Patients with cystic fibrosis (CF) experience a progressive deterioration in health leading to a shortened life expectancy with concomitant psychologic challenges that also may require intervention. Approaches to address psychologic dysfunction include insight-oriented therapy, cognitive-behavioral therapy, biofeedback, hypnosis, massage, music therapy, relaxation, and family therapy. Patients who learn to use coping strategies are more likely to adhere to treatment, which helps improve both their physical and psychologic well-being. Unique stressors arise for patients awaiting lung transplant as a result of their advanced state of disease along with their fear of death before donor lungs become available. This case report demonstrates some of the psychologic struggles faced by a 10-year-old with CF as he awaited lung transplantation, which led to a loss of hope and his request for withdrawal of care. Encouraging of the patient to express how his life might be improved yielded changes in his management that restored his hopefulness, and allowed him to survive long enough to undergo successful lung transplantation. Thus, reestablishment of hope might be studied as an additional intervention to help improve the well-being of patients who are seriously ill.

J Altern Complement Med. 2010 Sep;16(9):1007-10. Anbar RD, Murthy VV. Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, NY, USA. Anbarr@upstate.edu

The aim of this study was to assess the levels of flexibility, functional autonomy and QoL in elderly yoga practitioners. The subjects were divided into a yoga group (YG; n=52; age=66.79±3.30 years; BMI=24.77±3.18) and control group (CG; n=31; age=69.33±4.84 years; BMI=24.32±3.71) and submitted to flexibility tests through goniometry, the LADEG autonomy protocol and QoL, using the WHOQOL-Old questionnaire. Repeated measures ANOVA showed increases in articular range of motion in shoulder abduction (?%SA=14.11%; p=0.0001), horizontal shoulder extension (?%HSE=33.90%; p=0.0001), lumbar spine flexion (?%LSF=50.74%; p=0.0001), hip flexion (?%HF=35.75%; p=0.0001), hip extension (?%HE=10.93%; p=0.021) and knee flexion (?%KF=3.90%; p=0.001) and in the GDLAM autonomy index (?%AI=-13.67%; p=0.0001) in the YG compared to the CG. The Mann-Whitney test revealed increases in QoL scores in Facet 1 (?%Fac1=9.04%; p=0.043), Facet 5 (?%Fac5=51.06%; p=0.0001) and in overall QoL (?%OqoL=8.13%; p=0.046) in the YG compared to the CG. The remaining variables showed no significant intergroup modifications. Thus, the study suggests that the regular practice of yoga may lead to improved range of motion in the performance of activities of daily living in elderly women.

Arch Gerontol Geriatr. 2010 Dec 15. Gonçalves LC, Vale RG, Barata NJ, Varejão RV, Dantas EH. Laboratory of Human Motricity Biosciences (LABIMH), Castelo Branco University (UCB), Av. Salvador Allende, n. 6700, Recreio do Bandeirantes, Rio de Janeiro, RJ, CEP 22780-160, Brazil.