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.
Stress is increasingly being recognized as one of the main factors that is negatively affecting our health, and therefore there is a need to regulate daily stress and prevent long-term stress. This need seems particularly important for adults with mild intellectual disabilities (MID) who have been shown to have more difficulties coping with stress than adults without intellectual disabilities. Hence, the development of music therapy interventions for stress reduction, particularly within populations where needs may be greater, is becoming increasingly important. In order to gain more insight into the practice-based knowledge on how music therapists lower stress levels of their patients with MID during music therapy sessions, we conducted focus group interviews with music therapists working with adults with MID (N = 13) from different countries and clinical institutions in Europe. Results provide an overview of the most-used interventions for stress reduction within and outside of music. Data-analysis resulted in the further specification of therapeutic goals, intervention techniques, the use of musical instruments, and related therapeutic change factors. The main findings indicate that music therapists used little to no receptive (e.g., music listening) interventions for stress reduction, but preferred to use active interventions, which were mainly based on musical improvisation. Results show that three therapy goals for stress relief could be distinguished. The goal of “synchronizing” can be seen as a sub goal because it often precedes working on the other two goals of “tension release” or “direct relaxation,” which can also be seen as two ways of reaching stress reduction in adults with MID through music therapy interventions. Furthermore, the tempo and the dynamics of the music are considered as the most important musical components to reduce stress in adults with MID. Practical implications for stress-reducing music therapy interventions for adults with MID are discussed as well as recommendations for future research.
Individuals with mild intellectual disabilities or borderline intellectual functioning are at increased risk to develop a substance use disorder—however, effective treatment programs adapted to this target group are scarce. This study evaluated the effectiveness of Take it Personal!+ in individuals with mild intellectual disabilities or borderline intellectual functioning and substance use disorder. Take it Personal!+ is a personalized treatment based on motivational interviewing and cognitive-behavioral therapy supported by an mHealth application. Data were collected in a nonconcurrent multiple baseline single-case experimental design across individuals with four phases (i.e., baseline, treatment, posttreatment, and follow-up). Twelve participants were randomly allocated to baseline lengths varying between 7 and 11 days. Substance use quantity was assessed during baseline, treatment, and posttreatment with a daily survey using a mobile application. Visual analysis was supported with statistical analysis of the daily surveys by calculating three effect size measures in 10 participants (two participants were excluded from this analysis due to a compliance rate below 50%). Secondary, substance use severity was assessed with standardized questionnaires at baseline, posttreatment, and follow-up and analyzed by calculating the Reliable Change Index. Based on visual analysis of the daily surveys, 10 out of 12 participants showed a decrease in mean substance use quantity from baseline to treatment and, if posttreatment data were available, to posttreatment. Statistical analysis showed an effect of Take it Personal!+ in terms of a decrease in daily substance use in 8 of 10 participants from baseline to treatment and if posttreatment data were available, also to posttreatment. In addition, data of the standardized questionnaires showed a decrease in substance use severity in 8 of 12 participants. These results support the effectiveness of Take it Personal!+ in decreasing substance use in individuals with mild intellectual disabilities or borderline intellectual functioning.
Dementie komt steeds vaker voor en heeft grote invloed op het dagelijks leven van alle betrokkenen. Wat is voor mensen met dementie en hun naasten belangrijk? En welke rol kunnen professionals vanuit het gezondheids- en sociaal domein hierin vervullen? Doel Dit promotieonderzoek richt zich op de onderbouwing van handelen en ontwikkeling van werkwijzen van professionals die thuiswonende mensen met dementie en hun naasten begeleiden. Resultaten Een framework met de betekenis van dementie voor het dagelijks leven. Bouwstenen voor een integrale werkwijze voor professionals in het gezondheids- en sociaal domein in samenwerking met mensen met dementie en hun sociaal netwerk. Artikel: Everyday Experiences of People Living with Mild Cognitive Impairment or Dementia: A Scoping Review en de posterpresentatie erover. Looptijd 01 februari 2021 - 31 januari 2025 Aanpak In een scoping review kijken we naar wat bekend is over het dagelijks leven vanuit het perspectief van mensen met dementie zelf. Dit gaan we verrijken met een veldstudie onder mensen met dementie en hun naasten. In een praktijkanalyse kijken we naar de huidige werkwijze en ontwikkelrichtingen vanuit professionals in het gezondheids- en sociaal domein. Vervolgens ontwerpen we een integrale werkwijze, die zal worden uitgevoerd en geëvalueerd in ontwikkelwerkplaatsen. Relevantie voor de beroepspraktijk Door de ontwikkeling van een integrale benadering wordt domeinoverstijgend samengewerkt aan een belangrijke opgave op het snijvlak van gezondheid en welzijn. De resultaten van dit onderzoek zijn direct toepasbaar voor de beroepspraktijk en worden vertaald naar het onderwijs. Samenwerking Samenwerkingspartners binnen het onderzoek zijn: Academische Werkplaats Sociaal Werk en Academische Werkplaats Ouderen, Tranzo en Universiteit van Tilburg Samenwerkingspartners uit het werkveld zijn: Zorgspectrum, Alzheimer Nederland afdeling Lekstroom, SWOM, Tympaan de Baat, Careyn, Rijnhoven, Netwerk Dementie Lekstroom en Netwerk Dementie West Utrecht. Samenwerking met het onderwijs vindt plaats in het interprofessioneel leernetwerk dementie. Hierin werken studenten van gezondheids- en sociale opleidingen samen met praktijkpartners en onderzoek aan vraagstukken over dementie. Daarnaast worden regelmatig open webinars georganiseerd.
