Healthcare最新文献

{"title":"Efficacy and Safety of the Combination of Diclofenac and Thiocolchicoside in the Treatment of Low Back Pain and Other Conditions: Systematic Review of the Literature.","authors":"Ioannis Oikonomou, Karolina Akinosoglou","doi":"10.3390/healthcare13060677","DOIUrl":"10.3390/healthcare13060677","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Low back pain (LBP) is a leading cause of disability worldwide. Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), and thiocolchicoside, a muscle relaxant, are commonly combined to target inflammation and muscle spasm. However, the efficacy and safety of their combination remain under discussion. This systematic review evaluates the efficacy and safety of diclofenac-thiocolchicoside therapy for LBP and other musculoskeletal conditions. <b>Methods</b>: A systematic review was conducted following PRISMA guidelines. Eligible studies included randomized controlled trials (RCTs) and observational studies comparing diclofenac-thiocolchicoside combination with placebo, monotherapy, or alternative treatments. A search was performed in PubMed, Scopus, and relevant websites, identifying articles published up to 30 September 2024. Studies from trial registries were excluded. Risk of bias was assessed using Revised Cochrane Risk of Bias for randomized trials (RoB 2) for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. Evidence certainty was evaluated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. Results were visualized using Robvis, tables, and graphs. <b>Results:</b> Of 393 identified records, 9 studies (1097 patients) met the inclusion criteria. Seven RCTs reported significant pain reduction and functional improvement with combination therapy compared to placebo or active controls. However, study heterogeneity, dosage variations, and risk of bias limited comparability. Adverse events (AEs) included gastrointestinal (GI) discomfort and drowsiness, though no severe complications were consistently reported. <b>Conclusions</b>: Despite methodological limitations, the diclofenac-thiocolchicoside combination demonstrates promising efficacy for acute LBP and musculoskeletal pain management. However, there is no clear evidence of its clinical superiority over other available treatments, due to study heterogeneity and potential biases. Rigorous, standardized research with larger sample sizes and consistent methodologies is essential to definitively establish the efficacy and safety of diclofenac-thiocolchicoside, providing clearer guidance for clinical decision-making.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Poor Sleep Quality and Lipid Levels Among Dyslipidemia Patients in Thailand: A Prospective Cross-Sectional Study.","authors":"Jakkrit Pintacom, Suphawita Pliannuom, Nida Buawangpong, Chaisiri Angkurawaranon, Kanokporn Pinyopornpanish","doi":"10.3390/healthcare13060678","DOIUrl":"10.3390/healthcare13060678","url":null,"abstract":"<p><p><b>Background:</b> Dyslipidemia increases cardiometabolic risk, but the impact of sleep quality on lipid levels remains uncertain. This study aims to assess the prevalence of poor sleep quality in patients with dyslipidemia and its association with lipid levels. <b>Methods:</b> A cross-sectional and prospective study was conducted among patients aged 20 years and older who were diagnosed with dyslipidemia at the Family Medicine Outpatient Clinic in Thailand from July to December 2023. Data were collected through interviews and a review of electronic health records. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Blood levels of triglycerides, HDL-C, and LDL-C were measured. The association between sleep quality and lipid levels was analyzed using multivariable regression, adjusting for age, sex, body mass index, diabetes mellitus, hypertension, alcohol use, exercise, statins, fibrates, and ezetimibe. <b>Results:</b> Of the 257 participants, 183 (71.21%) were female, with a mean age of 69.31 ± 7.48 years. Overall, 86 participants (33.64%) reported poor sleep quality. A higher sum score of PSQI was significantly associated with elevated triglyceride levels (adjusted mean difference [AMD] 2.59, 95% CI 0.07-5.11, <i>p</i> = 0.044), particularly in the sleep latency domain (AMD 8.58, 95% CI 0.00-17.16, <i>p</i> = 0.050). Additionally, higher scores in the subjective sleep quality domain were significantly associated with increased LDL-C levels (AMD 8.08, 95% CI 1.70-14.60, <i>p</i> = 0.013). <b>Conclusions:</b> This study highlights a significant association between poor sleep quality and elevated triglyceride and LDL-C levels. These findings underscore the importance of integrated healthcare strategies that address both sleep quality and lipid management to mitigate cardiovascular risks.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Depressive Symptoms and Self-Neglect in Chinese Older Adults Living Alone: A Latent Profile Analysis.","authors":"Yali Hu, Miaomiao Wu, Yan Zhang, Lunfang Xie","doi":"10.3390/healthcare13060676","DOIUrl":"10.3390/healthcare13060676","url":null,"abstract":"<p><p><b>Objectives</b>: To clarify the latent profile of depressive symptoms in Chinese older adults living alone and to explore the relationship between this profile and self-neglect. <b>Methods</b>: Data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) were utilized to conduct a latent profile analysis for the identification of depressive symptoms. Logistic regression was employed to analyze the related factors. Generalized linear modeling was used to assess the impact of different profiles of depressive symptoms on self-neglect. <b>Results</b>: A total of 1822 older adults living alone, with a mean age of (83.60 ± 9.15) years, were included in the study. Three categories of depression were identified: the C1 mild depression-sleep disturbance group (29.36%), the C2 moderate depression-forcefulness group (55.22%), and the C3 major depression-loneliness loss group (15.42%). Logistic regression analysis indicated that gender, place of residence, annual household income, educational level, reason for living alone, self-rated health status, cognitive function, and emotional support were significant influencing factors (<i>p</i> < 0.05). The risk of experiencing higher levels of self-neglect in the C2 was 1.264 times greater than in the C1. Furthermore, the risk of higher levels of self-neglect in the C3 was 2.040 times greater than in the C1. <b>Conclusions</b>: Heterogeneity in depressive symptoms is evident among Chinese older adults living alone, with variations in self-neglect across different potential categories of these individuals. The focus should be on older adults in the C2 and C3 profiles. This study proposes targeted intervention strategies from family, community, and policy development perspectives to help improve self-neglect in older adults.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Impact of Workplace Violence in Urban Emergency Departments: A Qualitative Study.","authors":"Brendan Lyver, Brendan Singh, Nathan Balzer, Manu Agnihotri, Jennifer Hulme, Kathryn Chan, Rickinder Sethi, Charlene Reynolds, Jennifer Haines, Robert Whiteside, Marc Toppings, Christian Schulz-Quach","doi":"10.3390/healthcare13060679","DOIUrl":"10.3390/healthcare13060679","url":null,"abstract":"<p><p><b>Background:</b> Workplace violence (WPV) in healthcare, particularly in emergency departments (EDs), is a growing and complex issue that significantly impacts healthcare providers (HCPs). Following the COVID-19 pandemic, the rates of WPV have increased globally, contributing to increased burnout, reduced morale, and heightened challenges in staff retention within EDs. <b>Objective:</b> This study aimed to explore HCPs' perspectives on WPV in EDs. The insights gathered were intended to inform targeted interventions in a quality improvement initiative focused on addressing WPV in our healthcare institutions. <b>Methods:</b> A qualitative study involving semi-structured interviews was conducted with 52 HCPs across two urban EDs at a multi-site academic health center. Participants from various roles and shifts shared experiences related to safety, leadership, training, and security. Interviews were recorded, transcribed, anonymized, and thematically analyzed to identify key themes surrounding WPV in EDs. <b>Results:</b> The thematic analysis identified four main themes, including (1) Violence is Part of the Job, (2) Leadership Dynamics regarding WPV, (3) Disconnect Among ED Staff During WPV Response, and (4) Enhancing Systems and Culture for Effective WPV Management. These themes provide a comprehensive view of HCPs' experiences and offer actionable recommendations for healthcare organizations seeking to address WPV. <b>Conclusions:</b> The study provides valuable qualitative insights into WPV in EDs, emphasizing the importance of addressing cultural, structural, and procedural gaps. These findings can guide the development of more supportive and effective strategies to create a safer environment for ED staff. Further rounds of interviews are planned post-intervention to assess changes in HCPs' perceptions and experiences.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Poor Sleep Quality and Subjective Cognitive Decline in Older Adults Living in the United States During the COVID-19 Pandemic.","authors":"Celina Pluim McDowell, Jairo E Martinez, Averi Giudicessi, Diana Munera, Clara Vila-Castelar, Edmarie Guzmán-Vélez, Liliana Ramirez-Gomez, Jeanne F Duffy, Alice Cronin-Golomb, Yakeel T Quiroz","doi":"10.3390/healthcare13060675","DOIUrl":"10.3390/healthcare13060675","url":null,"abstract":"<p><strong>Background/objectives: </strong>Poor sleep quality, depression, and anxiety are associated with subjective cognitive decline (SCD) and greater risk for developing cognitive impairment and Alzheimer's disease. The COVID-19 pandemic negatively impacted sleep habits and psychological well-being in many individuals, yet their relationship to SCD in this context remains understudied. We examined sociodemographic characteristics, depression, anxiety, and sleep changes during the pandemic (i.e., increased problems/poorer quality) and SCD in older individuals living in the US.</p><p><strong>Methods: </strong>In total, 288 older adults (M_age = 67.4 [7.4]) completed an online survey including a sociodemographic questionnaire, the Center for Epidemiologic Studies Depression Scale (Revised) (CES-D-10; depression), General Anxiety Disorder-7 (GAD-7; anxiety), the Everyday Cognition scale (ECog; SCD), and a question about increased sleep problems/worsened sleep quality during the pandemic. Hierarchical and logistic regression analyses were used to assess relations among sociodemographic factors, depression, anxiety, changes in sleep quality, and SCD.</p><p><strong>Results: </strong>Self-reported pandemic-related impairments in sleep were associated with greater SCD (β = 0.16, <i>p</i> = 0.01). Depression (β = 0.46, <i>p</i> < 0.001) and anxiety (β = 0.29, <i>p</i> < 0.001) were also associated with greater SCD. Depression (OR = 1.17, <i>p</i> < 0.001) and anxiety (OR = 1.15, <i>p</i> = 0.017) predicted reported poorer sleep during the pandemic.</p><p><strong>Conclusions: </strong>Depression, anxiety, and poorer sleep quality during the COVID-19 pandemic were associated with greater SCD concerns. Greater depression and anxiety were also associated with the reported sleep problems/worsened sleep quality. Prevention and management of anxiety and depressive symptoms may help maintain sleep quality and reduce risk of cognitive decline.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Adolescent Idiopathic Scoliosis with the Conservative Schroth Method: A Randomized Controlled Trial.","authors":"Vanja Dimitrijević, Bojan Rašković, Miroslav P Popović, Dejan Viduka, Siniša Nikolić, Nikola Jevtić, Samra Pjanić, Borislav Obradović","doi":"10.3390/healthcare13060688","DOIUrl":"10.3390/healthcare13060688","url":null,"abstract":"<p><p><b>Objective:</b> The objective of this study was to determine the effectiveness of the conservative Schroth method in patients with adolescent idiopathic scoliosis. <b>Methods:</b> A total of 34 respondents, 24 male and 10 female, aged between 11 and 16 years, participated in the research. The study was a single-blind randomized trial, in which subjects were divided into control and experimental groups by stratified randomization according to the stratum of the Cobb angle. The control group performed the Schroth method at home without the supervision of Schroth therapists, while the experimental group performed the Schroth method under the supervision of Schroth therapists three times a week for 90 min over eight weeks. Initial and final outcome measurements were performed: Cobb angle, angle of trunk rotation, vital capacity, forced vital capacity, forced expiratory volume in the first second, the percentage of forced expiratory volume in the first second in forced vital capacity, and chest expansion. <b>Results:</b> There was a statistically significant improvement in all measured outcomes in the experimental group, while no statistically significant changes were recorded in the control group. The Cobb angle decreased by 2.12°, while ATR decreased by 2.88°; VC increased by 0.15 L, FVC by 0.13 L, FEV1 by 0.1 L, and CE increased by 0.78 cm. <b>Conclusions:</b> The application of an eight-week therapy program using Schroth method by subjects with adolescent idiopathic scoliosis had statistically significant changes in all measured outcomes in the group that was supervised by Schroth's therapists, while there was no statistically significant improvement in the group that applied therapy at home without supervision.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Service-Related Musculoskeletal Injuries in Polish Firefighters: A 2021-2023 Accidents Analysis.","authors":"Łukasz Dudziński, Łukasz Czyżewski, Janusz Wyzgał","doi":"10.3390/healthcare13060684","DOIUrl":"10.3390/healthcare13060684","url":null,"abstract":"<p><p><b>Aim:</b> The aim of this study was to analyze service-related musculoskeletal injuries of professional firefighters in 2021-2023. <b>Material and methods:</b> Analysis was completed on the basis of annual reports on the injury status of the State Fire Service (SFS) obtained from the Office of Occupational Safety and Health (OOSH) at General Headquarters. The report databases were searched using keywords typical of bone injuries and including anatomical names: \"sprain\", \"fracture\", \"dislocation\", \"bone injury\", \"bone\", \"joint\", \"spine\", \"skull and \"musculoskeletal injury\". <b>Results:</b> Events matching the analysis target of N = 1944 (2021-n = 707; 2022-n = 589; 2023-n = 648) accounted for 49.4% from all accidents in the State Fire Service in Poland in the analyzed period. A significant increase in the analyzed period 2021-2023 was observed in events where the cause of injury was sports activities (45% vs. 49% vs. 63%, <i>p</i> < 0.001). A significant decrease was observed in events where the cause of injury was interventions (26% vs. 27% vs. 17%, <i>p</i> < 0.001), technical and maintenance (TM) work (8% vs. 6% vs. 5%, <i>p</i> = 0.008) and category \"other\" (15% vs. 14% vs. 11%, <i>p</i> = 0.034). Statistically significant differences were found between cause and the type of injury (<i>p</i> = 0.002), season (<i>p</i> < 0.001) and the location of injury (<i>p</i> < 0.001). <b>Conclusions:</b> A large number of musculoskeletal injuries are associated with sports activities, which is inherent in the risks of the activities. The lower extremities are most affected by injuries during sports activities The spring period dominates in the season category, which may be related to the difficulty of the terrain and return to increased sports activity after the winter period.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unequal Burdens: Gendered and Socioeconomic Dimensions of Occupational Health Among Hong Kong's Informal Waste Pickers.","authors":"Siu-Ming Chan, Yuen-Ki Tang, Heng Xu, Jasmine Zhang, Kim Kwok, Wai-Yiu Tam, Wing-Him Tang","doi":"10.3390/healthcare13060683","DOIUrl":"10.3390/healthcare13060683","url":null,"abstract":"<p><p><b>Background</b>: This study explores the multifaceted inequalities faced by informal waste pickers in Hong Kong, focusing on the impacts of gender and socioeconomic status in shaping their working environment, income, and psychological health. Recognizing that social stratification encompasses a series of structural factors, i.e., gender, race, and socioeconomic status, we aim to fill the gap in existing literature regarding the precarious employment of this population. <b>Methods</b>: Utilizing a comprehensive, territory-wide survey, we analyzed the experiences of male and female waste pickers across different socioeconomic backgrounds. Differences between genders for continuous variables were assessed using the independent samples <i>t</i>-test. Differences across categories defined by gender and socioeconomic status were analyzed using one-way ANOVA, followed by post hoc comparisons with the least significant difference (LSD) method. <b>Results</b>: Our findings indicate that both gender and socioeconomic status significantly influence working environment, occupational income, and psychological health outcomes. Specifically, female waste pickers from lower socioeconomic backgrounds face more adverse working environments, lower income levels, and heightened psychological health risks compared to their higher-status counterparts. <b>Conclusions</b>: These results underscore the urgent need for targeted outreach and tailored healthcare services for vulnerable female waste pickers, as well as social support systems that empower them to negotiate with intermediaries and recycling shop owners. By recognizing their essential role in Hong Kong's urban recycling ecosystem, this study advocates for policies that address these disparities and promote psychological health and social well-being among this marginalized group.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Study-Based Informed Decision-Making Tool for Empowerment of Treatment Adherence Among Chronic Heart Failure Patients-A Pilot Study.","authors":"Lea Iten, Kevin Selby, Celine Glauser, Sara Schukraft, Roger Hullin","doi":"10.3390/healthcare13060685","DOIUrl":"10.3390/healthcare13060685","url":null,"abstract":"<p><p><b>Background:</b> Adherence to drug prescriptions is often suboptimal among heart failure (HF) patients. Informed decision-making may improve patients' adherence to HF drug prescriptions. <b>Aims of the study:</b> We aimed to test whether a self-study-based informed decision-making tool could improve adherence to drug prescriptions among ambulatory HF patients. <b>Methods:</b> A tool and a statement-based questionnaire were developed to evaluate drug adherence willingness based on COMPAR-EU recommendations. The test group (<i>n</i> = 40) was exposed to the tool + questionnaire; controls (<i>n</i> = 40) answered the questionnaire only. Agreement with statements of the questionnaire was graded on a scale of 0 to 4 points, reflecting no to full agreement. <b>Results:</b> The median age of controls was younger (56 vs. 61 years; <i>p</i> = 0.04); test and control group patients did not differ across other parameters (always <i>p</i> > 0.05). Patients in both groups agreed that \"HF is a life-long disease\" (3.5 vs. 4; <i>p</i> = 0.19) and that \"only life-long drug treatment provides benefit\" (4 vs. 4; <i>p</i> = 0.22). More test group patients confirmed improved comprehension of HF disease (3 vs. 2; <i>p</i> = 0.03) and greater acceptance that \"achievement of benefit asks for a combination of HF drugs\" (4 vs. 3; <i>p</i> = 0.009) and \"daily intake\" (4 vs. 3; <i>p</i> = 0.004). In test group patients, questions remained, resulting in less agreement that \"all aspects of my heart disease\" are understood (1 vs. 3; <i>p</i> < 0.001). Willingness to adhere to HF-drug treatment was not different between the groups (3 vs. 3.5; <i>p</i> = 0.28). <b>Conclusions:</b> The self-study-based informed decision-making tool improved the comprehension of HF and the need for HF treatment, but did not improve willingness to adhere since questions remained unanswered.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timely and Personalized Interventions and Vigilant Care in Neurodegenerative Conditions: The FIT4TeleNEURO Pragmatic Trial.","authors":"Francesca Baglio, Federica Rossetto, Elisa Gervasoni, Ilaria Carpinella, Giulia Smecca, Irene Aprile, Roberto De Icco, Stefania De Trane, Chiara Pavese, Christian Lunetta, Cira Fundarò, Laura Marcuccio, Giovanna Zamboni, Franco Molteni, Cristina Messa, Fit TeleNEURO Working Group","doi":"10.3390/healthcare13060682","DOIUrl":"10.3390/healthcare13060682","url":null,"abstract":"<p><p>Parkinson's disease (PD) and multiple sclerosis (MS) are two chronic neurological diseases (CNDs) that have a high demand for early and continuous rehabilitation. However, accessing professional care remains a challenge, making it a key priority to identify sustainable solutions for ensuring early rehabilitation availability. <b>Objective</b>: The FIT4TeleNEURO pragmatic trial proposes to investigate, in real-life care settings, the superiority in terms of the effectiveness of early rehabilitation intervention with harmonized, mix-model telerehabilitation (TR) protocols (TR single approach, task-oriented-TRsA; TR combined approach, task-oriented and impairment-oriented-TRcA) compared to conventional management (control treatment, CeT) in people with PD and MS. <b>Design, and Methods</b>: This multicenter, randomized, three-treatment arm pragmatic trial will involve 300 patients with CNDs (PD, N = 150; MS, N = 150). Each participant will be randomized (1:1:1) to the experimental groups (20 sessions of TRsA or TRcA according to a mix-model-3 asynchronous + 1 synchronous session/week) or the control group (20 sessions of CeT). Primary and secondary outcome measures will be obtained at the baseline (T0), post-intervention (T1, 5 weeks after baseline), and follow-up (T2, 3 months after the end of the treatment). A multidimensional evaluation (cognitive, motor, and quality of life domains) will be conducted at each time point of assessment (T0; T1; T2). The primary outcome measures will be the assessment of change (T0 vs. T1 vs. T2) in static and dynamic balance, measured using the Mini-Balance Evaluation Systems Test. Usability and acceptability assessment will be also investigated. <b>Expected Results</b>: Implementing TR protocols will enable a more targeted and efficient response to the growing demand for rehabilitation in the early stages of CNDs. Both the TRsA and TRcA approaches are expected to be more effective than CeT, with the combined approach likely providing greater benefits in secondary outcome measures. Finally, the acceptability of the asynchronous modality could open the door to scalable solutions, such as digital therapeutics.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}