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Mancheva L, Reichle ED, Lemaire B, Valdois S, Ecalle J, Guérin-Dugué A. An Analysis of Reading Skill Development using E-Z Reader. JOURNAL OF COGNITIVE PSYCHOLOGY 2015; 27:357-373. [PMID: 27148437 DOI: 10.1080/20445911.2015.1024255] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Previously reported simulations using the E-Z Reader model of eye-movement control suggest that the patterns of eye movements observed with children versus adult readers reflect differences in lexical processing proficiency (Reichle et al., 2013). However, these simulations fail to specify precisely what aspect(s) of lexical processing (e.g., orthographic processing) account for the concurrent changes in eye movements and reading skill. To examine this issue, the E-Z Reader model was first used to simulate the aggregate eye-movement data from 15 adults and 75 children to replicate the finding that gross differences in reading skill can be accounted for by differences in lexical processing proficiency. The model was then used to simulate the eye-movement data of individual children so that the best-fitting lexical-processing parameters could be correlated to measures of orthographic knowledge, phonological-processing skill, sentence comprehension, and general intelligence. These analyses suggest that orthographic knowledge accounts for variance in the eye-movement measures that is observed with between-individual differences in reading skill. The theoretical implications of this conclusion will be discussed in relation to computational models of reading and our understanding of reading skill development.
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Lemaire B, Geron D, Malaise O, Krzesinski JM, Ansseau M, Scantamburlo G. [Depression as a common complication of systemic lupus erythematosus]. REVUE MEDICALE DE LIEGE 2015; 70:215-218. [PMID: 26054174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Systemic lupus erythematosus (SLE) is an inflammatory disease with multiple and disabling consequences, including the psychological status. The prevalence of major depressive episodes among patients suffering from SLE is significantly higher than in healthy people, or people suffering from other inflammatory diseases. While it is obvious that its chronic disease status with a frequently pejorative ending, as well as the number of treatments it requires, are contributing factors, it is likely that due to its pathogenic mechanisms, SLE causes direct injury to the brain, leading to a depressive symptomatology. Numerous hypotheses are under consideration. We shall review them all, recall a few epidemiologic features, add histology and medical imaging contributions and discuss the importance of setting up a fitting therapy for such patients.
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Segouin C, Peyron I, Lemaire B, Gilleron V, Mercier G, Janvois B, Nicolas C, Rymer R, Lestienne A. Programme de reconversion au métier de DIM. Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.01.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Xerri O, Lemaire B, Nasser G, Rousseau-Huvey B, Labetoulle M, Rousseau A. [Severe linezolid-induced toxic optic neuropathy]. J Fr Ophtalmol 2015; 38:e55-8. [PMID: 25637235 DOI: 10.1016/j.jfo.2014.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 05/01/2014] [Accepted: 05/09/2014] [Indexed: 11/26/2022]
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Bourguignon S, Milojevic K, Lemaire B, Le LK, Faille S, Parisse S, Pico F, Lambert Y. Interest Of A Hospital Database To Analyze The Cost For Acute Stroke: The Example Of Versailles Hospital. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A483. [PMID: 27201413 DOI: 10.1016/j.jval.2014.08.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Debieuvre D, Locher C, Neidhardt AC, Goupil F, Lemaire B, Blanchet-Legens AS, Renault D, Tavernier JY, Tagu P, Mahmoud H, Figueredo M, Grivaux M. [Ten-year evolution in non-small-cell lung cancer according to sex. Results of the KBP-2010-CPHG study by the College of General Hospital Respiratory Physicians]. Rev Mal Respir 2013; 31:805-16. [PMID: 25433585 DOI: 10.1016/j.rmr.2013.10.644] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 10/06/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Comparison by sex and presenting features between 2000 and 2010 of the characteristics of new cases of non-small-cell lung cancer (NSCLC). METHODS Observational KBP-2010-CPHG study similar to KBP-2000-CPHG. Both studies were promoted by the French College of General Hospital Respiratory Physicians (CPHG). KBP-2010-CPHG collected data for 6083 NSCLC diagnosed between January 1st and December 31st, 2010, and followed in the respiratory departments of 119 French general hospitals. RESULTS In 2010, 24.4 % of the patients were women (16 % in 2000, p<0.0001). Compared to men, women were more commonly non-smokers (34.2 vs 4.7 %) or lighter consumers (37.2 vs 43.7 pack per years) (p<0.0001). Their tumours (mostly adenocarcinoma: 64.6 vs 48.7 %, p<0.0001) were more frequently diagnosed at stage IV (62.4 vs 56.9 %, p=0.0008). EGFR mutation research was more frequently performed (48.5 vs 31.0 %, p<0.0001) and positive (20.6 vs 5.2 %, p<0.0001) in women than men. Their treatment more frequently included targeted therapy (13.4 vs 5.7 %, p<0.0001). Compared to 2000, the percentage of non-smokers increased in men (4.7 vs 2.5 %, p<0.0001) while remaining stable in women (36.1 vs 34.2 %, p=0.32). The percentage of adenocarcinomas increased, particularly in men (48.7 vs 31.5 %, p<0.0001). CONCLUSIONS The percentage of women with NSCLC has increased in 10years in France. In 2010, the main gender differences persist, but have decreased with the increasing proportion of non-smokers and adenocarcinomas in men. Various hypotheses to explain these changes are discussed.
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Delavierre D, Lemaire B, Corcia L, Dolique M. Épidémiologie de la consultation d’hypofertilité masculine. À propos de 182 hommes. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chanceaux M, Guérin-Dugué A, Lemaire B, Baccino T. A Computational Cognitive Model of Information Search in Textual Materials. Cognit Comput 2012. [DOI: 10.1007/s12559-012-9200-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stegeman J, Goldstone J, Jonsson M, Kubota A, Lemaire B. Evolutionary history and functional diversity of the cytochrome P450 1 gene family. Comp Biochem Physiol A Mol Integr Physiol 2012. [DOI: 10.1016/j.cbpa.2012.05.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Marquette D, Pichon E, Deschasse G, Lemaire B, Lemarié E, Diot P, Marchand-Adam S. Cancer du poumon du sujet jeune : étude rétrospective et comparative en région Centre. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alouini S, Rossard L, Lemaire B, Mégier P, Mesnard L. [Anal sphincter tears after vaginal delivery: risks factors and means of prevention]. REVUE MEDICALE DE LIEGE 2011; 66:545-549. [PMID: 22141262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
To identify incidence and risks factors of obstetrical anal sphincter lacerations, we reviewed all cases of 3rd and 4th degree sphincter lacerations after vaginal deliveries (VD) occured in a tertiary maternity between 2005 and 2010. 78 anal sphincter lacerations were identified (3.8/1000 deliveries). 66 women (85%) were nulliparous. The mean age of women was of 29 +/- 5 years. The mean duration of the second stage of labour was of 3.4 +/- 1,7 hour. The birth weight of 12 newborns (15%) was greater than 4000 grams. Fourty-six women (2.5%) had sphincter lacerations after instrumental delivery and 32 after spontaneous vaginal delivery (0.2%). 51 patients out of 78 (65%) had a medio-lateral episiotomy, 82% occured after instrumental extraction and 43% after spontaneous delivery. A forceps of Tarnier was used in 18 cases, a Suzor forceps in 12 cases, spatula in 12 cases and vacuum in 4 cases. 76% of foetuses were in anterior presentation and 78% at the medium part of the pelvis. 2 patients experienced anal incontinence in early post-partum. Anal sphincter lacerations are relatively frequent after VD especially after instrumental delivery. Macrosomia, nulliparous women, prolonged second stage of labor were associated with anal sphincter tears. Medio-lateral episiotomy does not protect enough anal sphincters. Anal sphincter lacerations lead to anal incontinence in some cases.A long follow-up is useful for these patients.
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Alouini S, Mesnard L, Coly S, Dolique M, Lemaire B. [Gynecological emergencies: etiology and degree of gravity]. ACTA ACUST UNITED AC 2011; 41:48-54. [PMID: 21944576 DOI: 10.1016/j.jgyn.2011.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 07/20/2011] [Accepted: 08/17/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the type and the emergency degree of the pathologies met in gynecological emergencies. METHODS prospective study including 205 patients presented to the Emergency department of a maternity level 3 between the 2011 January 4 and February 15. RESULTS One hundred and ninety-four patients (95%) came from their own initiative. One hundred and eighty-one patients (88%) consulted for abdominal/pelvic or lumbar pain and or metrorragia. The mean age of the patients was of 31 ± 11 years and the average waiting time before being examined was of 84 ± 101 minutes. For 94 patients (46%), the diagnosis was an asymptomatic intra-uterine pregnancy in 41 cases or associated with minor symptoms. 21 patients (8.9%) consulted for menstruation with or without dysmenorrhea, 17 (8,3%) had a miscarriage, 14 (7%) a genital infection, 11 (5%) an ovarian pathology and eight (4%) an ectopic pregnancy or its follow-up. Seven patients had an axillary lymphocele or a breast tumor and four symptomatic myomas. Six patients presented with non-gynecological pathologies. In 23 cases (11%) no organic cause was found. Only 24 patients (12%) were hospitalized and nine (4.5%) operated. CONCLUSION Most of the patients consulted for minor obstetrical or gynecological pathologies without relation with the function of Emergency department. Ectopic pregnancy remains a rare event. Better information of the users on the significance of the urgency is desirable. Consultation of a referent physician before emergency services should be privileged.
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Abstract
This paper presents a computational model of the way humans inductively identify and aggregate concepts from the low-level stimuli they are exposed to. Based on the idea that humans tend to select the simplest structures, it implements a dynamic hierarchical chunking mechanism in which the decision whether to create a new chunk is based on an information-theoretic criterion, the Minimum Description Length (MDL) principle. We present theoretical justifications for this approach together with results of an experiment in which participants, exposed to meaningless symbols, have been implicitly encouraged to create high-level concepts by grouping them. Results show that the designed model, called hereafter MDLChunker, makes precise quantitative predictions both on the kind of chunks created by the participants and also on the moment at which these creations occur. They suggest that the simplicity principle used to design MDLChunker is particularly efficient to model chunking mechanisms. The main interest of this model over existing ones is that it does not require any adjustable parameter.
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Rochet S, Obert L, Lepage D, Lemaire B, Leclerc G, Garbuio P. Proximal ulna comminuted fractures: fixation using a double-plating technique. Orthop Traumatol Surg Res 2010; 96:734-40. [PMID: 20801732 DOI: 10.1016/j.otsr.2010.06.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 03/29/2010] [Accepted: 06/14/2010] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Comminuted fractures of the proximal ulna are severe injuries often associated with bone and ligament injuries of the elbow joint (Monteggia lesion, radial head fractures, dislocation of the elbow). The treatment of these fractures is very demanding and the functional results often fairly mediocre due to associated injuries. Based on a single-center retrospective study, we report the results of the treatment of these fractures fixed using a double-plate technique. The aim was to evaluate the feasibility and reliability of this fixation mode and to compare it with other fractures series using a single plate fixation (in terms of bone union, elbow joint function, and complications stemming from the plates). PATIENTS AND METHODS Eighteen patients sustained a comminuted proximal ulna fracture between 2002 and 2006. The fractures were associated in five cases with a Monteggia type lesion, in two cases with elbow dislocation, and in four cases with a Mason 3 radial head fracture. Four patients had an open fracture. These comminuted ulna fractures included nine Mayo Clinic IIIB fractures. Bone fixation was performed with two third-cylinder tubular plates, one plate on each side of the proximal ulna. This allows more versatile solutions for screw insertion. Functional assessment (according to Broberg and Morrey) and radiological evaluation (bone healing) were provided at 6 months and at the longest follow-up by an independent surgeon. RESULTS Sixteen of 18 patients achieved bone union. No septic complications occurred and no hardware removal was required on patient request. In 67% of the cases, the Morrey score indicated excellent or good results with a mean score of 82. DISCUSSION There are no reports in the literature on the technical point of fixation concerning complex fractures of the ulna. Two plates mean the possibility of twice the number of screw insertions for epiphyseal reconstruction . This fixation remains easy to perform and provides stable anatomic reconstruction of the ulna. LEVEL OF EVIDENCE Level IV. Retrospective study.
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Alouini S, Mesnard L, Megier P, Lemaire B, Coly S, Desroches A. Procidence du cordon : prise en charge obstétricale et conséquences néonatales. ACTA ACUST UNITED AC 2010; 39:471-7. [DOI: 10.1016/j.jgyn.2010.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 05/19/2010] [Accepted: 05/26/2010] [Indexed: 10/19/2022]
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Belin de Chantemèle EJ, Retailleau K, Pinaud F, Vessières E, Bocquet A, Guihot AL, Lemaire B, Domenga V, Baufreton C, Loufrani L, Joutel A, Henrion D. Notch3 is a major regulator of vascular tone in cerebral and tail resistance arteries. Arterioscler Thromb Vasc Biol 2008; 28:2216-24. [PMID: 18818417 DOI: 10.1161/atvbaha.108.171751] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Notch3, a member of the evolutionary conserved Notch receptor family, is primarily expressed in vascular smooth muscle cells. Genetic studies in human and mice revealed a critical role for Notch3 in the structural integrity of distal resistance arteries by regulating arterial differentiation and postnatal maturation. METHODS AND RESULTS We investigated the role of Notch3 in vascular tone in small resistance vessels (tail and cerebral arteries) and large (carotid) arteries isolated from Notch3-deficient mice using arteriography. Passive diameter and compliance were unaltered in mutant arteries. Similarly, contractions to phenylephrine, KCl, angiotensin II, and thromboxane A2 as well as dilation to acetylcholine or sodium nitroprusside were unaffected. However, Notch3 deficiency induced a dramatic reduction in pressure-induced myogenic tone associated with a higher flow (shear stress)-mediated dilation in tail and cerebral resistance arteries only. Furthermore, RhoA activity and myosin light chain phosphorylation, measured in pressurized tail arteries, were significantly reduced in Notch3KO mice. Additionally, myogenic tone inhibition by the Rho kinase inhibitor Y27632 was attenuated in mutant tail arteries. CONCLUSIONS Notch3 plays an important role in the control of vascular mechano-transduction, by modulating the RhoA/Rho kinase pathway, with opposite effects on myogenic tone and flow-mediated dilation in the resistance circulation.
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Charrier JB, Racy E, Nowak C, Lemaire B, Bobin S. Embryologie et anomalies congénitales du nez. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s0246-0351(07)41889-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dellalibera O, Lemaire B, Lafay S. Le Svetol ®, un extrait de café vert décaféiné, induit une perte de poids et augmente le ratio masse maigre sur masse grasse chez des volontaires en surcharge pondérale. ACTA ACUST UNITED AC 2006. [DOI: 10.1007/s10298-006-0181-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lemaire B, Denhière G, Bellissens C, Jhean-Larose S. A computational model for simulating text comprehension. Behav Res Methods 2006; 38:628-37. [PMID: 17393834 DOI: 10.3758/bf03193895] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the present article, we outline the architecture of a computer program for simulating the process by which humans comprehend texts. The program is based on psycholinguistic theories about human memory and text comprehension processes, such as the construction-integration model (Kintsch, 1998), the latent semantic analysis theory of knowledge representation (Landauer & Dumais, 1997), and the predication algorithms (Kintsch, 2001; Lemaire & Bianco, 2003), and it is intended to help psycholinguists investigate the way humans comprehend texts.
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Lemaire B, Racy E, Lescanne E, Doyon D, Bobin S, Portier F. Complications méningo-encéphaliques des otites chroniques cholestéatomateuses. ACTA ACUST UNITED AC 2004; 121:197-204. [PMID: 15545927 DOI: 10.1016/s0003-438x(04)95509-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lemaire B, Bothorel P, Roux D. Micellar interactions in water-in-oil microemulsions. 1. Calculated interaction potential. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100229a021] [Citation(s) in RCA: 156] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lemaire B, Bothorel P. Conformational Analysis of Aliphatic Chains at Interfaces. Influence of the Radius of Curvature. Macromolecules 2002. [DOI: 10.1021/ma60074a020] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Danet S, Richard F, Montaye M, Beauchant S, Lemaire B, Graux C, Cottel D, Marécaux N, Amouyel P. Unhealthy effects of atmospheric temperature and pressure on the occurrence of myocardial infarction and coronary deaths. A 10-year survey: the Lille-World Health Organization MONICA project (Monitoring trends and determinants in cardiovascular disease). Circulation 1999; 100:E1-7. [PMID: 10393689 DOI: 10.1161/01.cir.100.1.e1] [Citation(s) in RCA: 340] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Associations between an increase in coronary heart disease occurrence and low atmospheric temperatures have been reported from mortality data and hospital admission registries. However, concomitant increases in noncardiovascular case fatality rates and selection bias of hospital cases may weaken this observation. In this study, we addressed the question of the relationships between fatal and nonfatal coronary diseases and meteorological variables in 10-year data (1985 to 1994) collected in a morbidity registry (Lille-WHO MONICA Project) monitoring 257 000 men from 25 to 64 years of age. METHODS AND RESULTS The impacts of atmospheric temperature (in Celsius) and pressure (in millibars) on daily rates of myocardial infarction (MI) and coronary deaths were studied. Percentages of variation of event rates according to meteorological variations were derived from the relative risks estimated with a Poisson regression model. During the 10-year longitudinal survey, 3616 events occurred. Rates of events decreased linearly with increasing atmospheric temperature. For atmospheric pressure, we detected a V-shaped relationship, with a minimum of daily event rates at 1016 mbar. A 10 degrees C decrease was associated with a 13% increase in event rates (P<0.0001); a 10-mbar decrease <1016 mbar and a 10-mbar increase >1016 mbar were associated with a 12% increase (P=0.001) and an 11% increase (P=0. 01) in event rates, respectively. These effects were independent and influenced both coronary morbidity and mortality rates, with stronger effects in older age groups and for recurrent events. CONCLUSIONS This longitudinal study is the first to estimate the attributable effect of meteorological variables on MI morbidity in population and strongly argues for a systematic fight against cold in cardiovascular disease prevention, particularly in older ages and after a first MI.
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Grosbois JM, Lamblin C, Lemaire B, Chekroud H, Dernis JM, Douay B, Fortin F. Long-term benefits of exercise maintenance after outpatient rehabilitation program in patients with chronic obstructive pulmonary disease. JOURNAL OF CARDIOPULMONARY REHABILITATION 1999; 19:216-25. [PMID: 10453428 DOI: 10.1097/00008483-199907000-00002] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Optimal strategies to maintain short-term benefits of an initial rehabilitation program (RP) are not known. To assess the long-term effects of exercise maintenance (EM) after an initial outpatient RP, the authors conducted a prospective study. PATIENTS AND METHODS Fifty-eight patients with moderate to moderately severe chronic obstructive pulmonary disease who completed an initial 7-week outpatient RP were included. They were allocated into four groups according to the conditions of EM they self-selected: 15 patients received a structured EM session supervised by a physiotherapist twice a week (group A); 14 patients received a structured EM session supervised by a physiotherapist once a week (group B); 15 patients continued self EM daily at home (group C); and 14 patients did not continue EM (group D). Patients were evaluated before, immediately after, and 18 months after the initial outpatient RP. Measurements included exercise testing on a cycle ergometer and a visual analog scale to evaluate chronic dyspnea. RESULTS After RP, all patients exhibited improvements in maximal workload (P < 0.05) and in dyspnea (P < 0.05). Improvements in maximal workload were maintained at 18 months in patients in groups A, B, and C but these only reached significance in groups B and C (P < 0.05). On the other hand, maximal workload returned to baseline values in group D (P = 0.01) at 18 months. CONCLUSION Our results indicate definite benefits of EM after an initial outpatient RP compared with no EM. Daily EM at home appears to be as efficient as structured EM sessions supervised by a physiotherapist, once or twice a week, in moderate to moderately severe chronic obstructive pulmonary disease.
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