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Objective: To investigate the effect of high-intensity exercise on emotional distress, fatigue, and ability to do a full day’s activities in patients with axial spondyloarthritis (axSpA). Method: A total of 28 physically inactive axSpA patients were randomized to either an exercise group (EG), which performed 12 weeks of cardiorespiratory and strength exercises, or a control group (CG), which received treatment as usual. The outcomes reported in this paper are secondary outcomes in the trial and included emotional distress (General Health Questionnaire-12, 0–36, 36 = worst), fatigue [numeric rating scale (NRS), 0–10, 10 = worst], and ability to do a full day’s activities (NRS, 0–10, 10 = worst). Post-intervention differences were assessed by analysis of covariance with baseline values as covariates. Results: Twenty-four patients were included in the analyses. All patients in the EG followed the exercise protocol. The EG had a statistically significant beneficial effect [mean group differences (95% confidence interval)] on emotional distress [−5.8, (−9.7, −1.9), p < 0.01], fatigue [−2.4, (−4.3, −0.4), p = 0.02], and ability to do a full day’s work [−2.2, (−3.9, −0.4), p = 0.02] compared to the CG. Conclusion: This pilot study showed promising effects of cardiorespiratory and strength exercises on emotional distress, fatigue, and ability to do a full day’s activities in patients with axSpA. The findings need to be confirmed in a larger trial. [ABSTRACT FROM PUBLISHER]

The main goal of this study was to evaluate the impact of a cognitive rehabilitation programme on 12 behavioural and psychological symptoms of dementia (BPSD) in patients with mild to moderate Alzheimer's disease (AD). This six-month single-blind block-randomised cross-over controlled study was conducted with 15 mild to moderate AD participants and their caregivers. All participants received a four-week home-based cognitive rehabilitation programme to learn/re-learn an instrumental activity of daily living. They were assessed up until three months following the end of the intervention. The Neuropsychiatric Inventory (NPI-12) was employed to evaluate patients' BPSD at seven assessment points during the course of the study. A general linear mixed model analysis performed on the NPI data revealed that aberrant motor behaviours (AMB) increased significantly more in the treatment condition than in the control condition. In addition, both groups registered a significant reduction of delusional symptoms during the second half of the study. Employing a multi-symptom approach to assess participants' BPSD, this cross-over randomised controlled study showed that an individualised cognitive rehabilitation intervention was generally well-tolerated by mild to moderate AD patients. Future cognitive rehabilitation studies conducted with this population should pay attention to AMB symptom changes. [ABSTRACT FROM AUTHOR]

There is an acknowledged need for valid and reliable injury scores, suitable for use at the population level, which can accurately predict the long-term outcome of injury. The objective was to quantify the extent to which the abbreviated injury severity score (AIS) and the functional capacity index score (FCI) predict use of health services in the 12 months following an injury event. A cohort of injured people (ICD-9-CM 800-995) aged 18 - 64 years was identified from Manitoba hospital discharge abstracts from January 1988 to December 1991. For each member of the cohort whose injuries could be mapped to an abbreviated injury scale unique identifier, a maximum AIS (maxAIS) and a maximum FCI (maxFCI) were obtained. The cohort was linked with hospital discharge abstracts, physicians' claims and deaths from the population registry for the 12 months following injury. Negative binomial regression was used to model the relationships between the severity scores and the three outcome measures, while controlling for potential confounding variables. In total, 20 677 (97%) eligible cases were identified, of which 16 834 (81%) could be assigned a maxAIS and 15 823 (77%) a maxFCI. MaxAIS and maxFCI were significantly associated with total days in hospital following injury, but explained little of the variation in any of the health service use outcome variables (maxAIS, partial pseudo r2 ranging from < 0.001 to 0.041; and maxFCI, partial pseudo r2 ranging from < 0.001 to 0.018). It was concluded that anatomical damage is only partly responsible for long-term injury outcome. Additional variables would need to be included in predictive models of health outcomes of injury before these models could be reliable. [ABSTRACT FROM AUTHOR]

The Assessment of Quality of Life (AQoL) is a generic health-related quality of life (HRQL) measure. It is the only HRQL instrument, currently available, that incorporates health preference values derived from an Australian population and has been extensively trialled in over 40 studies. However, prior to this study, it had not been used to measure HRQL in injury patients. The aim of this study was to evaluate the AQoL, as a measure of the impact of injury on HRQL, by examining its correlation with other commonly used measures of health outcome and its ability to discriminate between groups with injuries of varying type and severity. A total of 221 admitted injury patients, aged 18-74 years, were recruited into the study from four major Victorian metropolitan hospitals and followed up over 12 months. The AQoL and the SF-36 were administered to obtain retrospective measures of pre-injury HRQL and health status with post-injury measurements obtained at five intervals post-injury (to 12 months). A preliminary analysis of data from this study showed the AQoL was positively related to other common outcome measures and, overall, showed a strong correlation with the SF-36 Physical Component Summary and a moderate correlation with the Mental Component Summary. It also demonstrated good discrimination between groups on the basis of type of injury, body region injured and severity of injury. While further testing of the AQoL, in this context, is still necessary, this study suggests that the AQoL may be a useful measure of the impact of injury on HRQL. [ABSTRACT FROM AUTHOR]