Browsing by Author "Delgado, Bruno"
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- Patient-reported outcome measures in knee injuries rehabilitation: a protocol for interventionPublication . Moreira, José; Mesquita, Marina; Flamínio, José; Almeida, Manuel de; Delgado, Bruno; Boto, PauloDifferent musculoskeletal conditions affect people all over the world and were considered by the WHO to be the main cause of disability in 4 of 6 regions in 2017, with an increase in the associated burden and the impact they have on today's society. One of these conditions is related to the knee, which is associated with complex and vulnerable injuries associated with ligaments, menisci, and cartilage. After surgery, there is a reflex inhibition of motor neurons and immobilization, there is rapid atrophy and weakness in the different associated muscles, affecting proprioception, strength and muscle function, compromising quality of life. The aim of this article is to describe a protocol for a rehabilitation program after surgery for people with knee injuries. An experimental study will be carried out with 75 patients, with control and experimental groups. In both groups, initial measurements will be compared with measurements after the program, at different times. It is hoped that this study will generate significant information on rehabilitation intervention for people with knee injuries.
- Patient-reported outcome measures in rehabilitation after knee surgery: a rapid systematic reviewPublication . Moreira, José; Miguel, Susana; Delgado, Bruno; Boto, PauloAim: Musculoskeletal conditions impact our society owing to the associated burden, with significant implications for health systems and people’s quality of life. Patient-reported outcome measures (PROMs) are used to optimize the results of rehabilitation programs. The study aims to identify the PROMs used in rehabilitation programs after knee surgery. Subject and methods: This rapid systematic review was conducted using MEDLINE® and CINAHL® databases, considering all studies carried out until December 2023, with a registered protocol (PROSPERO reference: CRD42024504263). Studies were included with adult participants undergoing knee surgery and using PROMs to measure outcomes before and after rehabilitation programs. Results: Sixteen studies with 3469 participants in rehabilitation programs after knee surgery were included. Methodologically and according to the criteria recommended by the Joanna Briggs Institute, more than half of the studies were of high quality, with values of more than 80%, including randomized controlled trials, cohorts, and quasi-experimental designs. Outcomes were assessed before and after rehabilitation programs, using general (n = 6) and knee-specific (n = 11) PROMs. Of all the PROMs identified in the different studies selected for this systematic review, the ones used the most were KOOS (in 14 studies), EQ5D-5L, and WOMAC (in 3 studies). Conclusion: This rapid systematic review shows the need to identify and implement PROMs during rehabilitation programs after knee surgery, measuring participants’ health status, symptoms, treatment satisfaction, and physical and mental performance. In this way, it is possible to make value-based comparisons with other interventions, improving and tailoring rehabilitation care.
- Physical and mental components of quality of life after a cardiac rehabilitation intervention: a systematic review and meta-analysisPublication . Moreira, José; Bravo, Jorge; Aguiar, Pedro; Delgado, Bruno; Raimundo, Armando; Boto, PauloBackground: This study aimed to analyze the effect of cardiac rehabilitation programs on the health-related quality of life of patients after a coronary cardiac event using patient-reported outcome measures (PROMs) for up to 6 months of evaluation. Methods: A comprehensive search was carried out in the MEDLINE, CINAHL, CENTRAL, and Web of Science databases for randomized controlled trials comparing the cardiac rehabilitation program with usual care. Two independent reviewers assessed the studies for inclusion, risk of bias using the Cochrane tool, and quality of evidence through the GRADE system. A meta-analysis was performed on studies assessing health-related quality of life with the SF-12 (Physical Component Summary and Mental Component Summary) up to 6 months after the program. Results: Twelve studies encompassed 2260 patients who participated in a cardiac rehabilitation program after a coronary event, with a mean age of 60.06 years. The generic PROMs used to assess quality of life were the SF-12, SF-36, EQ-5D-3L, EQ-5D-5L, and GHQ, and the specific coronary heart disease PROMs were MacNew and HeartQoL. There was a positive effect of participation in cardiac rehabilitation on the physical component of health-related quality of life at 6 months (MD [7.02]; p = 0.04] and on the mental component (MD [1.06]; p = 0.82) after applying the SF-12. Conclusions: This study highlights the significant benefits of cardiac rehabilitation programs on health-related quality of life, particularly in the physical domain at 6 months. Assessing outcomes over time through PROMs after coronary heart events is essential, thus making it possible to personalize patients’ care and improve their health status.
- Risk and management of patients with cancer and heart diseasePublication . Hill, Loreena; Delgado, Bruno; Lambrinou, Ekaterini; Mannion, Tara; Harbinson, Mark; McCune, ClaireCancer and cardiovascular disease are two of the leading causes of global mortality and morbidity. Medical research has generated powerful lifesaving treatments for patients with cancer; however, such treatments may sometimes be at the expense of the patient’s myocardium, leading to heart failure. Anti-cancer drugs, including anthracyclines, can result in deleterious cardiac effects, significantly impacting patients’ functional capacity, mental well-being, and quality of life. Recognizing this, recent international guidelines and expert papers published recommendations on risk stratification and care delivery, including that of cardio-oncology services. This review will summarize key evidence with a focus on anthracycline therapy, providing clinical guidance for the non-oncology professional caring for a patient with cancer and heart failure.