Objectives: To test the feasibility of using a new activity pacing framework to standardise healthcare professionals' instructions of pacing, and explore whether measures of activity pacing/symptoms detected changes following treatment.
Design: Single-arm, repeated measures study.
Setting: One National Health Service (NHS) Pain Service in Northern England, UK.
Participants: Adult patients with chronic pain/fatigue, including chronic low back pain, chronic widespread pain, fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis.
Interventions: Six-week rehabilitation programme, standardised using the activity pacing framework.
Outcome Measures: Feasibility was explored via patients' recruitment/attrition rates, adherence and satisfaction, and healthcare professionals' fidelity. Questionnaire data were collected from patients at the start and end of the programme (T1 and T2, respectively) and 3 months' follow-up (T3). Questionnaires included measures of activity pacing, current/usual pain, physical/mental fatigue, depression, anxiety, self-efficacy, avoidance, physical/mental function and quality of life. Mean changes in activity pacing and symptoms between T1-T2, T2-T3 and T1-T3 were estimated.
Results: Of the 139 eligible patients, 107 patients consented (recruitment rate=77%); 65 patients completed T2 (T1-T2 attrition rate=39%), and 52 patients completed T3 (T1-T3 attrition rate=51%). At T2, patients' satisfaction ratings averaged 9/10, and 89% attended ≥5 rehabilitation programme sessions. Activity pacing and all symptoms improved between T1 and T2, with smaller improvements maintained at T3.
Conclusion: The activity pacing framework was feasible to implement and patients' ability to pace and manage their symptoms improved. Future work will employ a suitable comparison group and test the framework across wider settings to explore the effects of activity pacing in a randomised controlled trial.
Trial Registration Number: NCT03497585.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655535 | PMC |
http://dx.doi.org/10.1136/bmjopen-2020-045398 | DOI Listing |
Cureus
January 2025
Anesthesiology and Reanimation, Military Hospital of Avicenne, Marrakech, MAR.
Infectious myocarditis (IM) and infective endocarditis (IE), sometimes associated with infection of the surrounding mediastinal tissue or embolic complications caused by residual implantable cardioverter defibrillator (ICD) lead material embedded in the ventricle, present a significant challenge for cardiac surgeons due to the difficulty of precisely locating the old intracardiac pacing lead remnants because of the heart's continuous movement. We present the case of successful two-stage elective sternotomy extraction of two residual defibrillator leads, one trapped in the left innominate vein, easily removed after veinotomy without cardiopulmonary bypass (CPB), and the other embedded intramyocardially in the inferior wall of the right ventricle, successfully removed under CPB after fluoroscopic guidance. The patient was discharged four weeks post-operation without complications.
View Article and Find Full Text PDFCureus
December 2024
Clinical Engineering, Soseikai General Hospital, Kyoto, JPN.
Left bundle branch area pacing (LBBAP) can effectively enhance cardiac contraction by engaging the conduction system. LBBAP, compared with right ventricular apex pacing, can reduce QRS duration and enhance left ventricular function. Consequently, LBBAP has been proposed as a viable alternative to cardiac resynchronization therapy (CRT).
View Article and Find Full Text PDFInt J Exerc Sci
December 2024
Department of Kinesiology, California State Polytechnic University, Humboldt, Arcata, CA, USA.
High-incline walking is a relatively new trend with little comparative information. This study compared physiological and psychological differences between high-incline walking at 20% grade (HIW) and level-grade jogging (LGJ) at isocaloric intensities in young adults. Twenty-two participants (M = 11, F = 11) aged 19-31 years completed the study.
View Article and Find Full Text PDFHerzschrittmacherther Elektrophysiol
January 2025
Klinik für Innere Medizin-Kardiologie, Diabetologie und Nephrologie, Evangelisches Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld-Bethel, Burgsteig 13, 33617, Bielefeld, Germany.
Like children, adult patients with active or abandoned epicardial pacing leads are also at risk of developing life-threatening cardiac ischemia due to mechanical compression of the coronary arteries. As this complication is amenable to surgical removal, these patients require periodic evaluation for myocardial ischemia even if they are asymptomatic.
View Article and Find Full Text PDFHeart Rhythm O2
December 2024
Department of Cardiovascular Medicine, Kyorin University School of Medicine, Mitaka, Japan.
Background: Junctional rhythm (JR) frequently occurs during radiofrequency (RF) ablation procedures targeting the slow pathway (SP) for atrioventricular nodal re-entrant tachycardia (AVNRT), signaling successful ablation. Two types of JR have been noticed: typical JR as His activation preceding atrial activation, and atypical JR as atrial activation preceding the His activation. Nevertheless, the origin and characteristics of JR remain incompletely defined.
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