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Exercise is important for those with chronic medical conditions. Most individuals living with PID can participate in low/moderate physical activity, but struggle with vigorous physical activity, since fatigue is the greatest barrier. Respondents view exercise as beneficial, and would like to increase participation in an exercise program.

Context: Knee osteoarthritis is a prevalent condition that is often accompanied by pain and limited mobility. Acupuncture has been suggested as a potential treatment for osteoarthritis, particularly in conjunction with other modalities such as physical therapy (PT). Objective: To critically evaluate the literature investigating the efficacy of acupuncture as an adjunctive treatment for knee osteoarthritis in conjunction with or in comparison to PT treatment programs. Design and Sources: This literature review included studies that incorporated a PT protocol along with true or sham acupuncture. The goal was to identify specific PT and acupuncture protocols used and to determine if a specific treatment had a more beneficial effect on functional mobility or pain. Criteria for article selection included diagnosis of knee osteoarthritis and the use of acupuncture and PT. The following electronic databases were searched between January 2007 and January 2008: EBSCO Host, CINAHL, MEDLINE, Cochrane Database, and Healthsource. Results: Seven studies were identified for use in this review. There was high variability among the PT and acupuncture protocols used in the studies. Of the 6 studies with published results, only 2 compared acupuncture directly to PT. Conclusions: Because acupuncture has become popular in the United States, it is important to ascertain effectiveness of acupuncture compared with conventional treatment. There are limited publications concerning the use of acupuncture in combination with or in comparison to PT treatment. Published studies have high variability in protocols for both acupuncture and PT, making it difficult to make accurate conclusions.

Individuals with Primary Immunodeficiency Disease (PID) have increased risk for infection, autoimmune conditions, and inflammatory disorders. Cognitive impairment, also referred to as brain fog, has been recognized in other medical conditions and as a side-effect of treatments; however, it has not been previously reported in individuals with PID. The phenomenon of brain fog is recognized in other autoimmune or inflammatory conditions, including lupus, multiple sclerosis, chronic fatigue syndrome, and has resulted from chemotherapy treatment for cancer. This research investigates the self-reported memory function of individuals with a diagnosis of PID. Respondents completed a survey which used reliable and valid questionnaires: Memory Functioning Questionnaire, Beck’s Depression Inventory II, and Beck’s Anxiety Inventory. Of the 292 completed surveys, 133 did not report any comorbid neurological diagnosis or incident of concussion (both of which could influence perceived memory function). When compared to normative scores, the respondents in this study were found to have significantly greater perceived memory impairment. The respondents had a significant higher score for anxiety and depression as compared to non-anxious and non-depressed normative values. This study finds that individuals with a diagnosis of PID have a greater degree of perceived memory impairment, or brain fog, in addition to greater levels of anxiety and depression. Individuals with a diagnosis of PID would benefit from prospective surveillance through a comprehensive neuropsychological assessment to track cognitive status and implement corrective measures, should any decline be identified.

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