BACKGROUND: Patients with glioma often suffer from cognitive deficits. Physical exercise has been effective in ameliorating cognitive deficits in older adults and neurological patients. This pilot randomized controlled trial (RCT) explored the possible impact of an exercise intervention, designed to improve cognitive functioning in glioma patients, regarding cognitive test performance and patient-reported outcomes (PROs).METHODS: Thirty-four clinically stable patients with World Health Organization grades II/III glioma were randomized to a home-based remotely coached exercise group or an active control group. Patients exercised 3 times per week for 20-45 minutes, with moderate to vigorous intensity, during 6 months. At baseline and immediate follow-up, cognitive performance and PROs were assessed with neuropsychological tests and questionnaires, respectively. Linear regression analyses were used to estimate effect sizes of potential between-group differences in cognitive performance and PROs at 6 months.RESULTS: The exercise group (n = 21) had small- to medium-sized better follow-up scores than the control group (n = 11) on several measures of attention and information processing speed, verbal memory, and executive function, whereas the control group showed a slightly better score on a measure of sustained selective attention. The exercise group also demonstrated small- to medium-sized better outcomes on measures of self-reported cognitive symptoms, fatigue, sleep, mood, and mental health-related quality of life.CONCLUSIONS: This small exploratory RCT in glioma patients provides a proof of concept with respect to improvement of cognitive functioning and PROs after aerobic exercise, and warrants larger exercise trials in brain tumor patients.
Abstract Background: Patients with glioma often suffer from cognitive deficits. Physical exercise has been effective in ameliorating cognitive deficits in older adults and neurological patients. This pilot randomized controlled trial (RCT) explored the possible impact of an exercise intervention, designed to improve cognitive functioning in glioma patients, regarding cognitive test performance and patient-reported outcomes (PROs). Methods: Thirty-four clinically stable patients with World Health Organization grades II/III glioma were randomized to a home-based remotely coached exercise group or an active control group. Patients exercised 3 times per week for 20-45 minutes, with moderate to vigorous intensity, during 6 months. At baseline and immediate follow-up, cognitive performance and PROs were assessed with neuropsychological tests and questionnaires, respectively. Linear regression analyses were used to estimate effect sizes of potential between-group differences in cognitive performance and PROs at 6 months. Results: The exercise group (n = 21) had small- to medium-sized better follow-up scores than the control group (n = 11) on several measures of attention and information processing speed, verbal memory, and executive function, whereas the control group showed a slightly better score on a measure of sustained selective attention. The exercise group also demonstrated small- to medium-sized better outcomes on measures of self-reported cognitive symptoms, fatigue, sleep, mood, and mental health-related quality of life. Conclusions: This small exploratory RCT in glioma patients provides a proof of concept with respect to improvement of cognitive functioning and PROs after aerobic exercise, and warrants larger exercise trials in brain tumor patients.
Low-grade inflammation and metabolic syndrome are seen in many chronic diseases, including rheumatoid arthritis (RA) and osteoarthritis (OA). Lifestyle interventions which combine different non-pharmacological therapies have shown synergizing effects in improving outcomes in patients with other chronic diseases or increased risk thereof, especially cardiovascular disease. For RA and metabolic syndrome-associated OA (MSOA), whole food plant-based diets (WFPDs) have shown promising results. A WFPD, however, had not yet been combined with other lifestyle interventions for RA and OA patients. In this protocol paper, we therefore present Plants for Joints, a multidisciplinary lifestyle program, based on a WFPD, exercise, and stress management. The objective is to study the effect of this program on disease activity in patients with RA (randomized controlled trial [RCT] 1), on a risk score for developing RA in patients with anti-citrullinated protein antibody (ACPA) positive arthralgia (RCT 2) and on pain, stiffness, and function in patients with MSOA (RCT 3), all in comparison with usual care.We designed three 16-week observer-blind RCTs with a waiting-list control group for patients with RA with low to moderate disease activity (2.6 ≤ Disease Activity Score [DAS28] ≤ 5.1, RCT 1, n = 80), for patients at risk for RA, defined by ACPA-positive arthralgia (RCT 2, n = 16) and for patients with metabolic syndrome and OA in the knee and/or hip (RCT 3, n = 80). After personal counseling on diet and exercise, participants join 10 group meetings with 6-12 other patients to receive theoretical and practical training on a WFPD, exercise, and stress management, while medication remains unchanged. The waiting-list control group receives usual care, while entering the program after the RCT. Primary outcomes are: difference in mean change between intervention and control groups within 16 weeks for the DAS28 in RA patients (RCT 1), the RA-risk score for ACPA positive arthralgia patients (RCT 2), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score for MSOA patients (RCT 3). Continued adherence to the lifestyle program is measured in a two-year observational extension study.
Aanleiding Onderzoek wijst uit dat de leesvaardigheid van zowel vmbo- als hbo-studenten te wensen over laat; studerend lezen gaat ze niet goed af. Zowel hbo- als vmbo-studenten blijken vaak onvoldoende in staat om op een bevredigende manier kennis te verwerven uit studieteksten. Samenvattend is de vraag vanuit de onderwijspraktijk: 1) Op welke wijze kunnen vmbo-leerlingen en hbo-studenten binnenschools leren om informatie uit teksten te gebruiken voor (studeertaken gericht op) kennisverwerving? 2) In hoeverre kan men bij het uitvoeren van lees-studeertaken in groepjes gebruikmaken van ICT? Doelstelling Doel van het project is de ontwikkeling van een nieuwe leeromgeving voor studerend lezen in het vmbo en hbo, en het bepalen van de effectiviteit daarvan. Het onderzoek bestaat uit 2 delen. 1) Ontwikkelonderzoek. Het onderzoeksteam optimaliseert de leeromgeving in samenwerking met lerarenopleiders en vmbo-leerkrachten en de ICT-ondersteuning wordt afgestemd op de praktijk van het zaakvakonderwijs. 2) Effectonderzoek. Er worden twee 'randomized controlled trials' uitgevoerd (een in het vmbo en een in het hbo) om te toetsen welke effecten de nieuwe leeromgeving heeft op de vaardigheid 'studerend lezen' van leerlingen en studenten. Voorafgaand aan de experimenten maken de leerlingen/studenten voortoetsen om hun woordenschat en studerend lezen in kaart te brengen. De resultaten worden ingezet als co-variaten. Beoogde resultaten Het project resulteert in: 1) meer aandacht voor ondersteuning bij het lezen van teksten in vakonderwijs; 2) de ontwikkeling van een nieuwe leeromgeving voor studerend; 3) vergroting van de leesvaardigheden van vmbo-leerlingen/hbo-studenten. Het consortium zal de gegenereerde kennis over didactiek voor studerend lezen en de rol van de ICT-ondersteunde leeromgeving daarin verspreiden via wetenschappelijke artikelen en een proefschrift, presentaties op onderwijsconferenties en publicaties in landelijke vaktijdschriften voor het vmbo en hbo. De ontwikkelde didactiek wordt door Hogeschool Rotterdam geïntegreerd in het curriculum van de lerarenopleiding en wordt verspreid binnen de hogeschool, de consortiumscholen en de scholen van het Rotterdamse schoolbestuur BOOR. Ook Stichting Lezen, een intermediair tussen wetenschap en beroepspraktijk, gaat kennis over de didactiek verspreiden. Uitgeverij ThiemeMeulenhoff helpt de didactiek en leeromgeving beschikbaar te maken voor het onderwijsveld.
