Search Results (153)

Purpose: We aimed to evaluate the safety and feasibility of a remote electrocardiogram (ECG) monitoring-based cardiac rehabilitation (CR) program during an early postoperative period in patients who underwent cardiac surgery. Methods: Five days after cardiac surgery, patients were referred to a CR department and participated in a low-intensity inpatient CR program while wearing an ECG monitoring device. Prior to discharge, the patients underwent a cardiopulmonary exercise test (CPET) and squat endurance test to determine the suitable intensity and target heart rate (HR) for home-based CR (HBCR). During 2 weeks of the HBCR period after discharge, patients participated in aerobic and resistance exercises. Electrocardiogram data were transmitted to a cloud, where researchers closely monitored them through a website and provided feedback to the patients via telephone calls. Grip strength (GS), 6 min walk distance (6 MWD), EuroQol-5 dimension (EQ-5D), short-form 36-item health survey (SF-36), and Korean Activity Scale/Index (KASI) were measured at three different time points: 5 d post-surgery (T1), pre-discharge (T2), and 2 weeks after discharge (T3). Squat endurance tests and CPET were performed only at T2 and T3. Result: Sixteen patients completed the study, seven (44%) of whom underwent coronary artery bypass graft surgery (CABG). During the study period between T2 and T3, peak VO₂ improved from 12.39 ± 0.57 to 17.93 ± 1.25 mL/kg/min (p < 0.01). The squat endurance test improved from 16.69 ± 2.31 to 21.81 ± 2.31 (p < 0.01). In a comparison of values of time points between T1 and T3, the GS improved from 28.30 ± 1.66 to 30.40 ± 1.70 kg (p = 0.02) and 6 MWD increased from 249.33 ± 20.92 to 387.02 ± 22.77 m (p < 0.01). The EQ-5D and SF-36 improved from 0.59 ± 0.03 to 0.82 ± 0.03 (p < 0.01) and from 83.99 ± 3.40 to 122.82 ± 6.06 (p < 0.01), and KASI improved from 5.44 ± 0.58 to 26.11 ± 2.70 (p < 0.01). In a subgroup analysis, the CABG group demonstrated a greater increase in 6 MWD (102.29 m, p < 0.01) than the non-CABG group. At the end of the study, 75% of the patients expressed satisfaction with the early CR program guided by remote ECG monitoring. Conclusions: Our findings suggest that early remote ECG monitoring-based CR programs are safe and feasible for patients who have undergone cardiac surgery. Additionally, the program improved aerobic capacity, functional status, and quality of life. Full article

Background: The efficacy of postoperative exercise rehabilitation after spine surgery is controversial, and a protocol for exercise treatment and detailed outcomes based on functional activity have not yet been established. This study aimed to determine the efficacy of exercise rehabilitation after lumbar spine surgery. Methods: A prospective, randomized controlled trial was conducted in 40 patients who underwent lumbar spine surgery (20 patients each in the exercise and control groups) for 12 weeks. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and EuroQol-5 Dimensions 5-Level version (EQ-5D-5L). Body proportions, including body mass index, total muscle mass, and body fat percentage were analyzed. Functional activity was evaluated based on the range of motion of the lumbar spine, strength and endurance of lumbar flexion/extension, flexibility, 6 min walking test, single-leg stance, coordination, and gait pattern analysis. Results: The exercise group showed significantly greater improvement in VAS for pain (66.67% versus 20.00%, p < 0.001) and EQ-5D-5L (45.56% versus 20.00, p = 0.039) compared to the control group. Serial assessment revealed significant improvement in strength of lumbar flexion/extension, 6 min walking test, single-leg stance, coordination, and gait patterns in the exercise group compared to the control group. In particular, the single-leg stance time for the affected leg improved more markedly in the exercise group (280.9% versus 48.7%, p < 0.001). Conclusion: Tailored postoperative exercise after lumbar spine surgery is effective in reducing pain and enhancing functional recovery, including strength and balance. Full article

Background/Objectives: Evidence of patient experiences with heart failure with preserved ejection fraction (HFpEF) and disease impact on quality of life (QoL) is scarce. This study explored perceived impacts on QoL and healthcare experiences of HFpEF patients and their caregivers. Methods: This was a mixed-methods study with HFpEF patients, ≥40 years, New York Heart Association functional classes I-IV in Spain. Qualitative data were collected through semi-structured interviews with patients (n = 19) and caregivers (n = 17). The EuroQoL 5D-5L, Patient Global Impression of Severity, and Kansas City Cardiomyopathy Questionnaire were used to collect QoL measures. Results: The themes were as follows. (1) Impact of HFpEF on QoL; (2) new roles of informal caregiving; and (3) the increasing value of multidisciplinary care. Qualitative data were supported by a trend of worsening QoL on quantitative measures as HF progressed, despite quantitative measures not fully capturing the burden. Qualitative data further captured discrepancies of QoL perceptions. Conclusions: The impact of HFpEF on patients and their caregivers was similar to the HFrEF population’s. Insights from discrepancies between PROMs data and interviews could help with tailoring QoL questionnaires to capture the broader impact of HFpEF, identify unmet needs, and customize care. Full article

Background/Objectives: Adverse effects of antipsychotics represent a significant limiting factor in achieving favorable therapeutic outcomes in the treatment of schizophrenia, and may contribute to a diminished quality of life among affected individuals. The primary objective of this study was to identify and evaluate the adverse effects of antipsychotics in patients diagnosed with schizophrenia who were treated at the social welfare institution, as well as to analyze the impact of these adverse effects on patients’ overall quality of life. Methods: A clinical, observational cross-sectional study was conducted, involving a sample of 278 patients diagnosed with schizophrenia. The patients were assessed in terms of their sociodemographic and clinical characteristics. Adverse effects of antipsychotics were evaluated using The Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale, while quality of life was assessed in the previous study. Results: The average number of adverse effects per patient with schizophrenia was 3.56 for psychiatric, 1.18 for neurological, 2.62 for autonomic, and 7.12 for other side effects. The average UKU score was 17.22 ± 11.04, with significant differences based on accommodation, antipsychotic type, and dosing regimen. UKU scores were negatively correlated with the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) index, Visual Analog Scale (VAS) score, the Quality-of-Life Enjoyment and Satisfaction Questionnaire—Short Form (Q-LES-Q-SF) score, and the scores of physical and psychological domains of the World Health Organization Quality-of-Life Scale (WHOQOL-BREF). Conclusions: The findings of this study suggest that the presence of antipsychotic-related adverse effects is a significant determinant that can negatively influence the quality of life in patients with schizophrenia. These results underscore the importance of an individualized approach when determining pharmacological treatment strategies in the management of schizophrenia. Full article

Background and Objectives: Chronic wounds severely impair patients’ quality of life (QoL), impacting physical, emotional, and functional well-being. Understanding the multidimensional effects of treatment is key to implementing effective, patient-centered care strategies. This study aimed to assess changes in QoL among patients with chronic wounds using the Dermatology Life Quality Index (DLQI) and EuroQol-5D (EQ-5D), comparing outcomes across treatment modalities. Materials and Methods: A longitudinal observational study was conducted between 2019 and 2024 across three hospitals in the Valencian Community. A total of 278 patients with venous lower-limb ulcers of more than six weeks’ duration were included. Quality-of-life assessments were performed at baseline, one-month follow-up, and discharge. Treatments included alginate, foam, moist wound healing (MWH), compression therapy, and negative-pressure wound therapy (NPWT). Statistical analysis involved Friedman’s test and repeated-measures ANOVA. Results: Significant improvements were observed in overall QoL across most treatment modalities. EQ-5D scores progressively increased, while DLQI scores decreased. Pain, embarrassment, and limitations in daily life (e.g., shopping and social activities) showed marked reductions. MWH and foam demonstrated the most favorable impact on QoL, while NPWT showed more modest improvements, possibly due to patient complexity. Notably, the variable “sexuality” remained unchanged (mean = 0.00), possibly due to underreporting or communication barriers. Conclusions: Chronic wound treatments significantly improve patients’ quality of life, particularly in terms of pain and social functioning. The use of combined tools (DLQI and EQ-5D) allows for a more comprehensive understanding of these outcomes. These findings highlight the importance of tailoring wound care to individual needs and addressing psychosocial domains, including sexuality. Community nursing, nutritional support, and long-term follow-up should be incorporated into care plans to optimize results, especially in older adults. Full article

Background: Although previous studies have suggested a variety of sociodemographic and psychological factors as predictors of poor outcomes in patients with chronic low back pain (CLBP), longitudinal studies remain rare. Objectives: To examine the prognostic indicators for poor outcome at 6 months on pain, disability, quality of life, anxiety, depression and somatic symptom disorders (SSDs) in Greek backache patients and to evaluate the medium-term effects of a conservative physiotherapeutic approach (massage, ultrasound, transcutaneous electrical nerve stimulation, low-level laser and exercise program). Methods: A prospective cohort study of 145 volunteers receiving treatment for CLBP in a physiotherapy unit was conducted using random systematic sampling. The intervention was assessed by comparing pre-treatment, post-treatment and six-month measurements with Friedman’s test and the Bonferroni correction, using the pain numerical rating scale (PNRS), Roland–Morris disability questionnaire (RMDQ), EuroQol-5-dimension-5-level (EQ-5D-5L), Hospital Anxiety and Depression Scale (HADS) and Somatic Symptom Scale-8 (SSS-8). Multiple linear regression analysis was carried out to determine the impact of demographics and pre-treatment scores with scores at six months. Results: The mean age was 60.6 years (±14.7). Post-treatment, statistically significant improvements were observed across all outcome measures, including PNRS, RMDQ, EQ-5D-5L and SSS-8 (all p ≤ 0.001), with anxiety showing a notable reduction (p = 0.002). After examining the multiple regression analysis, pre-treatment SSS-8 emerged as a predictor of elevated levels of pain, disability, anxiety and depression at 6 months. Conclusions: The findings yielded not only somatic symptom burden, greater age and pain intensity as prognostic indicators for poor outcomes at six months, but also reported favorable medium-term effects for a conventional physiotherapy regimen in CLBP management, as well. Full article

Background/Objectives: We aim to assess the effect of the Espaijove.net mental health literacy program on adolescents’ quality of life (QOL). Additionally, we aim to describe their QOL and mental well-being. Methods: A multicenter, randomized, controlled trial was conducted, with pre- and post-intervention assessments and 6- and 12-month follow-ups. A total of 1032 students aged 13–14 from 18 schools in Barcelona participated in one of the three following mental health literacy (MHL) programs or were placed in a control group (CG): (1) a 1 h awareness session (G1h); (2) a 6 h MHL program (G6h); (3) a 7 h MHL program with stigma reduction (G7h). Measures: (1) Mental well-being: Strengths and Difficulties Questionnaire (SDQ); (2) QOL: EuroQol 5D-5L with its two parts: the EuroQol 5D-5L Index (0–1) and EuroQol 5D-5L visual analog scale (EQ-VAS) (0–100). Analyses were conducted on an intention-to-treat basis, using data imputation methods for missing data. Intervention effects were assessed using multilevel models. Results: Baseline EQ-VAS and EQ-5D-5L index scores were 77.84 (CI = 76.77–78.91) and 0.91 (CI = 0.90–0.92), respectively. Boys reported higher QOL and SDQ scores (p < 0.001), whereas participants of foreign nationality showed lower scores in QOL (EQ-VAS; p = 0.039) and mental well-being (p < 0.001). Post-intervention, all groups (intervention and control), except G6h, showed QOL improvements. However, in the 6-month follow-up, the CG outperformed the other groups. At 12 months, G7h achieved the highest EQ-VAS scores compared to the other groups. Conclusions: MHL-based interventions improved short-term QOL but failed to sustain these improvements over time. Groups with lower QOL and SDQ scores included girls and adolescents of foreign nationality. Full article

Background/Objectives: We aimed to compare non-pharmacological (non-PHM) and pharmacological (PHM) treatment for patients with non-acute lumbar disc herniation (LDH) and determine the feasibility of a large-scale study. Methods: This was a two-armed, parallel, multicenter, pragmatic controlled trial performed in South Korea. All patients underwent magnetic resonance imaging (MRI) scans both at the screening stage and the last follow-up. Patients with LDH findings on MRI were randomly assigned to non-PHM and PHM groups. Treatment was administered twice a week for a total of 8 weeks, and follow-up assessments were performed at weeks 9, 13, and 27 post-randomization. The primary outcome was the Oswestry Disability Index (ODI) score. A linear mixed model was used for primary analysis from intention-to-treat perspectives. The incremental cost-effectiveness ratio (ICER) was calculated for economic evaluation. Results: Thirty-six patients were enrolled, and thirty-five were included in the final analysis. At Week 9, the difference in ODI scores between the two groups was 5.17 (95% CI: −4.00 to 14.35, p = 0.262), and the numeric rating scale scores for lower back and leg pains were 1.89 (95% CI: 0.68 to 3.10, p = 0.003) and 1.52 (95% CI: 0.27 to 2.77, p = 0.018), respectively, confirming greater improvement in the non-PHM group than in the PHM group. The non-PHM group showed lower costs and higher quality-adjusted life years than the PHM group. The ICER calculated using the EuroQoL-5 Dimension (EQ-5D) was USD 20,926. Conclusions: We confirm the possibility that a non-PHM strategy could be a more effective and cost-effective treatment option than PHM for patients with non-acute lumbar disc herniation. Furthermore, this pilot study confirmed the feasibility of the main study in terms of design and patient compliance. Full article

Background: Non-classical manifestations such as neuropsychiatric manifestations in primary hyperparathyroidism (PHPT) have long been documented as symptoms of PHPT and are commonly reported by these patients, despite this connection still being a matter of debate, and they (per se) do not represent an indication of parathyroidectomy. Objective: We aimed to overview the most recent findings regarding the link between depression and/or anxiety (D/A) in subjects confirmed with PHPT, including the impact of the surgery in improving their outcome. Methods: This was a comprehensive review of English-based original studies published between January 2020 and October 2024. Results: The studies (n = 16) included a total of 10,325 patients and an additional 152,525 patients with hypercalcemia (out of whom 13,136 had a PHPT diagnosis and 45,081 were at risk of PHPT diagnosis). Out of these subjects with PHPT, 10,068 underwent parathyroidectomy. Female prevalence was between 62.5 and 92%. Most individuals were over 50, with the youngest studied population having a mean age of 52.7 ± 13.8 years, and the oldest had a median of 71. Depression was documented based on ICD-10 codes (n = 3) and patients’ records (n = 2), Depression Anxiety Stress Scales (DASS) (n = 2), Beck Depression Inventory (BDI) (n = 3), BDI-II (n = 3), Symptom Check List 90-revised (SCL) (n = 1), Hamilton Depression Rating Scale (HAM-D) (n = 2), HADS (n = 2), Patient Health Questionnaire-9 (n = 1), and European Quality of Life 5 Dimensions 3-Level Version (EuroQOL-5D-3L) (n = 1). Patient records’ (n = 1) and ICD-10 codes (n = 2) were also used for anxiety. Most studies used questionnaires to identify anxiety in PHPT: DASS (n = 2), SCL90R (n = 1), Generalized Anxiety Disorder-7 (n = 1), HADS (n = 2), EuroQOL-5D-3L (n = 1), and State–Trait Anxiety Inventory (n = 1). Depression prevalence varied from 20–36.6% to 65.7% (scale-based assessment) and to 10.5% upon ICD-10. A rate of newly onset depression was reported of 10.7% and of 0.2% with concern to the prevalent suicidal ideation (an incidental rate of 0.4% after a median follow-up of 4.2 years). Most studies identified a moderate depression (when assessing its severity), affecting approximately one third of the surgery candidates. The prevalence of anxiety in PHPT varied between 10.4% and 38.6% (n = 8). Discordant results were generated when applying distinct questionnaires for the same population, and this might come as a potential bias. Other confounding factors are generated by the sub-population referred for surgery that typically displays a more severe parathyroid condition or non-endocrine overlapping conditions (e.g., related to the social or familial status). Conclusion: The modern approach of the patient with PHPT should be complex and go beyond the traditional frame. D/A had a high prevalence in the mentioned studies, associated with increased medication use. Yet, the underlying pathogenic mechanisms remain incompletely elucidated. No correlations between D/A and serum calcium levels were confirmed, while PTH had a slight positive correlation with depression. Parathyroid surgery appears to be beneficial for D/A as it improves the scores, prevalence, and severity. Cinacalcet might reduce depression scores, although more evidence is needed. Women are prone to both PHPT and D/A. The optimal method of D/A screening in PHPT remains to be determined, and the current scales need validation and perhaps adjustment for this specific population sub-group, while PHPT management should be refined upon D/A identification. Full article

Background and Objectives: Despite the critical importance of effective healthcare management for patients with multimorbidity, robust and reliable tools for assessing health-related quality of life in Lithuania remain scarce. We aim to identify trends in the quality of life of patients with multimorbidity and to evaluate the effectiveness of the Lithuanian version of the EuroQol EQ-5D-5L questionnaire. Materials and Methods: The study included patients between the ages of 40 and 85 (N = 498) who had at least two chronic conditions, arterial hypertension being a prerequisite. The participants completed a comprehensive set of questionnaires specifically prepared for the TELELISPA “Improved healthcare quality for patients with multimorbidity in Lithuania” project which included the translated EQ-5D-5L questionnaire. The predictive validity of the EQ-5D-5L questionnaire was assessed using correlations with the SF-36 and EQ-VAS scores, a random forest regression model. Reliability was evaluated using Cronbach’s alpha and inter-item correlations. Trends in the quality of life in different patient groups were assessed with Chi-square tests. Results: The EQ-5D-5L questionnaire demonstrated high reliability and validity with a Cronbach’s alpha value of 0.737, EQ-5D-5L random forest machine learning regression model RMSE value of 0.1396, and adequate scores from other measures. Lower quality of life was found in patients with multimorbidity who had chronic conditions such as angina pectoris, heart failure, atrial fibrillation, or joint diseases, as well as the patients who were older than 60 years of age, women, or unemployed. Different aspects of quality of life were also significantly negatively impacted by diabetes, asthma, and chronic kidney disease. Heart failure, joint diseases, and older age had the biggest negative effect on quality of life. Conclusions: It is found that the Lithuanian EQ-5D-5L questionnaire is suitable for the assessment of the quality of life in patients with multimorbidity and indicates lower quality of life among those with specific cardiovascular and joint disorder chronic conditions and, in particular, demographic groups. Full article

Background and Objectives: To evaluate urinary incontinence (UI) and its effect on quality of life (QoL) in male stroke patients. Materials and Methods: A quantitative cross-sectional study was conducted with 103 adult male stroke survivors. The individuals’ degree of disability was evaluated using the Modified Rankin Scale (MRS) and Barthel Index (BI). The UI assessment was performed with the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire-7 (IIQ-7). In addition, the QoL was questioned with EuroQoL 5-Dimension 3-Level (EQ-5D-3L)”. Results: The mean age of the participants was 68.4 ± 9.9 years. The average scores of the IIQ-7 and UDI-6 were 9.7 ± 7.2 and 36.6 ± 26.3, respectively. According to these scores, both UI questionnaire results were slightly above the reference cut-off value. According to the UDI-6 scores, 52.4% of the participants exhibited symptoms, while 55.3% demonstrated symptoms according to the IIQ-7 scores. The IIQ-7 was strongly correlated with the MRS (p < 0.001, r = 0.740), BI (p < 0.001, r = −0.770), EQ-5D-3L Index (p < 0.001, r = −0.804), and EQ-5D-3L VAS (p < 0.001, r = −0.679) scores. In addition, the UDI-6 was strongly correlated with the MRS (p < 0.001, r = 0.697), BI (p < 0.001, r = −0.730), EQ-5D-3L Index (p < 0.001, r = −0.726), and EQ-5D-3L VAS (p < 0.001, r = −0.623) scores. Furthermore, the IIQ-7 and UDI-6 scores were statistically higher in patients with cortical-level involvement (p < 0.05). Regression results showed that the IIQ-7 was associated with the MRS, BI, EQ-5D-3L Index, and EQ-5D-3L VAS scores (R² = 0.627, p < 0.001). Similarly, the UDI-6 was significantly associated with the MRS, BI, EQ-5D-3L Index, and EQ-5D-3L VAS scores in a multiple hierarchical regression model (R² = 0.423, p < 0.001). Conclusions: The severity of UI was classified as high. As expected, UI was higher in individuals with increased disability. The QoL of individuals with UI is more negatively affected. Finally, the severity of UI was higher in individuals with cortical stroke. Full article

Background/Objectives: The COVID-19 pandemic had significant implications for healthcare workers (HWs), especially those that work in hospitals. This study evaluated health related quality of life (HRQOL) and its relationship with dyspnea approximately one year after COVID-19 infection in HWs. Methods: HWs with previous COVID-19 infections were interviewed, and the EuroQol five-dimensional three-level questionnaire (EQ-5D-3L) with a visual analog scale (VAS) was used to evaluate HRQOL. Self-reported clinical and sociodemographic data were also obtained. Data were stratified by the presence of self-reported dyspnea in the moment of the study interview. The association between self-reported dyspnea and HRQOL was evaluated by regression models, either unadjusted or adjusted for potential confounders (for age and sex, marital status, work category, number of comorbidities, and number of days between diagnosis and evaluation). Results: A total of 109 HWs were interviewed; the median number of days post COVID-19 diagnosis for this group was 400 (IIQ 25–75% 321–428). The majority were women (67.9%); the median age was 44 (IIQ 25–75% 38–52) years. Overall, the median EQ-5D-3L score was 0.79 (IIQ 25–75% 0.74–0.85), and the median VAS score was 80 (IIQ 25–75% 70–90). Self-reported dyspnea was indicated by 22 individuals (20.2%). Self-reported dyspnea was associated with lower EQ-5D-3L and VAS scores, both in adjusted and non-adjusted models. In addition, self-reported dyspnea was associated with more problems in carrying out usual activities in both the non-adjusted and adjusted models (p < 0.01). Conclusions: Our results underscore the long-term implications of COVID-19, based on persistent perceptions of self-reported dyspnea and its relationship with HRQOL in HWs. Future studies, with extended follow-up and the employment of cardiopulmonary and mental health testing, may help to elucidate the nature and extent of COVID-19 sequelae. Full article

Background/Objectives: Dementia is a syndrome which involves cognitive and motor problems such as memory and motor control that impacts the individuals’ quality of life. In mental imagery (MI) technique, motor acts are mentally rehearsed without any overt body movements. The aim of this study was to investigate the effectiveness of MI on the quality of life, cognitive, and emotional status of older adults with an early stage of dementia. Methods: The present randomized controlled trial consisted of 160 participants. The sample from an Athens Day Care Center of the Alzheimer Association was randomized to (a) the MI and exercise group (intervention group, n = 55), (b) the only exercise group (1st control group, n = 52), and (c) the neither MI nor exercise group (2nd control group, n = 53). Participants engaged in a total of 24 physiotherapy sessions, each lasting approximately 45 min, scheduled twice weekly over a 12-week period. They performed three assessments: (a) one week prior to the program, (b) one and a half months, and (c) after the program. The intervention group performed a 30 min MI with exercise program content immediately following every physiotherapy exercise session. Walking While Talking Test (WWITT), the Euro-Qol 5-Dimensions 5-Level of severity scale (Euro-Qol 5D-5L scale), the Short-Form of Geriatric Depression Scale (SF-GDS), and the Short Anxiety Screening Test (SAST) were used to assess cognitive status, emotional status, and quality of life. Results: A total of 160 participants (43 men, 117 women, with MMSE M = 23.20 SD = 0.15) took part in this study in which most reported holding a university degree (n = 77), were married (n = 101), and had loss of memory as the 1st symptom of dementia (n= 117). The Friedman test revealed statistically significant differences across the three groups on (a) the WWITT_mistakes (X² = 14.95, df = 2, p = 0.001) and WWITT_time (X² = 13.35, df = 2, p = 0.01), (b) the total Euro-Qol 5D-5L scale (X² = 11.87.62, df = 2, p = 0.003) and quality of life on the measuring day (X² = 25.59, df = 2, p = 0.00), (c) the SF-GDS (X² = 6.54, df = 2, p = 0.038), and (d) the SAST (X² = 39.907.62, df = 2, p = 0.00). The Friedman test with post hoc Wilcoxon analysis revealed that the mean scores for the intervention group and the 1st control were significantly better than the 2nd control group in many dependent variables. Conclusions: The results indicate that incorporating MI can positively influence cognitive status, emotional status, and the quality of life in older adults diagnosed with early-stage dementia. Full article

Background and Objectives: The main aim of this study was to evaluate the impact of cervical pain on the quality of life of patients with multiple sclerosis in comparison with a group of healthy people (without diseases of the Central Nervous System). Materials and Methods: Data were collected at the Specialist Hospital St. Łukasz in Końskie (Poland) in the period from November 2023 to August 2024. The inclusion criteria for this study were as follows: age (20–50 years), women and men, healthy people (without diseases of the Central Nervous System) and people suffering from multiple sclerosis. People from the study group were diagnosed according to the McDonald criteria and tested with the EDSS. The mobility of the cervical spine was measured, and neck pain was assessed using the following: Visual Analogue Scale (VAS), Laitinen Scale and the Neck Disability Index (NDI). All participants self-assessed their quality of life using EuroQol 5D-5L (EQ-5D-5L). Results: 80 people took part in this study, the vast majority of whom were women (71.3%). The most common form of multiple sclerosis was relapsing-remitting (75.0%), and the average EDSS score was higher in the male group (1.6 ± 1.8). Cervical spine pain was reported by 27 people from the study group (67.5%) and 16 people from the control group (40.0%). In both groups, the cervical spine mobility was lower in people with neck pain. The level of cervical spine pain was statistically significantly (p < 0.05) higher in women, people living in small towns and in people with multiple sclerosis, depending on the type of disease and its duration. Cervical spine pain in people with multiple sclerosis was higher in all three scales (VAS mean = 5.7, ES = 0.79; Laitinen Scale mean = 10.1, ES = 0.60; and NDI Scale mean = 21.1, ES = 0.89). The study group obtained significantly higher scores on the EQ-5D scale (mean = 15.3; ES = 0.79) and EQ-VAS (mean = 53.2; ES = 0.94). Conclusions: This study proved that cervical spine pain is more common among people with multiple sclerosis. In these people, this problem is rarely diagnosed and properly treated. Full article

Background and Objectives: Adjuvant treatment with aromatase inhibitors (AIs) in breast cancer (BC) survivors can cause adverse effects such as metabolic syndrome (MS) (insulin resistance, central obesity, atherogenic dyslipidemia, and hypertension) associated with morbidity and premature mortality. We evaluate the effect of a multimodal program based on physical exercise and health education on MS and health-related quality of life (QoL) in postmenopausal women with BC under AIs. Methods: A total of 56 postmenopausal women, diagnosed with BC, aged 60 years or older (mean age 67.2 years) and on hormonal treatment with AIs, were included in the multimodal physical exercise and health education program, and evaluated before and after their participation. The assessment of the five criteria of the MS included the following: waist circumference, high blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol. Two main instruments were used to evaluate the impact of the intervention on QoL: the EORTC QLQ C30 (questionnaire for cancers in general) and the EORTC QLQ BR23 (specifically for breast cancer patients). The EuroQol 5D (EQ-5D) was also used to compare these results. Results: The percentage of women meeting the MS criteria was 37.7% at baseline and fell to 15.1% at 3 months after the intervention (p = 0.02). The intervention significantly reduced hypertension (p < 0.001), central obesity (p < 0.001), and the concentration of triglycerides (p = 0.016). No significant changes were observed in fasting glucose and HDL concentration. A statistically significant improvement was found in QoL (on both the QLQ30 and BR23 scales). A multivariate regression model analysis identified marital status (being married) (95% CI: 1.728–131.615, p = 0.014), and percentage of attendance at health education sessions (95% CI: 1.010–1.211, p = 0.029) as positive predictive variables of improvement in MS. Conclusions: The implementation of multimodal, community-based programs of physical exercise and health education improve the prevalence of MS and specific criteria of MS and QoL in postmenopausal women with breast cancer receiving AI treatment. Full article