Hyun-Ja Lim

Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis

We investigated the effects of home-based daily exercise on joint mobility, functional capacity, pain, and depression in patients with ankylosing spondylitis (AS). The patients were randomly assigned to a wait-list control group or to an exercise-therapy group. The exercise-therapy group performed a 20-min exercise program once per day for 8 consecutive weeks. After 8 weeks, compared with the control group, the exercise group showed improvements in joint mobility (cervical flexion, extension, shoulder flexion, abduction, hip abduction, and knee flexion), finger–floor distance, and functional capacity. Pain and depression scores were significantly lower after the exercise program in the exercise group than in the control group. These findings indicate that exercise therapy increases joint mobility and functional capacity, and decreases pain and depression in patients with AS. Home-based exercise, which is easily accessible to patients, might be an effective intervention for AS.

Effects of group music intervention on depression, anxiety, and relationships in psychiatric patients: a pilot study.

OBJECTIVE To test whether group music therapy is effective for improving depression, anxiety, and relationships in psychiatric patients. METHODS Twenty six patients were non-randomly allocated to either a music intervention group or a routine care group. The music intervention group received 60 minutes of music intervention for 15 sessions (1 or 2 times weekly). The outcomes were measured with Becks Depression Inventory, the State and Trait Anxiety Inventory, and the Relationship Change Scale. RESULTS After 15 sessions, the music intervention group showed significant improvements in depression, anxiety, and relationships compared with the control group. CONCLUSIONS These findings suggest that music can improve depression, anxiety, and relationships in psychiatric patients. However, we cannot elucidate the nonspecific effects. Furthermore, objective and replicable measures are required from a randomized controlled trial with a larger sample size and an active comparable control.

Tai chi for management of type 2 diabetes mellitus: A systematic review

ObjectiveTai chi has been recommended for treating type 2 diabetes mellitus. The purpose of this systematic review was to evaluate evidence from controlled clinical trials testing the effectiveness of tai chi in treating type 2 diabetes mellitus.MethodsSystematic searches were conducted on 14 electronic databases without restrictions on either population characteristics or language of publication. The outcome measures considered for inclusion were changes in fasting blood glucose (FBG), glycosylated haemoglobin A1c (HbA1c) and quality of life (QOL).ResultsEight randomised clinical trials (RCTs) and two controlled clinical trials (CCTs) met all inclusion criteria. Three RCTs from 1 trial compared the effects of tai chi with sham exercise and failed to show effectiveness of tai chi on FBG, HbA1c, or QOL. The other 3 RCTs tested the effects of tai chi compared with other types of exercise on FBG. The meta-analysis failed to show an FBG-lowering effect of tai chi [n=118, weighted mean difference (WMD): −0.14 mmol/L, 95% CI: −0.86 to 0.58, P=0.70]. Four studies (2 RCTs and 2 CCT) compared tai chi with no treatment or self-management programme and failed to report significant differences between the experimental and control groups except for QOL from 1 RCT and 1 CCT.ConclusionThe existing evidence does not suggest that tai chi is an effective therapy for type 2 diabetes. Currently, there are few high-quality trials on which to make definitive judgements.

Dietary supplements for benign prostatic hyperplasia: An overview of systematic reviews

Benign prostatic hyperplasia (BPH) is a common chronic condition in older men. The aim of this overview of systematic reviews (SRs) is to summarise the current evidence on the efficacy and adverse effects of dietary supplements for treating BPH with lower urinary tract symptoms. We searched 5 electronic databases and relevant overviews without limitations on language or publication status. Six SRs of 195 articles were included in this overview. Serenoa repens was reviewed in 3 studies and no specific effect on BPH symptoms and urinary flow measures was observed. However, β-sitosterol, Pygeum africannum and Cernilton were reviewed in one study each, and significant improvement was observed for all three. All the included compounds have mild and infrequent adverse effects. SRs on β-sitosterol, Pygeum africannum and Cernilton have not been updated since 2000, thus an update of reviews on these compounds will be necessary in the future.

Ginseng for managing menopause symptoms: a systematic review of randomized clinical trials.

The aim of this review was to assess the effectiveness of ginseng as a treatment option for managing menopause symptoms. We searched the literature using 11 databases from their inception to 26 September 2012 and included all randomized clinical trials (RCTs) that compared any type of ginseng to a placebo controls in postmenopausal women. The methodological quality of all studies was assessed using a Cochrane risk of bias tool. Four RCTs met our inclusion criteria. Most RCTs had high risk of bias. One RCT showed that Korean red ginseng (KRG) significantly improved sexual arousal and global health compared with placebo. Another RCT reported the superiority of KRG over placebo for treating menopause symptoms on Kupperman’s index and menopausal rating score. The third RCT failed to show a significant effect of KRG on hot flash frequency compared to placebo. The fourth RCT found beneficial effects of ginseng compared to placebo on depression and well-being. In conclusion, the evidence on ginseng as an effective treatment for managing menopause symptoms is limited. Most of the RCTs are burdened with a high risk of bias. Thus firm conclusions cannot be drawn. Rigorous studies seem warranted.

A systematic review and meta-analysis of tai chi for treating type 2 diabetes

The aim of this review was to update and critically evaluate the evidence from randomised clinical trials (RCTs) of tai chi for patients with type 2 diabetes mellitus (T2DM). Twelve databases were searched by August 2014. Fifteen RCTs met all of the inclusion criteria. One RCT compared the effects of tai chi with sham exercise and failed to show the effectiveness of tai chi on fasting blood glucose (FBG), or HbA1c. The other four RCTs tested the effects of tai chi compared with various types of exercise and the meta-analysis failed to show an FBG-lowering effect. Five RCTs compared the effects of tai chi with an anti-diabetic medication and the meta-analysis showed favourable effects of tai chi on FBG. One RCT showed the positive effects of tai chi plus standard care on HbA1c and FBG compared with standard care alone. Four RCTs compared the effects of tai chi to no treatment and the meta-analysis failed to show the positive effects of tai chi on HbA1c. Three RCTs reported superior effects of tai chi on quality of life. In conclusion, the existing trial evidence is not convincing enough to suggest that tai chi is effective for managing patients with T2DM.

Exercise, pain, perceived family support, and quality of life in Korean patients with ankylosing spondylitis.

Relations of habitual exercise and pain, perceived family support, and the quality of life in patients with functional class II for ankylosing spondylitis were explored. In a cross-sectional study perceived pain, family support, and quality of life were compared for 30 patients (23 women and 7 men whose mean age was 28.3 yr. ± 8.6 yr.) practicing exercise regularly and for 38 sedentary patients (31 women and 7 men whose mean age was 27.2 ± 6.7 yr.). Exercising patients reported significantly lower pain, greater perceived family support, and increased quality of life than their sedentary peers. Pain ratings were significantly negatively correlated with the quality of life in both groups (r = −.26 in exercisers and r = −.50 in sedentary patients) and control groups perceived family support was significantly correlated .44 with quality of life. These results encourage further study of the associations of habitual exercise with perceived pain, family support, and quality of life.

Relationship between self-efficacy and exercise duration in patients with ankylosing spondylitis

Ankylosing spondylitis (AS) is the main rheumatic disease of unknown etiology. Regular exercise is important in maintaining and improving mobility, physical fitness, and strength, and in preventing joint deformity [1, 2]. The concept of self-efficacy has been used in recent years as an indicator of an individual’s beliefs and confidence in performing certain health behaviors to manage conditions such as arthritis and fibromyalgia [3, 4]. Self-efficacious people are characterized by persistence, commitment, resourcefulness, and perseverance [5]. However, there is little reported evidence of the effects of exercise on self-efficacy in patients with AS. The purpose of this study was to investigate the relationship between exercise and perceived self-efficacy in patients with AS. Fifty patients with AS were recruited from the Rheumatism Center of the University Medical Center in Korea through a bulletin board notice offering patients the opportunity to have their psychological health assessed. Subjects were eligible to participate in the program if they were outpatients without complications, able to understand the content of questionnaires and experimental schedules, and classified in the functional class II for AS. We used a Korean-translated, shortened version of the 20-item scale to measure self-efficacy originally developed by Lorig et al. [6]. The participants were 50 patients with ankylosing spondylitis (36 men and 14 women) whose mean age was 28.0 years (SD=8.4) and mean duration of disease was 7.7 years (SD=6.1). Self-efficacy was significantly correlated with total duration of exercise (r=0.42, p<0.001) and with exercise duration over the preceding year (r=0.52, p<0.001). These correlations suggest that self-efficacy is an important factor influencing exercise behavior and are consistent with previous studies in elderly and middle-aged general populations [5]. However, Barlow reported that self-efficacy did not appear to influence exercise duration and that past exercise behavior was not a major determinant of self-efficacy for exercise in AS patients [7]. Although we found that self-efficacy was significantly correlated with exercise duration in AS patients, we acknowledge that this was a preliminary study with several limitations, such as a small sample size and the lack of a comparable control group. Further studies that include more objective measures, larger sample sizes, and more detailed data about the patients are needed to convincingly show the effects of perceived self-efficacy on quality of life or other psychological and physiological symptoms in patients with AS.

EFFECTIVENESS OF COMBINED ACUPUNCTURE THERAPY AND CONVENTIONAL TREATMENT ON SHOULDER RANGE OF MOTION AND MOTOR POWER IN STROKE PATIENTS WITH HEMIPLEGIC SHOULDER SUBLUXATION: A PILOT STUDY

The aim of this study was to elucidate the effects of combined conventional rehabilitation therapy and acupuncture on the active shoulder range of motion (ROM) and motor power in stroke patients with hemiplegic shoulder subluxation. Twenty-one patients received a combination of acupuncture and rehabilitation treatment at a hospital, and their active shoulder ROM and motor power were assessed at admission and discharge. The therapy produced significant improvements in joint mobility, such as in flexion, extension, internal rotation, external rotation, abduction, and adduction (p < .001), and in motor power (p < .05) in stroke patients with hemiplegic shoulder subluxation.

Pilot study of hormone replacement therapy and menopausal symptoms, depression, and quality of life in Korean climacteric women.

This cross-sectional survey compared scores on the Menopausal Symptoms Index, Depression, and the Quality of Life for 65 Korean climacteric women receiving regular hormone replacement therapy (M age = 52.8 yr., SD = 63) and 70 Korean climacteric patients not receiving such therapy (M age = 51.6 yr., SD = 7.1). Depression scores were positively correlated with the Menopausal Symptoms Index in both groups (r = .58 in the Therapy group and r = .50 in the Control group) and negatively correlated with scores for Quality of Life (r = −.48 in the Therapy group and r = −.68 in the Control group). Scores on the Menopausal Symptoms Index were negatively correlated with ratings of Quality of Life in both groups (r = −.53 in the Therapy group and r = −.45 in the Control group). These results suggest that hormone replacement therapy is associated with reduced Depression scores and higher Quality of Life scores in this sample of Korean climacteric women.