and 16 weeks significantly increased compared to the baseline in both SRIP and CMSRIP groups (P <.001), but not in the control group. The mean scores of MSCS and SDSCA at week 4 in CMSRIP group improved significantly more than SRIP group (98.43 ± 5.83 vs. 90.31 ± 12.62 and 70.38 ± 4.18 vs. 62.35 ± 5.53). Combined mindfulness and self-regulation education are significantly effective in promoting self-care skills and improving cognitive processes and can used to improve older adults' self-care behaviors. This trial (ISRCTN77260130) was retrospectively registered on 28/09/2021. [ABSTRACT FROM AUTHOR]

Wellness Recovery Action Planning (WRAP®) is a recovery-oriented program designed for people with mental illness to improve well-being and self-manage symptoms. This randomized controlled trial investigates the effectiveness of brief Wellness Recovery Action Planning (WRAP®) as a mental health self-management tool for adults without formal clinical diagnoses in Hong Kong. 182 adults were randomly assigned to WRAP® or waitlist control condition to investigate whether WRAP® can promote mental well-being and reduce psychological distress for community adults with no known diagnosable mental disorders. Significant improvements were found in depressive (ηp2 =.11) and anxiety symptoms (ηp2 =.06), empowerment (ηp2 =.09), and personal recovery (ηp2 =.11) among WRAP® participants compared with waitlist control participants. Moreover, changes in anxiety symptoms, hope, empowerment, and reliance on others were found to sustain at 3-month follow-up. Brief WRAP® is an effective self-management tool in enhancing mental health and alleviating psychological distress for millennials living in the community. [ABSTRACT FROM AUTHOR]

Perinatal depression has been shown to have deleterious effects on maternal postpartum functioning as well as early child development. However, few studies have documented whether depression care helps to mitigate these effects. We examined the effects of the M-DEPTH (Maternal Depression Treatment in HIV) depression care model (including antidepressants and individual problem solving therapy) on maternal functioning and infant development in the first 6 months post-delivery in an ongoing cluster randomized controlled trial of 391 HIV-infected women with at least mild depressive symptoms enrolled across eight antenatal care clinics in Uganda. A subsample of 354 (177 in each of the intervention and control groups) had a live birth delivery and composed the analytic sample, of whom 69% had clinical depression at enrollment; 70% of women in the intervention group (including 96% of those with clinical depression) received depression treatment. Repeated-measures multivariable regression models found that the intervention group reported better infant care, lower parental burden, and greater perceived adequacy of parental support, compared to the control group. These findings suggest that depression care for pregnant women living with HIV is important not only for maternal mental health but also because it helps women to better manage parenting and care for their infant. [ABSTRACT FROM AUTHOR]

This study evaluated learning and recall effects following a feedback-based retraining program. A 6-month follow-up of a quasi-randomized controlled trial was performed with and without recall. Twenty runners were assigned to experimental or control groups and completed a 3-week running program. A body-worn system collected axial tibial acceleration and provided real-time feedback on peak tibial acceleration for six running sessions in an athletic training facility. The experimental group received music-based biofeedback in a faded feedback scheme. The controls received tempo-synchronized music as a placebo for blinding purposes. The peak tibial acceleration and vertical loading rate of the ground reaction force were determined in a lab at baseline and six months following the intervention to assess retention and recall. The impacts of the experimental group substantially decreased at follow-up following a simple verbal recall (i.e., run as at the end of the program): peak tibial acceleration:-32%, p = 0.018; vertical loading rate:-34%, p = 0.006. No statistically significant changes were found regarding the retention of the impact variables. The impact magnitudes did not change over time in the control group. The biofeedback-based intervention did not induce clear learning at follow-up, however, a substantial impact reduction was recallable through simple cueing in the absence of biofeedback. [ABSTRACT FROM AUTHOR]

To estimate the effects of an interactive web-based support system via mobile phone on preference-based patient participation in patients with hypertension treated in primary care (compared with standard hypertensive care only). A parallel group, non-blinded, randomized controlled trial, conducted October 2018–February 2021. Besides standard hypertensive care, the intervention group received eight weeks of support via mobile phone to facilitate self-monitoring and self-management, tentatively providing for augmented patient engagement. 31 primary healthcare centers in Sweden. 949 patients treated for hypertension. The effects on preference-based patient participation, that is, the match between a patient's preferences for and experiences of patient participation in their health and healthcare. This was measured with the 4Ps (Patient Preferences for Patient Participation) tool at baseline, after 8 weeks, and at 12 months. Data were registered electronically and analyzed with multilevel ordinal regression. At baseline, 43–51% had a complete match between their preferences for and experiences of patient participation. There was an indication of a positive effect by a higher match for 'managing treatment myself' at 8-weeks in the intervention group. Such preference-based participation in their health and healthcare was reversed at 12 months, and no further effects of the intervention on preference-based patient participation persisted after 12 months. The interactive web-based support system via mobile phone had a wavering effect on preference-based patient participation. There is a prevailing need to better understand how person-centered patient participation can be facilitated in primary care. Although patient participation is essential when having a long-term condition, interventions optimizing individuals' engagement have not been fully identified. About half of the patients with hypertension in this study did not experience participation in the manner and extent they preferred. A web-based support system via mobile phone improved some aspects of patient participation in the short- but not long term. Strategies to better identify patients' preferences for patient participation are needed, to evaluate and improve the outcome of care. [ABSTRACT FROM AUTHOR]

In cases of schizophrenia and other psychoses, a comprehensive strategy that combines psychopharmacology with psychosocial interventions is often used to address symptoms, cognitive deficits, social functioning, and quality of life. The aim of this research was to carry out a randomized controlled trial to determine the effects of a music therapy (MT) treatment protocol on quality of life (primary outcome), symptoms, self-esteem, internalized stigma, social cognition, and social functioning (secondary outcomes), when implemented in combination with standard pharmacological and psychosocial rehabilitation (treatment as usual, TAU). Sixty clinically stable outpatients diagnosed with schizophrenia and other psychoses were randomly allocated to one of two groups: One group was administered TAU (n = 30) and the other TAU + MT (n = 30). The MT component consisted of 22 sessions of evidence-based MT. Outcome measures were obtained before and after treatment using a masked assessment process. A total of 57 participants completed the study. All participants were included in the intention-to-treat analysis. Differences between the groups were observed for internalized stigma (η2=.46), social functioning (η2=.18) and quality of life (η2=.25), with the TAU + MT group showing significantly greater improvements than the control group. The results obtained support the benefits of incorporating a MT treatment protocol as a complementary therapy to standard treatment. [ABSTRACT FROM AUTHOR]

Social work clients often face complex financial problems. We have developed a financial social work intervention, FinSoc, to increase financial literacy and economic self-efficacy and reduce financial anxiety among parents with financial problems in Finland. The aim of this pilot randomized controlled trial is to explore the feasibility, acceptability, and preliminary effectiveness of the intervention. This paper, a study protocol, describes the design and implementation of the trial. Study protocols are articles detailing a priori the research plan, rationale, proposed methods and plans for how a clinical trial will be conducted. This study is a pilot randomized controlled trial with a mixed methods approach applying both quantitative measures and qualitative interviews. Participating social work clients with children are randomly assigned to either the treatment or the waiting list control group at a ratio of 1:1. The treatment group receives the intervention and the control group receives services as usual. The quantitative data from social work clients are collected at three measurement points. Qualitative interviews are conducted post-intervention with both clients receiving, and professionals implementing the intervention. The feasibility is assessed through recruitment and retention rates and the interviews with social work professionals providing the intervention. Acceptability is assessed through feedback from participants on satisfaction with the intervention and usefulness of the specific intervention components. Potential effectiveness is measured by financial literacy, economic self-efficacy and financial anxiety. The intervention is hypothesized to increase financial literacy and economic self-efficacy and reduce financial anxiety among social work clients with children. The results of this pilot study will increase the evidence base of financial social work and offer new insights for developing interventions for clients experiencing financial difficulties. [ABSTRACT FROM AUTHOR]

Few studies have reported the cardiovascular health effects of different high-intensity interval training (HIIT) protocols among sedentary young women. We investigated the impact of a traditional HIIT programme and a high-intensity circuit training (HICT) programme on lipid profiles and inflammatory cytokine levels in sedentary young women. Forty-two women were randomly assigned to HICT (body weight-based training), HIIT (cycling-based training), or control groups (n = 14 each). HICT and HIIT participants completed an 8-week training programme of three sessions per week. Total cholesterol (TC), triglyceride, high- and low-density lipoprotein, leptin, resistin, tumour necrosis factor-alpha (TNF-α), interleukin-8, and interferon-gamma levels were measured before and after the intervention. Post-intervention, TC and leptin were decreased in the HICT group. The HICT group also demonstrated increased lean mass, upper and lower limb strength, and balance, while the HIIT group displayed improved lower limb strength. Additionally, the control group showed significant increases in triglyceride levels, weight, body mass index, and fat mass. In conclusion, although both HICT and HIIT interventions showed improvements in cardiovascular health and physical fitness, participants in the HICT group experienced more health benefits. [ABSTRACT FROM AUTHOR]

The treadmill, lift, and carry (TLC) battery is a composite functional performance test created to measure the effectiveness of a functional restoration (FR) program in a military population. To determine the validity, reliability, and minimal clinically important differences (MCIDs) of the individual tests and the composite TLC battery. We assessed the validity by mean differences, effect sizes, and standardized response means pre- and post-FR; and by correlations between the TLC battery and other established measures. We assessed reliability by correlating pre- and post-FR scores. We used principal component analysis (PCA) to create a composite measure. We determined MCIDs via distribution methods and receiver operator curve analysis. There were significant (p <.001) mean changes and large effect sizes (0.6–0.8) pre- to post-FR. Pre- and posttest Spearman's correlations ranged from 0.5 to 0.6. Spearman's correlations between TLC battery scores and other measures were small (± 0.3–0.4) and significant (p <.001). PCA supported use of a single-component composite. MCIDs were treadmill time: 3 minutes; metabolic equivalent of task: 1.5 units; floor-to-waist lift: 15 lbs; waist-to-shoulder lift: 10 lbs; 40-foot carry: 10 lbs; and composite score: 6 units. This secondary data analysis provides preliminary support for the validity and reliability of the TLC battery for use in military populations. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) co-occur frequently and have deleterious impact. Seeking Safety (SS) – an evidence-based, present-focused, coping skills model – lends itself to mobile app delivery. A novel SS mobile app is compared to a control app that lacks the interactivity, social engagement, and feature-richness of the SS app. We hypothesized that the SS app would outperform the control on primary outcome variables (substance use, trauma symptoms) and at least two secondary variables. Outpatients with current PTSD and SUD (n = 116) were randomized to the apps; assessed were pre, post (12 weeks), and 3-month follow-up in this online study. The SS app outperformed the control on the primary outcomes, but not on secondary outcomes. Also both conditions evidenced significant change over time from pre to post, with gains sustained at follow-up. External medication and supports during the trial did not differ by condition. This first RCT on a SS mobile app had positive results for reduction in substance use and trauma symptoms compared to a control app. This is noteworthy as mental health mobile apps, in general, evidence few positive outcomes. Our substance use finding is also notable as psychosocial interventions in PTSD/SUD populations find it harder to achieve reduction in SUD than trauma symptoms. Our control app may have represented too strong a comparison and weakened our ability to find results on secondary outcomes by condition. [ABSTRACT FROM AUTHOR]

Women with substance use disorders (SUDs) are more inclined to use drugs and relapse for regulating emotions compared to men. This study aimed to explore the effects of group music and imagery in alleviating anxiety, depression, emotion regulation difficulties, and craving for women with methamphetamine use disorder (MUD) in a compulsory rehabilitation context. A total of 90 women with MUD were randomly assigned to the music therapy treatment arm (n = 45) or control treatment arm (n = 45). Participants in the music therapy treatment arm received 12 biweekly sessions of group music and imagery (GrpMI) and those in the control treatment arm received 6 weeks of usual care. Anxiety, depression, emotion regulation difficulties, and craving were assessed at pre-test and post-test. After the intervention, participants in the GrpMI group reported significantly greater improvements than those in the control group for state anxiety (F = 6.27; p =.02; Partial η2 =.13), trait anxiety (F = 4.49; p =.04; Partial η2 =.09), depression (F = 5.48; p =.02; Partial η2 =.11), and craving (F = 4.53; p =.04; Partial η2 =.09). There was no significant difference between groups in emotion regulation difficulties (F =.95, p =.34, Partial η2 =.09). GrpMI significantly decreased depression, anxiety, and craving for women with MUD. Emotion regulation ability may need a longer period of treatment for significant improvement. Future studies could add long-term follow-up and compare the effects of group music therapy in women versus men with SUDs. [ABSTRACT FROM AUTHOR]

Long-term limitations in social participation are common after stroke. Whether these can be attenuated through a tele-rehabilitation approach is unknown. We were particularly interested in examining transfer of learning effects which could result in broader improvements in social participation. We adapted a strategy training rehabilitation approach (tele-CO-OP) for remote delivery. Participants with chronic stroke were randomized to receive the intervention (EXPT) or to a wait list (Control). Feasibility and acceptability were measured via attendance scores, satisfaction with the training and therapist evaluation of engagement with the training. The primary outcome measure was the Canadian Occupational Performance Measure (COPM), a standardized semi-structured interview which elicits difficulties in day-to-day life. Seventeen participants were randomized. Tele-CO-OP was found to be feasible and acceptable: participants reported high satisfaction and engagement, and missed few sessions. Large effect sizes for transfer of learning effects were observed in favor of receiving tele-CO-OP vs being waitlisted. Significant benefits were also conferred to the Control group following receipt of tele-CO-OP. The intervention also appeared to improve mood. This exploratory study demonstrates the feasibility and acceptability of tele-CO-OP and provides preliminary evidence for transfer of learning effects to untrained everyday social participation activities. Trial registration number: NCT02724813 Stroke results in long-term limitations in social participation. The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach provides a potential avenue for ameliorating these limitations. This pilot randomized controlled trial demonstrated that it is feasible to deliver tele-CO-OP and that positive benefits may accrue to those receiving the intervention for both trained and untrained activities. Tele-CO-OP is a promising intervention for addressing long-term participation limitations in individuals with chronic stroke. [ABSTRACT FROM AUTHOR]

Smoking among adolescents is prevalent and a significant public health issue associated with premature death. Family has a vital role in smoking prevention and quitting smoking; however, parents frequently question their ability to positively influence their children in this area, believing that such advice is ignored or despised by their children. Family empowerment is important enhance the role of family participation in child care. The goal of this study was to examine the impact of family empowerment on smoking prevention. A cluster randomized controlled trial (RCT) was conducted between January to April 2020. Parallel assignment was used in this cluster RCT. Family empowerment program included five intervention steps, including needs assessment, bonding process, problem-solving, educational participation method, process and outcome evaluations. At enrollment, approximately 500 students participated (response rate was 67 % at baseline and 90 % at follow-up). The family empowerment program improved outcomes relative to the control at time one (T1) across four outcomes: 1) family empowerment increased 0.08 (95% confident of interval (CI) 0.01 to 0.15), 2) Intention to smoke score saw a modest increased 0.07 (95% CI 0.02 to 0.12), 3) self-efficacy increased 0.26 (95% CI 0.07 to 0.69) and skill to refuse also saw a modest increase of 0.19 (95% CI 0.05 to 0.37). This study takes a significant step toward establishing an empowering and low-cost approach to delivering preventive interventions, while also elevating the voice of adolescents in health policy advocacy efforts.. [ABSTRACT FROM AUTHOR]

To compare the effects of lower limb loading training (LLLT) with or without augmented loading feedback during stepping activity on mobility, walking device use, and falls among ambulatory individuals with chronic spinal cord injury (SCI). Randomized controlled trial (assessor-blinded) with prospective fall data follow-up, clinical trial registration (NCT03254797). Forty-four ambulatory participants (22 participants/group) were prospectively monitored for their baseline fall data over six months, with baseline assessments for their mobility and walking device used after six months. Then participants involved in the LLLT programs with or without loading feedback according to their groups for 30 min/day, 5 days/week, over 4 weeks. Mobility outcomes were re-assessed at week two and week four, with prospective fall data monitoring over six months, and mobility measured thereafter. Mobility outcomes of the participants were significantly improved from their baseline ability, especially in those who were trained using augmented feedback (the difference in main outcome, timed up and go, between the groups was 1.8 s; 95% confidence interval = 1.0–3.5s). LLLT during stepping activity, especially with augmented loading feedback, could be applied effectively to promote mobility and safety of ambulatory individuals with chronic SCI (post-injury time of approximately four years). A training program of bodyweight shifting and lower limb loading training during stepping activity significantly improved mobility, walking ability, and fall rates of ambulatory individuals with chronic spinal cord injury. The improvement in those who were trained using augmented loading feedback was significantly greater than those who were trained without feedback. Such training programs may be applied to distribute effective community-based rehabilitation and home healthcare services. [ABSTRACT FROM AUTHOR]

Objective: Patient education based on the patient's individual needs and circumstances is known to be associated with positive changes in clinical outcomes in chronic obstructive pulmonary disease (COPD). We aimed to assess the levels of patients' subjective needs for information about COPD before and after their general practitioners had taken part in a COPD education. Design: A secondary analysis of a cluster randomized controlled trial Setting: 22 PHCCs in Stockholm, Sweden Subjects: Randomly selected primary care patients with COPD in GOLD stages 2 and 3 (n=293) Outcome measures: Scores in the Lung Information Needs Questionnaire (LINQ) at baseline and 18months, spirometry results, and self-reported, descriptive patient data. Results: GPs' improved skills in COPD did not affect patients' self-management skills over time. In general, patients' information needs remained great in issues concerning diet, exercise and self-management. However, 43% of the patients reported reduced and 57% increased or unchanged information needs, over time. Reduced information needs were mainly associated with a high level of information needs at baseline (OR = 3.17 [95% CI 1.93-5.23], p<.01) and establishing contact with a physiotherapist (OR = 2.26 [95% CI 1.05-4.86], p=.038). Patients in a mild or stable phase of COPD with no recent exacerbations reported greater needs than those with unstable, deteriorated COPD. Conclusion: Patients' information needs are substantial in most areas of self-management of COPD, and seem to covary with the patient's current clinical status. Care providers should thus continuously be vigilant about offering all patients with COPD support and education. [ABSTRACT FROM AUTHOR]

The objectives are to evaluate the effects of a sequential combination of aerobic exercise and cognitive training, compared with exercise or cognitive training alone, on cognitive function, physical function, daily function, quality of life, and social participation in stroke survivors with cognitive impairment. This is a single-blind, parallel, randomized controlled trial. Stroke patients with mild cognitive impairment (n = 56) were randomly assigned to aerobic exercise training (n = 18), computerized cognitive training (n = 18), and the sequential combination of aerobic exercise and computerized cognitive training (n = 20) group. All groups underwent training 60 min/day, 3 days/week, for a total of 12 weeks. The primary outcomes included Montreal Cognitive Assessment (MoCA), Wechsler Memory Scale-Third Edition, and the Stroop color-word test. Secondary outcomes were the Timed Up and Go test, 6-Minute Walk Test, Functional Independence Measure, Lawton Instrumental Activities of Daily Living Scale, Community Integration Questionnaire, and Stroke Impact Scale. 56 participants completed the trial. Compared with a single type of aerobic exercise or cognitive training, the combined training group showed significant improvement in MoCA (P <.05, η2 = 0.13), and two sub-tests in WMS-III (both P's < 0.05) following the intervention. However, no between-group differences were observed for physical functions, daily function, quality of life, and social participation measures. The findings provide evidence for the potential synergistic intervention in stroke survivors. Future studies investigating the transfer effects and the optimal training parameters with a larger sample is needed. [ABSTRACT FROM AUTHOR]

To determine the efficacy of the "Training for Occupational health physicians To Involve Significant others" (TOTIS) e-learning module for improving occupational health physicians' (OHPs) knowledge, attitudes, and self-efficacy regarding involving significant others in the return-to-work process. A randomized controlled trial with 87 OHPs, involving an intervention group and a wait-listed control group. Between-group differences in knowledge, attitude, and self-efficacy outcomes, and retention of effects were assessed using ANOVA and paired t-tests. Reactions to the e-learning module were analyzed with descriptive statistics and thematic analysis. We found moderate to large effects on OHPs' knowledge (p < 0.001, ηp2 = 0.202), attitudes (p = 0.003, ηp2 = 0.098), and self-efficacy (p < 0.001, ηp2 = 0.237), with retention of all changes at 10-week follow-up. OHPs graded the e-learning module with a mean score of 7.9 out of 10 (SD = 1.11) and indicated that the module increased their awareness of the role of significant others and encouraged them to address this more often. The TOTIS e-learning module and accompanying materials are valuable resources for OHPs to learn how significant others influence work outcomes of workers with chronic diseases and to manage their involvement in the re-integration process. This study is registered in the Netherlands Trial Register under trial number NL8744; . The TOTIS e-learning module is the first evidence-based training to improve the knowledge, attitudes, and self-efficacy of occupational health physicians with regard to involving significant others in the re-integration process of workers with chronic diseases. The e-learning module and accompanying tools can increase the awareness of occupational health physicians about the role of significant others and encourage them to address the role of significant others in the re-integration process of sick-listed workers. It could be beneficial to expand on the e-learning module with a face-to-face training program involving group interaction, peer discussion, and skills development. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of inspiratory muscle training (IMT) on respiratory and peripheral muscle strength, functional exercise capacity, health-related quality of life (HRQoL), fatigue, depression, and cardiac functions in patients with stable angina. Methods: A randomized, controlled, single-blinded study. Twenty patients (59.95 ± 7.35 y, LVEF - 58.77 ± 7.49) with stable angina received IMT at the lowest load (10 cmH2O), and 20 patients (55.85 ± 7.60 y, LVEF - 62.26 ± 7.75) received training at 30% of maximal inspiratory pressure (MIP) seven days/8 weeks. Respiratory muscle strength (MIP; maximal expiratory pressure, MEP), peripheral muscle strength, pulmonary functions, functional exercise capacity (6-min walking test; exercise test), fatigue, HRQoL, depression, and cardiac functions were evaluated before and after. Results: A statistical difference was found between groups in terms of respiratory and peripheral muscle strength, pulmonary functions, functional exercise capacity (p<0.05). The results of fatigue, depression, HRQoL, and cardiac functions were similar between the groups (p>0.05). Conclusions: This study is the first to demonstrate the positive effects of IMT in patients with stable angina. IMT is a safe and effective method and is recommended to be added to cardiopulmonary rehabilitation programs and guidelines, as it results in increased peripheral muscle strength and functional exercise capacity in stable angina patients. [ABSTRACT FROM AUTHOR]

To determine the effects of Perturbation-based Balance Training (PBT) on postural responses and falls in people with multiple sclerosis (PwMS) and compare the results with conventional balance training (CBT). Thirty-four PwMS were randomized to receive 4 weeks of PBT or CBT. Latency of postural responses to external perturbations, Timed-Up-and-Go (TUG), 10-meter-walk (10MW), Berg Balance Scale (BBS), and Activities-specific Balance Confidence Scale (ABC) were measured at baseline and post-training. Also, the proportion of fallers and fall rate were assessed at a 3-month follow-up. The latency of postural responses significantly decreased in PBT compared to CBT. TUG, 10MW, BBS, and ABC, at post-training, and relative risk of falls and fall rate at 3-month follow-up had no statistically significant between-group differences. The results show that PBT is at least as effective as CBT in improving balance and decreasing falls, while it has superiority over CBT whenever the clinicians mainly aim to improve reactive balance strategies. Future studies with a larger sample size are warranted to complement the results of this study. Perturbation-based Balance Training is at least as effective as conventional balance training (CBT) in improving proactive postural control in people with multiple sclerosis (PwMS). Perturbation-based Balance Training has superiority over CBT in improving reactive postural control in PwMS. Perturbation-based Balance Training has no superiority over CBT in improving fall-related outcomes. [ABSTRACT FROM AUTHOR]

Objective: Guided by the Operating Conditions Framework, the goal of this study was to identify how and for whom an online sexual health program called Health Education and Relationship Training (HEART) worked. Design: Data come from a randomized controlled trial among 198 U.S. high school girls who completed HEART or an attention-matched control. We conducted mediation and moderated mediation models to determine if sexual self-efficacy was a mediator and if program acceptability and sexual activity status were moderators of HEART efficacy. Main Outcome Measure: Sexual communication skills were assessed with a behavioral role-play task. Results: HEART significantly improved sexual communication skills. These effects were fully mediated through sexual self-efficacy. Specifically, HEART improved sexual self-efficacy which in turn increased sexual communication skills. Also, when participants liked the program more, the effect of HEART on sexual self-efficacy was stronger. Further, among girls who had engaged in sexual activity, sexual self-efficacy was significantly associated with sexual communication skills. Conclusion: This study provides insights into the mechanisms of behavior change underlying HEART. Results highlight the need to further 'unpack' the effects of other sexual health programs, as we showed that programs may work better under certain conditions. [ABSTRACT FROM AUTHOR]

Comparing short- and long-term effects of comprehensive physiotherapy (CP) and subacromial corticosteroid injection (SCI) on pain, disability, and quality of life in the patients with subacromial pain syndrome (SAPS). 2 × 4 randomized controlled trial. 50 participants with unilateral SAPS. Random assignment with allocation concealment into two groups labeled as 12 sessions, supervised CP (n = 22) and 1cc triamhexal SCI (n = 25). Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), shortened Disabilities of Arm, Shoulder and Hand (Quick-DASH), and Western Ontario Rotator Cuff Index (WORC). Outcomes were gathered pre- and post-intervention, with three- and six-month follow-ups. Variance analysis revealed that there was a significant interaction of group-in-time for SPADI and WORC (P <.05) but not for Quick-DASH and VAS (P >.05). The independent t-test analysis showed that the mean scores of all outcome measures in CP group were lesser than SCI group via 6 months (P <.05), except for the VAS (P >.05, mean difference = −0.97, 95% confidence interval −2.11–0.15). CP results in statistically significant and potentially clinically important difference in function and quality of the life at all timeframe. Moreover, there was no between group difference in order to reduce pain. [ABSTRACT FROM AUTHOR]

Occupational burnout is highly prevalent in the mental healthcare workforce and associated with poorer job satisfaction, performance and outcomes. To evaluate the effects of the Mind Management Skills for Life Programme on burnout and wellbeing. N = 173 mental health nurses were recruited from the English National Health Service during the acute phase of the COVID-19 crisis. Participants were allocated to an immediate intervention or a delayed intervention control group, using a stepped wedge randomized controlled trial design. Measures of burnout (OLBI) and wellbeing (WEMWBS) were completed at four time-points: [1] baseline; [2] after the first group finished the intervention; [3] after the second group finished the intervention; and [4] six-months follow-up. Between-group differences were compared at each time-point using ANCOVA adjusting for baseline severity. Statistically significant effects on burnout (d = 0.60) and wellbeing (d = −0.62) were found at time-point 2, favouring the intervention relative to waitlist control. No significant differences were found at subsequent time-points, indicating that both groups improved and maintained their gains after the intervention. This intervention led to moderate improvements in burnout and wellbeing, despite the adverse circumstances of the COVID-19 pandemic at the time of the study. [ABSTRACT FROM AUTHOR]

Our team developed an attention control condition, called the Brain Health Group (BHG), for a randomized controlled trial (RCT; NCT03594734). The focus of the BHG was on brain health education and self-management. The objectives of this supplementary analysis are to (1) Describe compliance with the 12-month BHG; (2) Examine efficacy for improving general self-efficacy (GSE, primary) and secondary outcomes; and (3) Describe findings from the program evaluation. English-speaking adults (18–64 years old) who were ≥6 months post a moderate-to-severe TBI were randomized to the BHG (n = 29) or active intervention (n = 28). Data were collected at baseline and 12 months, including GSE, depression, satisfaction with life (SWL), self-rated abilities for health practices (SRAHP), and alcohol use. Program evaluation was conducted at 12 months. Attendance was 89%, and goal tracking was 63%. Within group analysis showed a significant increase in SRAHP scores (p = 0.018). Non-significant increases in GSE and SWL were observed, and participants perceived the BHG as helpful. No significant changes in depression or alcohol use were reported. People with TBI can engage in and benefit from the BHG and perceive the program as helpful for improving knowledge about brain health and awareness of self-management skills. [ABSTRACT FROM AUTHOR]