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Introduction: Upper limb disability can limit the quality of life of lung cancer survivors. The COVID-19 era has required a finding of alternatives to attend the monitoring of presented disturbances with the minor risk of spread. Tele-assessment offers new possibilities for clinical assessment demonstrating good reliability compared to traditional face-to-face assessment in a variety of patients. No previous study has applied this type of assessment in lung cancer survivors. For this reason, the aim of this study was to evaluate the level of agreement between upper limb disability assessment using tele-assessment and the face-to-face method in lung cancer survivors., Methods: A reliability study was conducted with 20 lung cancer survivors recruited from the Oncological Radiotherapy Service of the "Hospital PTS" (Granada). Patients attended a session for clinical face-to-face and real-time online tele-assessment. The main outcome measurements of the study included upper limb function (shirt task) and musculoskeletal disturbances (active range of movement and trigger points), and these outcomes were recorded by two independent researchers., Results: The outcome measures showed good agreement between both assessments. The active range of movement presented heterogeneous results, being excellent reliability ( ρ  > 0.75) in extension, internal rotation, homolateral adduction, and contralateral abduction, good (0.4 <  ρ  < 0.75) for flexion, homolateral abduction, contralateral adduction and contralateral external rotation, and poor ( ρ  < 0.4) for homolateral external rotation. The measure evaluating upper limb function and trigger points show the highest interrater reliability with confidence interval lower limits ≥0.99., Discussion: The tele-assessment of upper limb function and musculoskeletal disorders of lung cancer survivors present a good interrater reliability compared to face-to-face assessment. It could be useful for monitoring the disability presented by cancer survivors whose access is difficult by the residential situation, physical limitations or the risk of COVID-19 spread., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

(1) Background: In the mHeart trial, we showed that an eHealth intervention, mHeart, improved heart transplant (HTx) recipients' adherence to immunosuppressive therapy compared with the standard of care. Herein, we present the analysis assessing whether mHeart reduces complication frequency and healthcare resource use, and whether this reduction depends on patients' adherence. (2) Methods: The mHeart was a single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were mortality, complications, and resource use during follow-up (mean 1.6 ± 0.6 years). (3) Results: A significantly lower proportion of HTx recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; p = 0.02), cardiovascular events (0.35% vs. 2.4%; p = 0.006), infections (17.2% vs. 56%; p = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; p = 0.03) than controls. In addition, a significantly lower proportion of patients in the intervention needed hospital (32.4% vs. 56.9%; p = 0.004) or urgent admissions (16.9% vs. 41.4%; p = 0.002) and emergency room visits (50.7% vs. 69.0%; p = 0.03). Adherence status (measured by the self-reported SMAQ) influenced only controls regarding hospitalizations and emergency room visits. Differences were not significant on deaths (intervention 4.2% vs. control 9.5%; p = 0.4) (4) Conclusions: the mHeart strategy significantly reduced the occurrence of the studied post-transplant complications and the need for medical attention in HTx recipients. Adherence status influenced controls in their need for medical care.

Background: Chronic foot pain (CFP) is a widespread condition worldwide; however, few studies that relate CFP and foot health-related quality of life have been reported., Objective: The aim of this study was to describe the impact of foot health and health in general in a sample of adult people with CFP compared with a control group., Study Design: This study was designed as a retrospective case-control study., Setting: Podiatric section of a care center., Methods: Two hundred adults were included in the study. Patients were divided into CFP patient (n = 100) and control groups (n = 100). All of them regularly attended a private podiatric clinic to take care of their foot health. Self-reported data and medical histories for people with and without CFP were evaluated. All findings were compared with quality of life (QoL) scores based on the Foot Health Status Questionnaire, Spanish version., Results: Adults with CFP (compared to the control group) showed reductions in QoL linked to overall health and foot health in particular and were statistically significant with respect to several domains: (1) foot pain, (2) foot function, (3) general health, and (4) physical activity. These differ-ences were evaluated with a t-test for independent samples, and statistical significance was consid-ered a P value of P < 0.05., Limitations: The study was not a randomized controlled trial. Although primary outcome data were self-reported, the assessor was not blinded., Conclusions: CFP patients, regardless of gender, recorded a negative influence on QoL-related foot health that seems to be linked with the presence of this chronic condition.

Introduction: Pulmonary rehabilitation is an effective intervention for individuals who have Chronic Obstructive Pulmonary Disease (COPD). The adequate intensity, components, and number of sessions are difficult to determine, specifically in patients who have severe ventilatory limitations in order to produce true physiological training effects without adverse events. Objective: Our aim is to assess the feasibility and possible effects of a daily versus a twice-daily functional electrostimulation program in hospitalized individuals who have a severe COPD. Methods: In this randomized controlled trial, 48 severe patients with COPD were randomized into three groups: Control Group (CG; n = 16), daily functional electrostimulation group (DFEG; n = 15) or twice-daily functional electrostimulation group (TFEG; n = 17). The main outcome measures were quadriceps strength, symptoms at rest and after exercise, and adverse events measured before and after the intervention. Results: After eight sessions, DFEG and TFEG showed significant differences when compared to the CG in all measured variables at discharge ( p ≤ .001), no adverse events were observed in any of the treatment groups. Significant improvements were found in strength ( p ≤ .05) between DFEG and TFEG groups. However, lower limb function did not present significant differences in spite of the fact that the mean change favored the TFEG (23.53 ± 3.53 vs. 19.56 ± 11.89). Conclusion: Further examination of twice per day functional electrostimulation in hospitalized patients with COPD with acute exacerbation appears warranted.

Introduction: The goal of this study is to determine whether Advanced glycosylated end-products (AGE), Advanced oxidation protein products (AOPP) and Matrix metalloproteinase 7 (MMP7) could be used as differential biomarkers for idiopathic pulmonary fibrosis (IPF) and connective tissue disease-associated interstitial lung disease (CTD-ILD)., Method: Seventy-three patients were enrolled: 29 with IPF, 14 with CTD-ILD, and 30 healthy controls. The study included a single visit by participants. A blood sample was drawn and serum was analysed for AGE using spectrofluorimetry, AOPP by spectrophotometry, and MMP7 using sandwich-type enzyme-linked immunosorbent assay., Results: AGE, AOPP and MMP7 serum levels were significantly higher in both IPF and CTD-ILD patients versus healthy controls; and AGE was also significantly elevated in CTD-ILD compared to the IPF group. AGE plasma levels clearly distinguished CTD-ILD patients from healthy participants (AUC = 0.95; 95% IC 0.86-1), whereas in IPF patients, the distinction was moderate (AUC = 0.78; 95% IC 0.60-0.97)., Conclusion: In summary, our results provide support for the potential value of serum AGE, AOPP and MMP7 concentrations as diagnostic biomarkers in IPF and CTD-ILD to differentiate between ILD patients and healthy controls. Furthermore, this study provides evidence, for the first time, for the possible use of AGE as a differential diagnostic biomarker to distinguish between IPF and CTD-ILD. The value of these biomarkers as additional tools in a multidisciplinary approach to IPF and CTD-ILD diagnosis needs to be considered and further explored. Multicentre studies are necessary to understand the role of AGE in differential diagnosis.

Non-adherence after heart transplantation (HTx) is a significant problem. The main objective of this study was to evaluate if a mHealth strategy is more effective than standard care in improving adherence and patients' experience in heart transplant recipients. Methods: This was a single-center, randomized controlled trial (RCT) in adult recipients >1.5 years post-HTx. Participants were randomized to standard care (control group) or to the mHeart Strategy (intervention group). For patients randomized to the mHeart strategy, multifaceted theory-based interventions were provided during the study period to optimize therapy management using the mHeart mobile application. Patient experience regarding their medication regimens were evaluated in a face-to-face interview. Medication adherence was assessed by performing self-reported questionnaires. A composite adherence score that included the SMAQ questionnaire, the coefficient of variation of drug levels and missing visits was also reported. Results : A total of 134 HTx recipients were randomized (intervention N = 71; control N = 63). Mean follow-up was 1.6 (SD 0.6) years. Improvement in adherence from baseline was significantly higher in the intervention group versus the control group according to the SMAQ questionnaire (85% vs. 46%, OR = 6.7 (2.9; 15.8), p -value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), p -value = 0.001). Patients' experiences with their drug therapy including knowledge of their medication timing intakes ( p -value = 0.019) and the drug indications or uses that they remembered ( p -value = 0.003) significantly improved in the intervention versus the control group. Conclusions : In our study, the mHealth-based strategy significantly improved adherence and patient beliefs regarding their medication regimens among the HTx population. The mHeart mobile application was used as a feasible tool for providing long-term, tailor-made interventions to HTx recipients to improve the goals assessed.

Objective: The main objective of this study was to evaluate the results of an in-hospital Self-Management program in addition to physiotherapy in severe patients with Chronic Obstructive Pulmonary Disease (COPD) compared to a physiotherapy program. Methods: In this randomized clinical trial, 66 acute exacerbation COPD patients were included and were randomly divided into three groups. The Control group received standard medical treatment. The Physical therapy group received Control Group intervention plus a Physical Therapy intervention, consisting of neuromuscular stimulation therapy on the quadriceps muscle accompanied by lower limb exercises. The Self-management group received Physical Therapy group intervention plus a Self-Management program, which included educational information complemented with a problem-based session, breathing exercises and relaxation exercises. The main outcomes measured were the health-related quality of life and functionality. Results: All treated groups show improvements in all outcomes, being significant in the case of all total scores of health-related quality of life and functionality( p  < 0.05) between Physical Therapy group and Self-Management group. At 3 months, health-related quality of life shows reductions in all subscores in Control Group and Physical Therapy groups, while Self-Management group shows minimal maintenance of the values. Conclusion: An individualized Self-Management program added to a physiotherapy program administered once a day improves health-related quality of life and functionality compared to a Physical Therapy and to a Control Group in hospitalized severe COPD patients.Implications for rehabilitationSelf-management is the most challenging area of chronic diseases improving patient self- efficacy and reducing cost.A self-management program improves health-related quality of life and functionality compared to a physical therapy treatment in severe Chronic Obstructive Pulmonary Disease hospitalized patients.