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Bayly J, Ahmedzai HH, Blandini MG, Bressi B, Caraceni AT, Carvalho Vasconcelos J, Costi S, Fugazzaro S, Guberti M, Guldin MB, Hauken M, Higginson I, Laird BJ, Ling J, Normand C, Nottelmann L, Oldervoll L, Payne C, Prevost AT, Stene GB, Vanzulli E, Veber E, Economos G, Maddocks M. Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE): a multinational European research project. Palliat Care Soc Pract 2023; 17:26323524231179979. [PMID: 37377743 PMCID: PMC10291227 DOI: 10.1177/26323524231179979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023] Open
Abstract
Background Disability related to incurable cancer affects over a million Europeans each year and people with cancer rank loss of function among the most common unmet supportive care needs. Objectives To test the clinical and cost-effectiveness of an integrated short-term palliative rehabilitation intervention, to optimise function and quality of life in people affected by incurable cancer. Design This is a multinational, parallel group, randomised, controlled, assessor blind, superiority trial. Methods The INSPIRE consortium brings together leaders in palliative care, oncology and rehabilitation from partner organisations across Europe, with complementary expertise in health service research, trials of complex interventions, mixed-method evaluations, statistics and economics. Partnership with leading European civil society organisations ensures citizen engagement and dissemination at the highest level. We will conduct a multinational randomised controlled trial across five European countries, recruiting participants to assess the effectiveness of palliative rehabilitation for people with incurable cancer on the primary outcome - quality of life - and secondary outcomes including disability, symptom burden and goal attainment. To support trial conduct and enhance analysis of trial data, we will also conduct: comparative analysis of current integration of rehabilitation across oncology and palliative care services; mixed-method evaluations of equity and inclusivity, processes and implementation for the intervention, at patient, health service and health system levels. Finally, we will conduct an evidence synthesis, incorporating INSPIRE findings, and a Delphi consensus to develop an international framework for palliative rehabilitation practice and policy, incorporating indicators, core interventions, outcomes and integration methods. Scientific contribution If positive, the trial could produce a scalable and equitable intervention to improve function and quality of life in people with incurable cancer and reduce the burden of care for their families. It could also upskill the practitioners involved and motivate future research questions. The intervention could be adapted and integrated into different health systems using existing staff and services, with little or no additional cost.
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Affiliation(s)
- Joanne Bayly
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, 5 Bessemer Road, London SE59PJ, UK
| | | | | | - Barbara Bressi
- Physical Medicine and Rehabilitation Unit, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Joana Carvalho Vasconcelos
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
- Nightingale-Saunders Clinical Trials and Epidemiology Unit, King’s College London, London, UK
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mai-Britt Guldin
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - May Hauken
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Irene Higginson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Barry J.A. Laird
- Western General Hospital and Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Julie Ling
- European Association for Palliative Care, Vilvoorde, Belgium
| | - Charles Normand
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
| | - Lise Nottelmann
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, København, Denmark
| | - Line Oldervoll
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Cathy Payne
- European Association for Palliative Care, Vilvoorde, Belgium
| | - A. Toby Prevost
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
- Nightingale-Saunders Clinical Trials and Epidemiology Unit, King’s College London, London, UK
| | - Guro B. Stene
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elisa Vanzulli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Eduardo Veber
- European Cancer Patient Coalition, Brussels, Belgium
| | - Guillaume Economos
- Centre Hospitalier Lyon-Sud, Palliative Care Centre, Pierre-Benite, France
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King’s College London, London, UK
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Paltrinieri S, Bressi B, Mazzini E, Fugazzaro S, Rondini E, Giorgi Rossi P, Costi S. Activities Carried Out during the First COVID-19 Lockdown by Italian Citizens. Int J Environ Res Public Health 2023; 20:3906. [PMID: 36900917 PMCID: PMC10001561 DOI: 10.3390/ijerph20053906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The SARS-CoV-2 pandemic has altered how citizens engage in activities. This study describes the new activities citizens engaged in during the first lockdown, factors that helped them cope with the confinement, the supports they used the most, and which supports they would have liked to receive. This cross-sectional study consists of an online survey made of 49 questions that was completed by the citizens of the province of Reggio Emilia (Italy) from 4 May until 15 June 2020. The outcomes of this study were explored by focusing on four of the survey questions. Of the 1826 citizens who responded, 84.2% had started new leisure activities. Males, participants who lived in the plain or foothills, and those who experienced nervousness engaged less in new activities, while those whose employment status changed, whose lifestyle worsened, or whose use of alcohol increased engaged in more activities. The support of family and friends, leisure activities, continuing to work, and an optimistic attitude were perceived to be of help. Grocery delivery and hotlines providing any type of information and mental health support were used frequently; a lack of health and social care services and of support in reconciling work with childcare was perceived. Findings may help institutions and policy makers to better support citizens in any future circumstances requiring prolonged confinement.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Public Health Sciences PhD Program, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Barbara Bressi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Reggio Emilia, Italy
| | - Elisa Mazzini
- Scientific Directorate Hospital Network, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Ermanno Rondini
- Lega Italiana Contro i Tumori-LILT Reggio Emilia, 42123 Reggio Emilia, Italy
- Regional Center for Education in Health Promotion-Luoghi di Prevenzione, 42122 Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41124 Modena, Italy
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Bressi B, Iotti C, Cagliari M, Cavuto S, Fugazzaro S, Costi S. Feasibility and safety of physical exercise in men with prostate cancer receiving androgen deprivation therapy and radiotherapy: a study protocol. BMJ Open 2022; 12:e048854. [PMID: 35292485 PMCID: PMC8928322 DOI: 10.1136/bmjopen-2021-048854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Androgen deprivation therapy (ADT) and radiotherapy (RT) increase survival in selected patients with prostate cancer. Nevertheless, the side effects of these therapies are associated with an increased risk of accidental falls and fractures and a decreased quality of life. Preliminary evidence suggests that physical exercise can be a valid strategy to reduce the side effects of ADT and RT in men with prostate cancer. Despite this knowledge, most patients with prostate cancer are insufficiently active, and there is a lack of data on the safety and adherence to the recommended dose of physical exercise. This study protocol is designed to examine the feasibility and safety of a multicomponent experimental physical exercise intervention targeting psychophysical and cognitive functions and the quality of life in this population. METHODS AND ANALYSIS This is a pilot feasibility study. Twenty-five men currently treated with ADT and RT for prostate cancer will be invited to participate in a 20-week, multicomponent physical exercise intervention, including supervised and unsupervised exercise sessions and meeting the current recommendation for exercise in cancer. The primary outcomes are physical exercise feasibility (recruitment, adherence and drop-out rates) and safety (adverse events related and unrelated to the intervention). The secondary outcomes are muscle strength, balance, fatigue, symptoms of anxiety and depression, cognitive function, quality of life, and patient satisfaction. We will also record the number of accidental falls and fractures occurring during the intervention and at 1 year of follow-up. ETHICS AND DISSEMINATION The study has received ethics approval from The Area Vasta Nord Local Ethics Committee (Province of Reggio Emilia, 23 June 2020, Number 520/2020/SPER/IRCCSRE). Recruitment began in September 2020 and will be completed in September 2021. The results will be disseminated through scientific journals and conference presentations. TRIAL REGISTRATION NUMBER NCT04500080.
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Affiliation(s)
- Barbara Bressi
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Iotti
- Department of Oncology and Advanced Technologies, Radiotherapy Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maribel Cagliari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvio Cavuto
- Research and Statistics Infrastructure, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Cagliari M, Bressi B, Bassi MC, Fugazzaro S, Prati G, Iotti C, Costi S. Feasibility and Safety of Physical Exercise to Preserve Bone Health in Men With Prostate Cancer Receiving Androgen Deprivation Therapy: A Systematic Review. Phys Ther 2022; 102:pzab288. [PMID: 34972863 PMCID: PMC8970430 DOI: 10.1093/ptj/pzab288] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 07/30/2021] [Accepted: 11/21/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Men with prostate cancer (PCa) receiving androgen deprivation therapy (ADT) experience the loss of bone mineral density (BMD) and lean body mass, which can increase their risk of falls and fractures. Physical exercise programs with appropriate components and dosage are suggested to preserve BMD and muscle strength, thereby potentially reducing accidental falls and fractures and associated morbidity and mortality. These benefits can be obtained if exercise programs are feasible and safe and if patient adherence is adequate. This systematic review investigates the feasibility and safety of exercise programs aimed at preventing the risk of accidental falls and fractures and BMD loss in men with PCa undergoing ADT. METHODS MEDLINE, Embase, CINAHL, and the Cochrane Library were searched from database inception to June 7, 2021. Randomized controlled trials were included when they analyzed the feasibility and safety of experimental exercise programs targeting bone health in men with PCa receiving ADT. Two reviewers independently selected the studies, assessed their methodological quality, and extracted the data. Exercise feasibility was measured through recruitment, retention, and adherence rates. Exercise safety was measured through the number, type, and severity of adverse events. Furthermore, the components, setting, intensity, frequency, and duration of exercise programs were extracted. RESULTS Ten studies were included, with a total of 633 participants. Exercise consisted of a combination of aerobic, resistance, and impact-loading exercise or football training. Exercise is feasible in men with PCa undergoing ADT, although football training should be prescribed with caution for safety reasons. CONCLUSION Multicomponent exercise programs targeting bone health seem feasible and safe in this population; however, adverse events should be systematically documented according to current guidelines. IMPACT The study shows that men with PCa receiving ADT can safely perform exercise programs to preserve bone health and supports that those programs should become part of lifestyle habits. LAY SUMMARY Men with PCa who are receiving ADT can safely perform exercise programs to preserve bone health and should make exercise an important part of their lifestyle.
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Affiliation(s)
- Maribel Cagliari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Barbara Bressi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Chiara Bassi
- Medical Library, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppe Prati
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Iotti
- Department of Oncology and Advanced Technologies, Radiotherapy Unit, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Scientific Directorate, Azienda USL–IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Bressi B, Iotti C, Cagliari M, Fugazzaro S, Cavuto S, Bergamaschi FAM, Moscato A, Costi S. Physical exercise habits, lifestyle behaviors, and motivation to change among men with prostate cancer: a cross-sectional study. Support Care Cancer 2022; 30:5017-5026. [PMID: 35194723 DOI: 10.1007/s00520-022-06911-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/12/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE To describe the physical exercise (PE) habits, lifestyle, and motivation to change toward healthier behaviors in patients newly diagnosed with prostate cancer (PCa). METHODS A cross-sectional study was conducted in an Italian hospital setting. Men newly diagnosed with PCa were consecutively invited to participate in a structured interview that was conducted either in person or by telephone. RESULTS The mean age of the 40 participants was 70.5 ± 6.6 (range 50-84). Most participants (65%) reported they were physically active, but more than half of the sample did not reach the recommended PE level. However, 40% of participants would be interested in participating in an exercise program. Only 10% of participants were current smokers, but 90% drank alcohol, and 62.5% were overweight/obese. Almost all participants were not willing to change their habits. CONCLUSIONS A high proportion of Italian men are insufficiently active when diagnosed with PCa. Moreover, even when exposed to behavioral risk factors, they are not willing to change their lifestyle. Health-care professionals who deal with men newly diagnosed with PCa should take advantage of the teachable moment and apply strategies that support patients' motivation to exercise and adherence to healthier lifestyles. TRIAL REGISTRATION The study was prospectively registered in ClinicalTrial.gov NCT03982095 on June 11, 2019.
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Affiliation(s)
- Barbara Bressi
- Ph.D Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, 41125, Italy.
- Physical Medicine and Rehabilitation Unit, Department of Neuromotor Physiopathology and Rehabilitation Medicine, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy.
| | - Cinzia Iotti
- Department of Oncology and Advanced Technologies, Radiotherapy Unit, AziendaUnità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Maribel Cagliari
- Department of Medicine, Surgery, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, 41124, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Department of Neuromotor Physiopathology and Rehabilitation Medicine, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Silvio Cavuto
- Clinical Trials and Statistics Unit, S.C. Infrastructure, Research and Statistics, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Franco Antonio Mario Bergamaschi
- Department of General and Specialist Surgeries, Urology and Mininvasive Surgery, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Alfredo Moscato
- Department of General and Specialist Surgeries, Urology and Mininvasive Surgery, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Stefania Costi
- Department of Medicine, Surgery, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, 41124, Italy
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
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Paltrinieri S, Bressi B, Costi S, Mazzini E, Cavuto S, Ottone M, De Panfilis L, Fugazzaro S, Rondini E, Giorgi Rossi P. Beyond Lockdown: The Potential Side Effects of the SARS-CoV-2 Pandemic on Public Health. Nutrients 2021; 13:nu13051600. [PMID: 34064715 PMCID: PMC8170902 DOI: 10.3390/nu13051600] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 12/16/2022] Open
Abstract
Lockdowns to contain the spread of the SARS-CoV-2 have disrupted routines and behaviors, which could lead to a worsening of lifestyle and an increase in the burden of non-communicable diseases. This study aimed to describe the changes in physical activity, diet, alcohol drinking, and cigarette smoking during lockdown. A self-administered online survey addressing adults living in a province in northern Italy was advertised through websites and social media. Citizens could access the survey in anonymity from 4 May until 15 June 2020. A total of 1826 adults completed the survey, with a worsening of physical activity (35.1%), diet (17.6%), alcohol drinking (12.5%), and cigarette smoking (7.7%) reported. In contrast, 33.5% reported an improvement in diet, 12.6% in alcohol drinking, 5.3% in physical activity and 4.1% in cigarette smoking. Female sex, young adult age, suspension of work activity, and symptoms of psychological distress were the factors associated with a greater likelihood of change, which was frequently for the worse. Lockdown had an impact on lifestyle, with some net beneficial effects on diet and mostly negative effects on physical activity. Public health measures should be implemented to avoid long-term negative effects of the lockdown, supporting individuals more prone to change for the worse.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (B.B.); (S.F.)
| | - Barbara Bressi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (B.B.); (S.F.)
- Department of Biomedical, Metabolic and Neural Sciences, Università di Modena e Reggio Emilia, 41124 Modena, Italy
| | - Stefania Costi
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Department of Medicine, Surgery, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41124 Modena, Italy
- Correspondence: ; Tel.: +39-0522-522-441
| | - Elisa Mazzini
- Medical Directorate Hospital Network, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Silvio Cavuto
- Clinical Trials and Statistics Unit, S.C. Infrastructure, Research and Statistics, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Marta Ottone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.O.); (P.G.R.)
| | - Ludovica De Panfilis
- Bioethics Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.P.); (B.B.); (S.F.)
| | - Ermanno Rondini
- Lega Italiana contro i tumori-LILT Reggio Emilia, 42123 Reggio Emilia, Italy;
- Regional Center for Education in Health Promotion-Luoghi di Prevenzione, 42122 Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.O.); (P.G.R.)
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Bressi B, Paltrinieri S, Fugazzaro S, Costi S. Letter to the editor: Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract 2021; 43:101368. [PMID: 33762161 PMCID: PMC7970414 DOI: 10.1016/j.ctcp.2021.101368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 01/21/2023]
Affiliation(s)
- Barbara Bressi
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy; Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy.
| | - Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy.
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy.
| | - Stefania Costi
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy; Department of Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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Costi S, Paltrinieri S, Bressi B, Fugazzaro S, Giorgi Rossi P, Mazzini E. Poor Sleep during the First Peak of the SARS-CoV-2 Pandemic: A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:E306. [PMID: 33406588 PMCID: PMC7795804 DOI: 10.3390/ijerph18010306] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 12/13/2022]
Abstract
The restrictions enacted during lockdown to limit the spread of the novel coronavirus (SARS-CoV-2) have led to changes in people's lifestyle habits. In Italy, these restrictions have dramatically changed the way people work and spend their leisure time, also with repercussions on diet and physical activity. An anonymous survey was disseminated via websites and social media to a convenience sample of the Italian population during and immediately after the first lockdown (10 March-18 May 2020). Data collected on 1826 individuals show that lockdown might have worsened the quality of sleep of almost half of the participants in this cross-sectional study. This worsening was associated with a deterioration in crucial determinants of health, such as physical activity and diet (OR 1.68; 95% CI 1.18-2.40 and OR 4.19; 95% CI 2.51-6.96, respectively), with symptoms of psychological distress, such as tension (OR 3.88; 95% CI 2.74-5.52) and loneliness (OR 3.27; 95% CI 2.23-4.79), and with the presence of financial problems (some OR 1.86; 95% CI 1.27-2.72; many OR 7.27; 95% CI 3.59-14.73). The multivariate regression analysis models confirmed these associations. This impact on sleep quality was seen especially among females, those with low education level, and those who experienced financial problems.
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Affiliation(s)
- Stefania Costi
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
- Department of Medicine, Surgery, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41124 Modena, Italy
| | - Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (B.B.); (S.F.)
| | - Barbara Bressi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (B.B.); (S.F.)
- Department of Biomedical, Metabolic and Neural Sciences, Università di Modena e Reggio Emilia, 41124 Modena, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (B.B.); (S.F.)
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
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Costi S, Mecugni D, Beccani L, Alboresi S, Bressi B, Paltrinieri S, Ferrari A, Pelosin E. Construct Validity of the Activities Scale for Kids Performance in Children with Cerebral Palsy: Brief Report. Dev Neurorehabil 2020; 23:474-477. [PMID: 32508188 DOI: 10.1080/17518423.2020.1764649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aims: This study collects evidence of construct convergent validity of the Activity Scale for Kids performance (ASKp), comparing its results with the 66-item Gross Motor Function Measure (GMFM-66) and with the Gross Motor Function Classification System (GMFCS) and testing the ASKp's ability to discriminate between individuals with different functional capabilities. Methods: This cross-sectional study involved 60 children with spastic cerebral palsy (CP) assessed with the GMFM-66 who self-administered the Italian version of the ASKp. Results: Children were 10.9 (±3) years old with GMFCS Level I-III. Moderate correlations were found between GMFM and ASKp scores (r = 0.577; p < .001), and between GMFCS levels and ASKp score (rs = -0.541, p < .001). The ASKp discriminated between children with different functional capabilities, determined by the GMFCS (F = 18.2, p < .001). Conclusions: ASKp is valid to assess physical functioning, a crucial domain in rehabilitation of children with spastic CP. Trial registration: ClinicalTrials.gov Identifier: NCT03325842.
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Affiliation(s)
- Stefania Costi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa , Genova, Italy.,Scientific Directorate, Azienda Unità Sanitaria Locale - IRCCS Di Reggio Emilia , Reggio Emilia, Italy.,Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia , Modena, Italy
| | - Daniela Mecugni
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia , Modena, Italy
| | - Laura Beccani
- Scientific Directorate, Azienda Unità Sanitaria Locale - IRCCS Di Reggio Emilia , Reggio Emilia, Italy
| | - Silvia Alboresi
- Scientific Directorate, Azienda Unità Sanitaria Locale - IRCCS Di Reggio Emilia , Reggio Emilia, Italy
| | - Barbara Bressi
- Scientific Directorate, Azienda Unità Sanitaria Locale - IRCCS Di Reggio Emilia , Reggio Emilia, Italy.,Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia , Modena, Italy
| | - Sara Paltrinieri
- Scientific Directorate, Azienda Unità Sanitaria Locale - IRCCS Di Reggio Emilia , Reggio Emilia, Italy
| | - Adriano Ferrari
- Scientific Directorate, Azienda Unità Sanitaria Locale - IRCCS Di Reggio Emilia , Reggio Emilia, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa , Genova, Italy
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Costi S, Bressi B, Cavuto S, Braglia L, Ferrari A, Pelosin E. Cross-cultural validation of Activities Scale for Kids: the performance of healthy Italian children. J Sports Med Phys Fitness 2020; 60:1014-1019. [PMID: 32597618 DOI: 10.23736/s0022-4707.20.10466-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The assessment of physical performance is a key element in the rehabilitation of individuals with disabilities, and understanding patients' perception of their abilities is of foremost importance for the success of the whole process. The Activities Scale for Kids performance (ASKp) is one of the few reliable and responsive outcome measures that allows children and adolescents to accurately report their physical functioning in typical activities for this age. The performance version of the ASKp has recently been translated and culturally adapted to the Italian context. METHODS This cross-sectional study was implemented to describe the ASKp score distribution in a population of Italian school aged individuals. RESULTS A population of 209 Italian children with a mean age of 10.96 years (SD 2.92, range 5-15) participated in this study during the academic year 2017/18. The ASKp score ranged from 52.58 to 100, with a mean value of 89.07 points (SD 10.57). Scores greater than 90 were attained for 57.4% of participants, confirming the ceiling effect of this assessment tool when administered in healthy children (95% CI: 50.4-64.2%). The ASKp was able to differentiate between different levels of physical performance according to different developmental ages (P<0.001), and it confirmed the ability to distinguish between children with typical development and those with disability (P<0.001). CONCLUSIONS The results of this study provide the first evidence of construct validity of the Italian version of the ASKp. These results will help clinicians to interpret ASKp scores of children with musculoskeletal limitations.
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Affiliation(s)
- Stefania Costi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy - .,Unit of Children Rehabilitation for Severe Developmental Disabilities - UDGEE, Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy - .,Surgical, Medical and Dental Department of Morphological Sciences Related to Transplants Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy -
| | - Barbara Bressi
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Modena, Italy
| | - Silvio Cavuto
- Research and Statistics Infrastructure, Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Luca Braglia
- Research and Statistics Infrastructure, Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Adriano Ferrari
- Unit of Children Rehabilitation for Severe Developmental Disabilities - UDGEE, Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,Surgical, Medical and Dental Department of Morphological Sciences Related to Transplants Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Pelosin
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
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Errante A, Bozzetti F, Sghedoni S, Bressi B, Costi S, Crisi G, Ferrari A, Fogassi L. Explicit Motor Imagery for Grasping Actions in Children With Spastic Unilateral Cerebral Palsy. Front Neurol 2019; 10:837. [PMID: 31447762 PMCID: PMC6692593 DOI: 10.3389/fneur.2019.00837] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/19/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Motor Imagery (MI) refers to mental simulation of a motor action without producing any overt movement. Previous studies showed that children with Unilateral Cerebral Palsy (UCP) are impaired in implicit MI, as demonstrated by the performance of Hand Laterality Judgment tasks. The aim of this study was to examine the specificity of explicit MI deficits in UCP children. Methods: A group of UCP children (n = 10; aged 9-14) performed a mental chronometry task consisting in grasping an object and placing it into a container, or in imagining to perform the same action. As control, a group of typically developing (TD) children, matched by age, performed the same task. Movement durations for executed and imagined trials were recorded. A subgroup of 7 UCP children and 10 TD children also underwent a session of functional MRI to examine the activation of parieto-frontal areas typically associated to MI processes, during the imagination of reaching-grasping actions performed with the paretic hand. Results: Behavioral results revealed the existence of a correlation between executed and imagined movement durations both in TD and UCP groups. Moreover, the regression analysis in TD children showed that higher scores in mental chronometry tasks were positively correlated to increased bilateral activation of the intraparietal sulcus (IPS), superior parietal lobule (SPL), and dorsal premotor (PMd) cortex. A similar analysis revealed in the UCP group a positive correlation between a higher score in the mental chronometry task and bilateral activations of IPS, and to activation of contralesional, right PMd, and putamen during imagination of grasping movements. Conclusions: These results provide new insights on the relationship between MI capacity and motor deficits in UCP children, suggesting the possibility of the use of explicit MI training to improve patient's upper limb motor functions.
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Affiliation(s)
- Antonino Errante
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Bozzetti
- Neuroradiology Unit, Department of Diagnostic, University Hospital of Parma, Parma, Italy
| | - Silvia Sghedoni
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Barbara Bressi
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Costi
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Girolamo Crisi
- Neuroradiology Unit, Department of Diagnostic, University Hospital of Parma, Parma, Italy
| | - Adriano Ferrari
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Fogassi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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