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The rapid evolution of Brain-Computer Interface (BCI) technology and the exponential growth of BCI literature during the past 20 years is a consequence of increasing computational power and the achievements of statistical learning theory and machine learning since the 1960s. Despite this rapid scientific progress, the range of successful clinical and societal applications remained limited, with some notable exceptions in the rehabilitation of chronic stroke and first steps towards BCI-based assisted verbal communication in paralysis. In this contribution, we focus on the effects of noninvasive and invasive BCI-based verbal communication on the quality of life (QoL) of patients with amyotrophic lateral sclerosis (ALS) in the locked-in state (LIS) and the completely locked-in state (CLIS). Despite a substantial lack of replicated scientific data, this paper complements the existing methodological knowledge and focuses future investigators’ attention on (1) Social determinants of QoL and (2) Brain reorganization and behavior. While it is not documented in controlled studies that the good QoL in these patients is a consequence of BCI-based neurorehabilitation, the proposed determinants of QoL might become the theoretical background needed to develop clinically more useful BCI systems and to evaluate the effects of BCI-based communication on QoL for advanced ALS patients and other forms of severe paralysis.

The integration of traditional Chinese and Western medicine and their clinical effects have been widely evaluated. Many studies have shown that using a combination of these two remedies has resulted in better outcomes than using only one of them. Acupuncture is a traditional Chinese medical technique, which plays an important role in enforcing pain control, prevention and functional improvement. In 1979, the World Health Organization (WHO) journal introduced acupuncture as a remedy for 43 diseases, including frozen shoulder. This study aims to assess the therapeutic outcomes of combining acupuncture and physical therapy to treat frozen shoulder, and hopes to establish an evidence-based study of the integration of acupuncture and western medicine in the future.

A total of 75 frozen shoulder patients treated in a medical center were recruited for the study between January 2002 and December 2002. The average age of these patients was 54.8 years. The average duration of the condition was 25.8 weeks before treatment. Of the 75 patients, 30 were treated by physical therapy, 30 by acupuncture and 15 by both remedies. Before the treatment began, all patients were evaluated by assessing static pain scale, motion pain scale, active and passive ROM (range of motion) and quality of life scale sheet SF-36 (Short Form-36). The outcome was evaluated by follow-up assessments conducted at the 2nd week and 4th week of treatment sessions.

All patients showed improvement in quality of life (Short Form-36). Pain was controlled better by acupuncture while ROM improved following physical therapy. However, patients treated by both methods had the best outcome.

The integration of acupuncture and physical therapy to treat frozen shoulder leads to a better outcome than using only one method. The author suggests that an evidence-based foundation of the integration of Chinese and Western medicine should be established in the future, to encourage the integration of Chinese and Western medicine.

Osteoarthritis (OA) is a costly disease that causes much morbidity and mortality in the world, and it was the sixth leading cause of disability in developed countries. We aim to study the utilization pattern of alternative therapies and their effects on quality of life and personal health spending in Chinese OA patients in Hong Kong. Five-hundred forty-seven patients with OA from four regional hospitals in Hong Kong were recruited, and we measured various types of alternative therapies, SF-36 scales, an overall Health Utility Index derived from a pre-scored multi-attribute classification system based upon SF-36 health surveys, health spending per person and out-of-pocket payments and side-effects. The study shows that out of the 547 OA patients, the patients have used a wide spectrum of alternative therapies and often used a multiplicity of them. Payment for alternative therapies constitutes 5% of the overall personal healthcare spending, and 29% of the out-of-pocket payments. The use of alternative therapies was significantly associated with higher personal healthcare spending (p = 0.01), after adjusting for socioeconomic variables, years of OA and severity of OA. The use of alternative therapies was not significantly associated with an improvement in the quality of life in the regression analysis (p = 0.64). The use of alternative therapies was statistically significant associated with the side effects, including gastric discomfort and gastric ulcer/bleeding (p = 0.04, 0.02, respectively). Alternative therapies were used extensively by OA patients in Hong Kong. Clinicians, health policy makers, and insurance carriers should be aware of the potential health and economic effects in practice and policy formulation.

Quality of life (QOL) of cancer patients is often diminished due to the side effects of treatment and symptoms of the disease itself. Medical Qigong (coordination of gentle exercise and relaxation through meditation and breathing exercise based on Chinese medicine theory of energy channels) may be an effective therapy for improving QOL, symptoms and side effects, and longevity of cancer patients. In this pilot study, the feasibility, acceptability, and impact of Medical Qigong (MQ) were evaluated on outcomes in cancer patients. Thirty patients diagnosed with heterogeneous cancers, were randomly assigned to two groups: a control group that received usual medical care and an intervention group who participated in a MQ program for 8 weeks in addition to receiving usual medical care. Randomization was stratified by completion of cancer treatment (n = 14) or under chemotherapy (n = 16). Patients completed measures before and after the program. Quality of life and symptoms were measured by the EORTC QLQ-C 30 and progress of disease by the inflammation biomarker (CRP: c-reactive protein) via a blood test was assessed. The MQ intervention group reported clinically significant improved global QOL scores pre- and post-intervention. The MQ intervention also reduced the symptoms of side effects of cancer treatment and inflammation biomarker (CRP) compare to the control group. Due to the small sample size, however, the results were not statistically significant between treatment and the control groups. Data from the pilot study suggest that MQ with usual medical treatment can enhance the QOL of cancer patients and reduce inflammation. This study needs a further investigation with a larger sample size.

The purpose of this study was to evaluate the effects of Baduanjin exercise on oxidative stress, antioxidant status and quality of life in middle-aged women. A quasi-experimental design was adopted. Subjects were 31 middle-aged women. Subjects completed a supervised and standardized Baduanjin exercise program 3 times a week for 12 weeks. Malondialdehyde (MDA) level was measured and determined by using a spectrophotometer for oxidative stress. The superoxide dismutase (SOD) was measured for the antioxidant status. A 36-item Short Form Health Survey (SF-36) was used to evaluate changes in quality of life. All outcome measures were collected before intervention and at the end of a 12-week intervention. The results suggest that there are significant differences in serum SOD level with Baduanjin exercise. SOD level was significantly increased after exercise (p < 0.05). Baduanjin exercise contributed significantly to antioxidant status on these samples. However, a reduction in MDA level was observed. The t-test value was 2.03 with a p-value of 0.052. The changes may be meaningful at a 5% level. There are significant improvements in quality of life after the exercise program. Subjects had greater improvements in 4 dimensions of SF-36, namely physical function, body pain, social function and general mental health (p < 0.05). In conclusion, Baduanjin exercise has beneficial effects on improving quality of life, increasing antioxidant enzymes and reducing oxidative stress in middle-aged women. Reduction of MDA level may be more attributable to the increase in the antioxidant enzyme SOD.

In order to pilot a study observing the feasibility of applying the Core Quality of Life Questionnaire (QLQ-C30) version 2.0 to assess the quality of life (QOL) of patients with NSCLC treated with Feiji Recipe, a randomized, parallel controlled clinical trial was conducted in the university-affiliated hospital. Seventy inpatients who met the inclusion criteria were randomized into the study, and 60 cases were available as subjects for QOL data analysis. The subjects were randomly assigned to one of three groups: the Feiji Recipe group (A); the Feiji Recipe combined with chemotherapy group (B); and the chemotherapy group (C) in which the patients were treated with vinorelbine plus cisplatin (NP) or gemcitabine plus cisplatin (GP). QOL was assessed with the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. Sixty cases that finished the questionnaires were analyzed, and we found that patients who received chemotherapy had low QOL, in terms of their global health, role, emotional, social, economic status and symptom burden including fatigue, nausea and vomiting, dyspnea, loss of appetite and abnormal bowel movements. Simultaneous treatment with Feiji Recipe and chemotherapy was able to prevent the worsening of function in terms of role, social, fatigue and global health. The Core Quality of Life Questionnaire (QLQ-C30) version 2.0 can be used to evaluate the QOL of patients with NSCLC treated by Chinese herbal medicine. Feiji Recipe might partially improve the QOL of NSCLC patients when administered alone or in combination with chemotherapy. No unexpected side effects were observed. However, further double-blinded placebo controlled studies are strongly recommended.

Lentinula edodes mycelia extract (L.E.M.) is extensively utilized as an herbal medicine. However, its safety and effectiveness have not yet been scientifically verified. In this study, we investigated its safety and its influence on quality of life (QOL) and the immune response in patients undergoing cancer chemotherapy. Seven patients were studied in total. The patients were undergoing postoperative adjuvant chemotherapy for breast cancer (n = 3) or gastrointestinal cancer (n = 2), or were receiving chemotherapy to prevent recurrence of gastrointestinal cancer (n = 2). The first course of treatment was chemotherapy alone and the second was chemotherapy plus concomitant administration of L.E.M. Adverse events and changes in the QOL score, lymphocyte subpopulations, lymphocyte activity and serum immune indices were evaluated during the study period. No adverse events attributable to L.E.M. were observed. Compared to the pre-chemotherapy state, no changes in QOL or immune parameters were noted after the first chemotherapy course. In contrast, following the second course of combined therapy, improvements were noted in QOL (p < 0.05), NK cell activity (p < 0.05) and immunosuppressive acidic protein (IAP) (p < 0.01) levels. Although a future large-scale investigation is necessary to confirm these results, these data suggest that the concomitant of L.E.M. with chemotherapy is safe and improves the QOL and immune function of patients undergoing chemotherapy.

Stroke is one of the most common causes of death and few pharmacological therapies show benefits in ischemic stroke. In this study, 290 patients aged 40–75 years old with first onset of acute ischemic stroke (more than 24 hours but within 14 days) were treated with standard treatments, and then were randomly allocated into an intervention group (treated with resuscitating acupuncture) and a control group (treated using sham-acupoints). Primary outcome measures included Barthel Index (BI), relapse and death up to six months. For the 290 patients in both groups, one case in the intervention group died, and two cases in the control group died from the disease (p = 0.558). Six patients of the 144 cases in the intervention group had relapse, whereas 34 of 143 patients had relapse in the control group (p < 0.001). The mean values for BI at six months were 70.25 ± 20.37 and 57.43 ± 19.61 for the two groups, respectively (p < 0.01). Acupuncture resulted in a significant difference between the two groups for the National Institute of Health Stroke Scale (NIHSS), not at two weeks (7.03 ± 3.201 vs. 8.13 ± 3.634; p = 0.067), but at four weeks (4.15 ± 2.032 vs. 6.35 ± 3.131, p < 0.01). The Chinese Stroke Scale (CSS) at four weeks showed more improvement in the intervention group than that in the control group (9.40 ± 4.51 vs. 13.09 ± 5.80, p < 0.001). Stroke Specific Quality of Life Scale (SS-QOL) at six months was higher in the intervention group (166.63 ± 45.70) than the control group (143.60 ± 50.24; p < 0.01). The results of this clinical trial showed a clinically relevant decrease of relapse in patients treated with resuscitating acupuncture intervention by the end of six months, compared with needling at the sham-acupoints. The resuscitating acupuncture intervention could also improve self-care ability and quality of life, evaluated with BI, NIHSS, CSS, Oxford Handicap Scale (OHS), and SS-QOL.

Acupuncture is used to treat a variety of symptoms and conditions associated with cancer and cancer treatments. The present study was performed to evaluate the feasibility of providing acupuncture in the hospital setting for breast cancer patients and to evaluate the short-term effect of acupuncture on stress, anxiety, and pain. This was an open label study conducted at Mayo Clinic Hospital, Methodist and Saint Marys Campus, Rochester, Minnesota. A total of 20 adult breast cancer patients undergoing mastectomy and/or breast reconstruction were recruited and offered daily acupuncture intervention beginning postoperative day 1 and continuing for the duration of the hospital stay. Outcome measures included the Symptom Visual Analog Scale (VAS) and Satisfaction Question and Was-it-Worth-it (WIWI) Questionnaire. It was found that acupuncture is a feasible option for postoperative breast cancer patients. In addition, it can significantly decrease the levels of anxiety (p = 0.0065), tension/muscular discomfort (p < 0.001) and pain (p = 0.023). The association between acupuncture and relaxation was found to be statistically borderline (p = 0.053). This feasibility study showed that acupuncture can be integrated into a busy postsurgical clinical practice. These results also suggest that acupuncture may be an important intervention in the postoperative setting for breast cancer patients.

Qigong and Tai chi are traditional methods of physical and mental training and exercises in East Asia. Their health-promoting effects against various diseases have been studied for a long time, and they have been the subject of many clinical trials and systematic reviews (SRs). The present study aimed to comprehensively evaluate all published SRs on Qigong and Tai chi and to summarize the supporting evidence. The following databases were searched: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Research Information Sharing Service, and Korean Studies Information Service System. The selection and extraction processes were performed by two independent reviewers, and a qualitative synthesis was conducted. There were 58 SRs of randomized controlled trials on Qigong and Tai chi. There have been many studies on patients with cardiovascular diseases and different cancers, and a number of other studies in which mobility, quality of life, blood lipids, and blood pressure were outcome measurements. Thus, Qigong and Tai chi for various diseases and medical conditions have been accumulated. Based on current evidence, the number of publications of Qigong and Tai chi-related articles showed an increasing trend, and most of them were performed in China. Qigong and Tai chi have shown beneficial effects in different age groups and health conditions, including decreasing blood lipid level, reducing blood pressure, facilitating mobility, preventing falls, and improving overall quality of life.

Ginseng is a very commonly used natural product in the world, and its two main species are Asian ginseng and American ginseng. Ginseng is an adaptogenic botanical that reportedly protects the body against stress, stabilizes physiological processes, and restores homeostasis. Previously, different animal models and contemporary research methodologies have been used to reveal ginseng’s biomedical activities in different body systems and the linked mechanisms of actions. However, human clinical observation data on ginseng effects have attracted more attention from the general public and medical community. In this paper, after an introduction of the phytochemistry of ginseng species, we review positive ginseng clinical studies, mainly conducted in developed countries, performed over the past 20 years. The reported effects of ginseng are presented in several sections, and conditions impacted by ginseng include diabetes; cardiovascular disorders; cognition, memory, and mood; the common cold and flu; cancer fatigue and well-being; quality of life and social functioning, etc. Administration of ginseng demonstrated a good safety record in humans. Although encouraging beneficial effects obtained from clinical data, using the study treatment regimen, the reported ginseng effects in general only ranged from mild to moderate. Nonetheless, these beneficial effects of ginseng could be a valuable add-on therapy for patients receiving standard drug treatments. Additionally, as a dietary supplement, ginseng possesses an important role in maintaining and promoting human health. We believe that the quality of future ginseng trials should be improved, particularly by providing detailed herbal phytochemistry and quality control information. With solid effectiveness data obtained from a well-designed, carefully executed ginseng clinical trial, this meritoriously herbal medicine will be widely used by consumers and patients.

There has been a growing scholarly interest in the links between natural resources and socio-economic development. While numerous studies offer robust evidence on the detrimental effects of natural resource dependence on economic outcomes, no study has robustly investigated the link between natural resource dependence and quality of life across countries. The aim of this study is to address this gap in the literature by investigating the relationship between natural resource dependency and social progress. Using the cross-country data from 143 countries for the period of 2012 to 2019, we find that resource rents are significantly and negatively linked to the Social Progress Index. Moreover, this effect remains robust even after controlling the potential transmission channels such as governance, economic development and human capital accumulation.

It is unanimously recognised in the literature that the concept of Quality of Life should be measured within a multidimensional framework, that is able to add to the information usually provided by indices based on economic variables. This paper proposes to adopt a new brand approach for the measurement of quality of life, which is based on the so called fuzzy set approach, and for the first time implement it in a comparative context. The empirical analysis is based on the third wave of European Quality of Life Survey, conducted in 2012 by Eurofound. The fuzzy set approach to Quality of Life measurement, results to be consistent when compared to the traditional approach defined by Eurofound; moreover, it results to also statistically robust. In conclusion, the fuzzy set approach provides quite significant added value for both data users and data analysts since it presents results which are easy to read, are concise, and it also facilitates comparison among dimensions.

In this paper, we analyze the correspondence among the rankings of the Spanish regions according to different measures of monetary poverty and quality of life, in 2012. To do that, the Spearman’s rank correlation coefficient is used. Different aggregation methods are applied to calculate the selected measures of poverty and quality of life. The monetary poverty measures aggregate the income gaps, while the quality of life measures aggregate a set of indicators dealing with ten different domains. In both cases, among other traditional aggregation procedures, the exponential mean is used because its properties are especially adequate in these contexts.

To evaluate the subjective satisfaction of brachial plexus injury (BPI) patients after surgery based on the medical outcomes study 36-item short form health survey (SF-36) and to correlate their SF-36 scores with upper extremity functions. Four items were assessed statistically for 30 patients: SF-36 scores after BPI surgery were compared with Japanese standard scores; the correlation between SF-36 scores and objective joint functions; difference in SF-36 scores between each type of BPI; and influence of each joint function on the SF-36 scores. The SF-36 subscale: PF — physical functioning, RP — role-physical, BP — bodily pain, and the summary score PCS — physical component summary, were significantly inferior to the Japanese standard scores. SF-36 is more sensitive to shoulder joint function than to elbow and finger joint functions. Little correlation was found between SF-36 scores and objective evaluations of joint functions. Greater effort is needed to improve the quality of life (QOL) of BPI patients. This study showed that SF-36 is not sensitive enough to evaluate regional conditions. A region- or site-specific questionnaire is required to evaluate upper extremity surgery.

The purpose of this study was to compare the concurrent validity of four questionnaires in the assessment of outcome after rotator cuff repair. Sixty-two patients, who were at least two years post-rotator-cuff repair, completed three upper extremity scales: the Western Ontario Rotator Cuff (WORC) index, the Disabilities of the Arm, Shoulder and Hand (DASH) and the Simple Shoulder Test (SST), and a measure of general health status (SF-36). Internal and external rotation ranges of motion and isometric strength were measured. Pearson correlations were used to evaluate the construct whereby scores should be related to the severity of measured impairments. One-way ANOVA was used to determine the ability of the questionnaires to discriminate between groups expected to have different outcomes based on measured impairment or worker's compensation status. The upper extremity questionnaires demonstrated similar response distributions and were highly correlated (0.88 < r < 0.91). The response distribution of the SF-36 was different from the other scales and its correlation with them was moderate (0.58 < r < 0.75). The upper extremity measures demonstrated better correlations with measured impairments (0.18 < r < 0.56) than the SF-36 (0 < r < 0.40). All the questionnaires were able to discriminate between levels of impairment and worker's compensation status. This study supported the validity of upper extremity scales to measure cuff-related disability and suggests that the use of both specific and general health measures provides a more comprehensive evaluation of patient outcome.

Objective: To identify what extent different patterns and severities of involvement affect quality of life of people suffering knee osteoarthritis.

Methods: This population-based survey involved 288 women and 288 men aged 40 years or older from Songkhla province, southern Thailand. Quality of life was measured using the Medical Outcome Study Short Form Health sutvery (SF-36) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiographic investigation included antero-posterior and skyline view of both knees. Osteoarthritis was categorized into 3 patterns; isolated patellofemoral, isolated tibiofemoral and combined with diagnosis based on Kellgren & Lawrence grade 2 or higher.

Results: Quality of life as measured by SF-36 and WOMAC showed poorer score in moderate or severe grade than in mild grade of severity. Isolated patellofemoral and combined patterns demonstrated showed poorer scores on both WOMAC and SF-36 than isolated tibiofemoral pattern. Body mass index, income level and pattern of involvement could independently predict total scores of WOMAC, while age, marital status and pattern of involvement affected total score of SF-36.

Conclusion: Pattern of involvement is a better predictor of quality of life than disease severity in patients with knee osteoarthritis.

Background: Stroke, either haemorrhagic or ischemic in nature, has the ability to culminate in devastating clinical outcomes thus effective rehabilitation is needed. Objective: To analyze the efficacy of Erigo tilt-table over conventional physiotherapy between ischemic and haemorrhagic stroke patients. Methods: A total of 110 haemorrhagic and ischemic stroke patients (age $51.08\pm 7.48$ years, $8.69\pm 4.62$ days after stroke) were assigned randomly into four groups, haemorrhagic conventional physiotherapy group ($n=33$), haemorrhagic Erigo tilt-table group ($n=27$), ischemic conventional physiotherapy group ($n=22$) and ischemic Erigo tilt-table group ($n=28$). The National Institutes of Health Stroke Scale (NIHSS), Mini Mental Scale Examination (MMSE), Modified Ashworth Scale, Quality of Life (QOL) and muscle strength outcomes were assessed at baseline, after the intervention (30th) and on 90th day of follow up. Results: In haemorrhagic Subjects, Erigo tilt-table patients had significant improvement ($P<0.05$) in outcome variables NIHSS, Ashworth, QOL, absolute upper and lower limb strength except for MMS as compared to Conventional Physiotherapy Group. Whereas in ischemic Subjects, there was no statistically significant difference between both groups($P>0.05$) on 30th as well as on 90th day comparison. Conclusions: Erigo tilt-table training are found to be effective than conventional physiotherapy in haemorrhagic stroke whereas in ischemic stroke both the interventions are equally effective.

Background: Oxford Elbow Score, abbreviated OES, is a tool used for measurement of a patient’s experience post elbow surgery. The tool is formulated as a questionnaire. OES has three subscales: pain, elbow function and social-psychological effects. The patient may complete the questionnaire and the results used as an outcome measure post elbow surgery. Objectives: The study aims to develop and evaluate the Arabic version of the OES for reliability, validity concerning patients after elbow trauma and surgery. Material and Methods: Fifty two patients participated in this survey at the baseline (14 days after the operation) and follow-up (after 60 days). We calculated internal consistency using Cronbach’s alpha. Also, Pearson’s correlation was calculated for construct validity verification. Results: The values for Cronbach’s alpha for psychological, function and pain subscales were 0.701, 0.704 and 0.779, respectively. Cronbach’s alpha for the questionnaire had a value of 0.743. We confirmed construct validity using correlation coefficients of values $-0.820$, $-0.750$ and $-0.800$ as compared to DASH. Conclusion: The Arabic OES is an internal consistent tool with good construct validity, which can be used to estimate the patient’s condition after the elbow surgery.

Purpose: Identifying factors related to low-back pain (LBP) can facilitate its management. However, information on how physical activity (PA) level, health-related quality of life (HRQoL) and anthropometric characteristics are related to LBP-associated health indices in individuals with chronic LBP (CLBP) is scarce. This study explored how PA level, HRQoL and anthropometric indices are related to CLBP-related disability in a Nigerian population.

Methods: This cross-sectional study involved 100 individuals with CLBP who were receiving treatment in physiotherapy out-patient clinics of selected tertiary hospitals, and 95 apparently healthy individuals. PA level, disability level and HRQoL were measured using standardized procedures.

Results: Disability level inversely correlated with physical component score (PCS) of HRQoL ($r=-0.84$; $p<0.001$), mental component score (MCS) of HRQoL ($r=-0.46$; $p<0.001$), pain intensity ($r=-0.84$; $P<0.001$) and PA level ($r=-0.39$; $p<0.001$), but positively correlated with duration of pain ($r=0.81$; $p<0.001$) among individuals with CLBP. PCS of HRQoL ($\beta =-1.68$; $p<0.001$) solely accounted for 71% of the prediction of disability level.

Conclusion: PA level and HRQoL decrease with increasing CLBP-related disability with the PCS of HRQoL being mostly affected. Individuals with CLBP may need to be motivated against their health problem, and be encouraged to participate in PA.