Browsing by Subject "quality of life"

Purpose: To assess the long-term outcome of breast reconstructions with special focus on chronic postsurgical pain (CPSP) in a larger cohort of breast cancer survivors. Materials and methods: A cross-sectional study on 121 women with mastectomy and breast reconstruction after mean 2 years 4 months follow up. The mean time from breast reconstruction to the follow-up visit was 4 years 2 months. We studied surveys on pain (Brief Pain Inventory, BPI and Douleur Neuropathique 4, DN4), quality of life (RAND-36), sleep (insomnia severity questionnaire, ISI), mood (Beck’s Depression Index, BDI; Hospital Anxiety and Depression Scale, HADS), and a detailed clinical sensory status. Patients were divided into three groups: abdominal flap (DIEP, fTRAM, and pTRAM), dorsal flap (LD and TDAP), and other (TMG, implant). Clinically meaningful pain was defined ≥ 4/10 on a numeric rating scale (NRS). We used patients’ pain drawings to localize the pain. We assessed preoperative pain NRS from previous data. Results: 106 (87.6%) of the patients did not have clinically meaningful persistent pain. We found no statistically significant difference between different reconstruction types with regards to persistent pain (p = 0.40), mood (BDI-II, p = 0.41 and HADS A, p = 0.54) or sleep (p = 0.14), respectively. Preoperative pain prior to breast reconstruction surgery correlated strongly with moderate or severe CPSP. Conclusion: Moderate to severe CPSP intensity was present in 14% of patients. We found no significant difference in the prevalence of pain across different reconstruction types. Preoperative pain associated significantly with postoperative persistent pain.

Objective: Traumatic brain injury (TBI) is a major public health issue leading to long-term cognitive, emotional, and physical impairments. New, effective, multimodal and multidisciplinary rehabilitation practices are needed. Dance is a multimodal activity that engages several brain regions simultaneously and, therefore, might be ideal for enhancing complex functions. Dance also combines physical exercise and the use of music, both of which positively affect healthy and neuropathological populations. The aim of the research project was to develop a multidisciplinary dance rehabilitation method and to evaluate its feasibility and effectiveness in chronic severe TBI. The current study investigates the intervention’s effects on cognition, depressive mood, and health-related quality of life. The feasibility of the intervention is also discussed. Methods: The current study had 11 participants with severe TBI; four women and seven men, 19 – 45 years old, with an average time of 7.6 years from the acquisition of the injury. A two-group crossover design with random allocation was used. The intervention (three months, two weekly sessions) was carried out together by a dance instructor and a physiotherapist. Neuropsychological assessments were conducted at the beginning of the study (t0), and twice after that every three months (t3 and t6). Performance before and after the intervention in general cognition, frontal lobe functions, abstract reasoning, visuo-spatial reasoning, working memory, mood, health-related quality of life, and executive functions were compared with paired sample t-tests. Time and group interactions were studied by repeated measures analyses of variance. Results: Abstract reasoning, health-related quality of life, and most saliently, mood improved significantly during the intervention. Qualitative findings also indicated enhanced mood. One of the participants described being reconnected to emotions for the first time a after the acquisition of the TBI and several other participants expressed positive feelings and experiences during the intervention. Conclusions: The current study suggests that dance rehabilitation may improve mood, abstract reasoning, and quality of life in the chronic state of severe TBI. These results are tentative and more research with larger samples is needed to verify the findings.