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Vranić L, Biloglav Z, Medaković P, Talapko J, Škrlec I. The Effects of a Pulmonary Rehabilitation Programme on Functional Capacity and Strength of Respiratory Muscles in Patients with Post-COVID Syndrome. Zdr Varst 2024; 63:123-131. [PMID: 38881631 PMCID: PMC11178033 DOI: 10.2478/sjph-2024-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/23/2024] [Indexed: 06/18/2024] Open
Abstract
Aim The aim of this study was to estimate the effects of a pulmonary rehabilitation programme (PR) on the functional capacity and respiratory muscle strength of patients with post-COVID syndrome. Methods A cross-sectional study was conducted using hospital data on patients who participated in a pulmonary rehabilitation programme at the Clinic for Lung Diseases, University Hospital Centre Zagreb, Croatia, between January 2021 and December 2022. Data on the spirometry, respiratory muscle strength, and functional exercise capacity of patients were collected at baseline and three weeks after the start of rehabilitation. The study included 80 patients (43 females, 37 males) with a mean age of 51±10 years. Results A significant increase in respiratory muscle strength (P<0.001) was observed after pulmonary rehabilitation, with effect sizes ranging from small to large (Cohen's d from 0.39 to 1.07), whereas the effect for PImax expressed as a percentage was large (Cohen's d=0.99). In addition, the pulmonary rehabilitation programme significantly improved the parameters of the six-minute walk test in patients, and the parameters of lung function, FVC, FEV1, and DLCO also improved significantly after PR (P<0.05). Conclusion The results showed that the pulmonary rehabilitation programme has clinically significant effects on functional capacity and respiratory muscle strength in patients with post-COVID syndrome.
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Affiliation(s)
- Lana Vranić
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Zrinka Biloglav
- Department of Medical Statistics, Epidemiology and Medical Informatics, School of Public Health Andrija Štampar, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Petar Medaković
- Department of Radiology, Polyclinic Croatia, 10000 Zagreb, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
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Lozano-Meca J, Montilla-Herrador J, Gacto-Sánchez M. Gait speed in knee osteoarthritis: A simple 10-meter walk test predicts the distance covered in the 6-minute walk test. Musculoskelet Sci Pract 2024; 72:102983. [PMID: 38851178 DOI: 10.1016/j.msksp.2024.102983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/25/2024] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND The 6-Minute Walk Test (6MWT) is a common performance-measure in Knee Osteoarthritis (KOA), but the pain and functional impairment characterizing the condition may interfere its adequate performance. OBJECTIVES The shorter 10-m Walk Test (10mWT) could predict the distance performed on the 6MWT, therefore decreasing the burden on patients, enhancing efficiency, and reducing space- and time-constraints in clinical settings. DESIGN A cross sectional study was conducted. METHODS The scores from the 6MWT and the shorter 10mWT of 58 ambulatory subjects with KOA were compared. Correlation, and a univariate regression analysis to explore the predictive ability of the 10mWT, were calculated. RESULTS Correlation was excellent (r = 0.913, p-value<0.001), and the predictive equation based on the 10mWT scores (R2 = 0.834, p-value<0.001) estimates the distance walked in the 6MWT with a relative error of 7.62%. CONCLUSIONS The 10mWT may be an excellent assessment-tool to predict the distance walked in the 6MWT, due to its low strain on patients and as a means of improving efficiency and reducing time-constraints.
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Affiliation(s)
- José Lozano-Meca
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
| | - Joaquina Montilla-Herrador
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain.
| | - Mariano Gacto-Sánchez
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
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Wang DD, Cheng M, Chen CY. Intervention control of aerobic exercise in maintaining quality of life and pulmonary hypertension in hemodialysis patients. World J Clin Cases 2024; 12:4217-4229. [DOI: 10.12998/wjcc.v12.i20.4217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/10/2024] [Accepted: 05/23/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Pulmonary hypertension is a serious complication in the treatment of maintenance hemodialysis patients, which seriously affects the quality of life of patients and threatens their life safety. Prevention, treatment and improvement of pulmonary hypertension are of great significance to improve the quality of life of patients.
AIM To investigate the intervention and control of pedal-powered bicycle in maintaining quality of life and pulmonary hypertension in hemodialysis patients.
METHODS 73 patients with maintenance hemadialysis combined with pulmonary arterial hypertension at a hemodialysis center in a certain hospital from May 2021 to May 2022 are selected. Patients are divided into two groups, 37 cases in the control group (group C) and 36 cases in the intervention group (group I). Patients are divided into two groups, group C is treated with oral administration of betaglandin sodium combined with routine nursing care. Based on group C, group I conducts power cycling exercises.
RESULTS After treatment, group I patients had higher muscle strength, 36-Item Short Form Health Survey scores, and Kidney Disease Targets Areas scores; The 6-minute walk distance test index level was higher and the Borg score was lower; The group I had lower systolic blood pressure, greater vital capacity, higher positive emotion, lower systolic pulmonary artery pressure index level, higher arterial partial oxygen pressure level, lower pulmonary vascular resistance index level, and higher blood oxygen saturation level [158.91 ± 11.89 vs 152.56 ± 12.81, 1795.01 ± 603.18 vs 1907.20 ± 574.15, 24.00 (22.00, 29.00) vs 24.00 (22.00, 28.00), P < 0.001].
CONCLUSION Aerobic exercise combined with Western medicine treatment can effectively improve patients' pulmonary hypertension, alleviate their negative emotions, and enable them to achieve a higher level of quality of life.
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Affiliation(s)
- Dan-Dan Wang
- Department of Rehabilitation Medicine, Zhejiang Hospital, Hangzhou 310012, Zhejiang Province, China
| | - Min Cheng
- Blood Purification Center, Zhejiang Hospital, Hangzhou 310012, Zhejiang Province, China
| | - Chun-Ying Chen
- Department of Rehabilitation Medicine, Zhejiang Hospital, Hangzhou 310012, Zhejiang Province, China
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Shen Y, Cong Z, Ge Q, Huang H, Wei W, Wang C, Jiang Z, Wu Y. Effect of nutrition-based prehabilitation on the postoperative outcomes of patients with esophagogastric cancer undergoing surgery: A systematic review and meta-analysis. Cancer Med 2024; 13:e70023. [PMID: 39001679 PMCID: PMC11245637 DOI: 10.1002/cam4.70023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 05/17/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Meta-analyses have primarily focused on the effects of exercise-based prehabilitation on postoperative outcomes and ignored the role of nutritional intervention. In this study, we filled this gap by investigating the effect of nutrition-based prehabilitation on the postoperative outcomes of patients who underwent esophagectomy and gastrectomy. METHODS Five electronic databases, namely, PubMed, the Web of Science, Embase, Cochrane Library, and CINAHL, were searched. Adults diagnosed with esophagogastric cancer who were scheduled to undergo surgery and had undergone uni- or multimodal prehabilitation, with at least a week of mandatory nutritional intervention, were included. Forest plots were used to extract and visualize the data from the included studies. The occurrence of any postoperative complication was considered the primary endpoint. RESULTS Eight studies met the eligibility criteria, with five randomized controlled trials (RCTs) and three cohort studies. In total, 661 patients were included. Any prehabilitation, that is, unimodal (only nutrition) and multimodal prehabilitation, collectively decreased the risk of any postoperative complication by 23% (95% confidence interval [CI] = 0.66-0.90). A similar effect was exclusively observed for multimodal prehabilitation (risk ratio [RR] = 0.78, 95% CI = 0.66-0.93); however, it was not significant for unimodal prehabilitation. Any prehabilitation significantly decreased the length of hospital stay (LOS) (weighted mean difference = -0.77, 95% CI = -1.46 to -0.09). CONCLUSIONS Nutrition-based prehabilitation, particularly multimodal prehabilitation, confers protective effects against postoperative complications after esophagectomy and gastrectomy. Our findings suggest that prehabilitation slightly decreases LOS; however, the finding is not clinically significant. Therefore, additional rigorous RCTs are warranted for further substantiation.
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Affiliation(s)
- Yi Shen
- Department of Cardiothoracic Surgery, Jinling Hospital, School of MedicineSoutheast UniversityNanjingChina
- Department of Cardiothoracic Surgery, Jinling Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Zhuangzhuang Cong
- Department of Cardiothoracic Surgery, Jinling Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Qiyue Ge
- Department of Cardiothoracic Surgery, Jinling Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Hairong Huang
- Department of Cardiothoracic SurgeryJinling HospitalNanjingChina
| | - Wei Wei
- Department of Cardiothoracic SurgeryJinling HospitalNanjingChina
| | - Changyong Wang
- Department of Cardiothoracic SurgeryJinling HospitalNanjingChina
| | - Zhisheng Jiang
- Department of Cardiothoracic SurgeryJinling HospitalNanjingChina
| | - Yuheng Wu
- Department of Cardiothoracic Surgery, Jinling Hospital, School of MedicineSoutheast UniversityNanjingChina
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Guo H, Zhou X, Li Y, Yang Y, Yu H, Li X, Yuan H, Chen Y, Feng Y, Huang J, Du Q. Application of the Six-Minute Walk Test in Assessment of the Cardiopulmonary Function of Children With Idiopathic Scoliosis. Spine (Phila Pa 1976) 2024; 49:840-846. [PMID: 38158748 PMCID: PMC11132092 DOI: 10.1097/brs.0000000000004913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
STUDY DESIGN A retrospective observational study. OBJECTIVE To assess whether the six-minute walk test (6MWT) can predict cardiopulmonary function in children with idiopathic scoliosis (IS) as an alternative to the cardiopulmonary exercise test (CPET). SUMMARY OF BACKGROUND DATA Cardiopulmonary functional impairment in the setting of IS is a common health problem. A simple and convenient assessment method is needed. MATERIALS AND METHODS We recruited 65 children (eight male, 57 female) aged 10.70 to 14.84 years old with IS. Radiographic characteristics of the cohort were measured, including Risser's sign and Cobb angle. We measured cardiopulmonary exercise tolerance using both the 6MWT and CPET and their corresponding indicators, including six-minute walking distance (6MWD) and peak oxygen uptake (peak VO 2 ), respectively. Pearson correlation analysis was used to determine the relationship between 6MWT indicators and IS parameters. Linear regression models were used to explore the relationship between 6MWT and CPET response indicators. RESULTS Over a third of the cohort (35.4%) had a Risser's sign grade of 0, with 21.5% in grade 2 and 3, respectively. The cohort's mean Cobb angle was 26.02°. 6MWD was significantly positively correlated with Risser's sign ( R =0.258; P =0.038) and change in respiratory rate positively correlated with vertebral rotation ( R =0.264; P =0.034). 6MWD positively correlated with peak VO 2 , peak VO 2 /heart rate (HR), and metabolic equivalents, and negatively correlated with the ventilation equivalent of the carbon dioxide slope (VE/VCO 2 slope) ( P <0.05). These four CPET indicators were found to be predicted from 6MWD in the linear regression model ( P <0.05). CONCLUSIONS CPET response indicators, especially peak VO 2 , can be predicted using 6MWD, among other factors. The 6MWT can therefore be used to rapidly and efficiently predict the cardiorespiratory tolerance of children with IS. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Haibin Guo
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuan Zhou
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanyan Li
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuqi Yang
- College of Global Public Health, New York University, New York, NY
| | - Hong Yu
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Li
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Yuan
- Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yushan Chen
- Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yufei Feng
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Du
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Vaes AW, Burtin C, Casaburi R, Celli BR, Evans RA, Lareau SC, Nici L, Rochester CL, Troosters T. Prevalence and prognostic importance of exercise limitation and physical inactivity in COPD. Breathe (Sheff) 2024; 20:230179. [PMID: 38873237 PMCID: PMC11167648 DOI: 10.1183/20734735.0179-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/08/2024] [Indexed: 06/15/2024] Open
Abstract
Exercise limitation and physical inactivity are separate, but related constructs. Both are commonly present in individuals with COPD, contribute to disease burden over and above the respiratory impairments, and are independently predictive of adverse outcomes. Because of this, clinicians should consider assessing these variables in their patients with COPD. Field tests of exercise performance such as the 6-min walk test and the incremental and endurance shuttle walk tests require limited additional resources, and results correlate with negative outcomes. Laboratory measures of exercise performance using a treadmill or cycle ergometer assess exercise capacity, provide prognostic information and have the advantage of explaining physiological mechanisms (and their interactions) underpinning exercise limitation. Limitations in exercise capacity (i.e. "cannot do") and physical inactivity (i.e. "do not do") are both associated with mortality; exercise limitation appears to be the more important driver of this outcome.
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Affiliation(s)
- Anouk W. Vaes
- Department of Research and Development, Ciro, Horn, The Netherlands
| | - Chris Burtin
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Richard Casaburi
- Rehabilitation Clinical Trials Center, Lundquist Institute for Biomedical Innovation at Harbor-University of California, Los Angeles (UCLA) Medical Center, Torrance, CA, USA
| | - Bartolome R. Celli
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachael A. Evans
- Department of Respiratory Science, University of Leicester, Leicester, UK
| | - Suzanne C. Lareau
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Linda Nici
- Providence Veterans Affairs Medical Center, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Carolyn L. Rochester
- Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
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Jin Z. Does Exercise Training Benefit Patients With Persistent Dyspnea After Pulmonary Embolism? Chest 2024; 165:e200-e201. [PMID: 38852980 DOI: 10.1016/j.chest.2024.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 06/11/2024] Open
Affiliation(s)
- Zhou Jin
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China.
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Al-Nemr A, Kora AN. Effect of core stabilization versus rebound therapy on balance in children with cerebral palsy. Acta Neurol Belg 2024; 124:843-851. [PMID: 38177509 PMCID: PMC11139745 DOI: 10.1007/s13760-023-02430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/05/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE This study aimed to compare the effect of core stabilization exercises and rebound therapy on balance in children with hemiplegic cerebral palsy (CP). METHODS Fifty- two children of spastic hemiplegic CP aged 5 up to 8 years from both genders were assigned randomly into two groups: core stability and rebound therapy groups. Both groups received 3 sessions/week, 1.5-h training per session, for 12 successive weeks. The measurement was performed at baseline and post-treatment. Balance as a primary outcome for this study was measured by a Biodex Balance System (BBS), and knee extensor strength and functional capacity as secondary outcomes were assessed using a hand-held dynamometer, and a six-minute walk test (6MWT), respectively. RESULTS All variables showed a significant improvement after intervention in each group (p < 0.0001), with significant improvement in all stability indices (overall, anteroposterior, and mediolateral) in core stability group when compared to rebound therapy group. CONCLUSION Core stability exercises and rebound therapy are recommended in the rehabilitation of children with hemiplegic CP. Core stability exercises were more effective than rebound therapy for balance improvement. TRIAL REGISTRATION NUMBER NCT05739396.
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Affiliation(s)
- Alaa Al-Nemr
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, El-Tahrir St., Giza, 12613, Egypt.
| | - Alaa Noureldeen Kora
- Department of Physical Therapy for Pediatrics and Pediatric Surgery, Faculty of Physical Therapy, Sinai University, East Qantara, Egypt
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Cao X, Dong Y, Yu H, Liu X, Gu Y, Song J, Ouyang P, Hong Z. The effect of sitting baduanjin in patients with ST-segment elevation acute myocardial infarction after percutaneous coronary intervention: A quasi-experimental study. Heart Lung 2024; 66:78-85. [PMID: 38593677 DOI: 10.1016/j.hrtlng.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Early cardiac rehabilitation plays a crucial role in the recovery of patients with ST-segment elevation acute myocardial infarction (STEMI) following percutaneous coronary intervention (PCI). This study sought to determine the effect of a program of sitting Baduanjin exercises on early cardiac rehabilitation. OBJECTIVE The goal of this study was to investigate the effects of sitting Baduanjin exercises on cardiovascular and psychosocial functions in patients with STEMI following PCI. METHODS This quasi-experimental study employed a randomized, non-equivalent group design. Patients in the intervention group received daily sitting Baduanjin training in addition to a series of seven-step rehabilitation exercises, whereas those in the control group received only the seven-step rehabilitation training, twice daily. Differences in heart rate variability (HRV) indicators, exercise capacity (Six-Minute Walking Distance; 6-MWD), anxiety (Generalized Anxiety Disorder-7; GAD-7), and depression (Patient Health Questionnaire-9; PHQ-9) between the two study groups during hospitalization were analyzed. RESULTS Patients in the intervention group exhibited lower rates of abnormalities in the time domain and frequency domain parameters of HRV. The median scores of GAD-7 and PHQ-9 in both groups were lower than those at the time of admission, with the intervention group exhibiting lower scores than the control group (P < 0.001; P < 0.001, respectively). The 6-MWD after the intervention was greater in the intervention group compared to the control group (P = 0.014). CONCLUSIONS We found that sitting Baduanjin training has the potential to enhance HRV, cardiac function, and psychological well-being in patients with STEMI after PCI. This intervention can potentially improve the exercise capacity of a patient before discharge.
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Affiliation(s)
- Xiaocui Cao
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China
| | - Yanyan Dong
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China
| | - Hongjing Yu
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China
| | - Xuemei Liu
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China
| | - Yuqin Gu
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China
| | - Jian Song
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China
| | - Peng Ouyang
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China
| | - Zehang Hong
- Departmengt of Cardiovascular Medicine, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong province, China.
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Chen S, Zhang W, Wang D, Chen Z. How robot-assisted gait training affects gait ability, balance and kinematic parameters after stroke: a systematic review and meta-analysis. Eur J Phys Rehabil Med 2024; 60:400-411. [PMID: 38647534 DOI: 10.23736/s1973-9087.24.08354-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Gait ability is often cited by stroke survivors. Robot-assisted gait training (RAGT) can help stroke patients with lower limb motor impairment regain motor coordination. EVIDENCE ACQUISITION PubMed, Cochrane Library, Embase were systematically searched until September 2023, to identify randomized controlled trials presenting: stroke survivors as participants; RAGT as intervention; conventional rehabilitation as a comparator; gait assessment, through scales or quantitative parameters, as outcome measures. EVIDENCE SYNTHESIS Twenty-seven publications involving 1167 patients met the inclusion criteria. Meta-analysis showed no significant differences in speed, cadence, spatial symmetry, and changes in joint mobility angles between the RAGT group and the control group. In addition, RAGT was associated with changes in affected side step length (SMD=0.02, 95% CI: 0.01, 0.03; P<0.0001), temporal symmetry (SMD=-0.38, 95% CI: -0.6, -0.16; P=0.0006], Six-Minute Walk Test (SMD=25.14, 95% CI: 10.19, 40.09; P=0.0010] and Functional Ambulation Categories (SMD=0.32, 95% CI: 0.01, 0.63; P=0.04). According to the PEDro scale, 19 (70.4%) studies were of high quality and eight were of moderate quality (29.6%). CONCLUSIONS Taken together, the review synthesis showed that RAGT might have a potential role in the recovery of walking dysfunction after stroke. However, its superiority over conventional rehabilitation requires further research. Additionally, it may provide unexpected benefits that the effects of RAGT with different types or treatment protocols were further compared.
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Affiliation(s)
- Shishi Chen
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Department of Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wanying Zhang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Department of Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Dingyu Wang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhaoming Chen
- Center for Rehabilitation Medicine, Rehabilitation and Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China -
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Huang Y, Hu B, Chen S, Jiang Z, Dai Z, Jiang Z, Liu C, Xu Y, Chen X, Jin W, Yu B, Zhang X. The role of serum chloride ion in the prognosis of COPD. Am J Med Sci 2024:S0002-9629(24)01221-7. [PMID: 38777153 DOI: 10.1016/j.amjms.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 04/21/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND As exacerbations of chronic obstructive pulmonary disease (COPD) are one of the leading causes of hospitalization and are associated with significant mortality, it is particularly important to accurately assess the risk of exacerbations in COPD. Most of the current clinical biomarkers are related to inflammation and few consider how ion levels affect COPD. Chloride ion, the second most abundant serum electrolyte, has been shown to be associated with poor prognoses in several diseases, but their relationship with COPD remains unclear. METHODS In total, 105 patients with acute exacerbations of COPD were recruited. Data on clinical characteristics, lung function, blood count, blood biochemistry, relevant scales including the Clinical COPD Questionnaire (CCQ), BODE (BMI, airflow obstruction, dyspnea, exercise capacity) index and the St. George's Respiratory Questionnaire (SGRQ) were collected from all patients for statistical analysis. RESULT There were significant differences in lung function indicators and disease severity in the low chloride ion subgroup compared with the high chloride ion subgroup. On multiple logistic regression analysis, chloride ion was an independent factor affecting lung function in COPD patients (OR = 0.808, 95% CI: 0.708 - 0.922, p = 0.002). The sensitivity of chloride ion in predicting COPD severity was 78%, the specificity was 63%, and the area under the curve was 0.734 (p < 0.001). Subgroup analysis showed that chloride ion was a stronger predictor in male and smoking patients. CONCLUSIONS Chloride ion was a novel prognostic biomarker for COPD, and low levels of chloride ion were independently associated with exacerbations in COPD patients.
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Affiliation(s)
- Yiben Huang
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Binbin Hu
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Siyao Chen
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Zerui Jiang
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Zicong Dai
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Zihan Jiang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chunyan Liu
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yage Xu
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xianjing Chen
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wanzhong Jin
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Beibei Yu
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaodiao Zhang
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Tan Y, Xie Y, Dong G, Yin M, Shang Z, Zhou K, Bao D, Zhou J. The Effect of 14-Day Consumption of Hydrogen-Rich Water Alleviates Fatigue but Does Not Ameliorate Dyspnea in Long-COVID Patients: A Pilot, Single-Blind, and Randomized, Controlled Trial. Nutrients 2024; 16:1529. [PMID: 38794767 PMCID: PMC11123997 DOI: 10.3390/nu16101529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/02/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: Hydrogen (H2) may be a potential therapeutic agent for managing Long COVID symptoms due to its antioxidant and anti-inflammatory properties. However, more scientific literature is needed to describe the effects of H2 administration on treating symptoms. A study aimed to investigate the impact of hydrogen-rich water (HRW) administration on the fatigue and dyspnea of Long-COVID patients for 14 consecutive days. (2) Methods: In this randomized, single-blind, placebo-controlled study, 55 participants were recruited, and 23 of them were excluded. A total of 32 eligible participants were randomized into a hydrogen-rich water (HRW) group (n = 16) and a placebo water (PW) group (n = 16) in which they were instructed to consume hydrogen-rich water or placebo water for 14 days, respectively. The participants completed the Fatigue Severity Scale (FSS), Six-Minute Walk Test (6MWT), 30 s Chair Stand Test (30s-CST), Modified Medical Research Council Dyspnea Rating Scale (mMRC), Pittsburgh Sleep Quality Index (PSQI), and depression anxiety stress scale (DASS-21) before and after the intervention. A linear mixed-effects model was used to analyze the effects of HRW. Cohen's d values were used to assess the effect size when significance was observed. The mean change with 95% confidence intervals (95% CI) was also reported. (3) Results: The effects of HRW on lowering FSS scores (p = 0.046, [95% CI = -20.607, -0.198, d = 0.696] and improving total distance in the 6WMT (p < 0.001, [95% CI = 41.972, 61.891], d = 1.010), total time for the 30s-CST (p = 0.002, [95% CI = 1.570, 6.314], d = 1.190), and PSQI scores (p = 0.012, [95% CI = -5.169, 0.742], d = 1.274) compared to PW were of a significantly moderate effect size, while there was no significant difference in mMRC score (p = 0.556) or DASS-21 score (p > 0.143). (4) Conclusions: This study demonstrates that HRW might be an effective strategy for alleviating fatigue and improving cardiorespiratory endurance, musculoskeletal function, and sleep quality. Still, it does not ameliorate dyspnea among Long-COVID patients.
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Affiliation(s)
- Yineng Tan
- School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China;
| | - Yixun Xie
- College of Swimming, Beijing Sport University, Beijing 100084, China;
| | - Gengxin Dong
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing 100084, China;
| | - Mingyue Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China;
| | - Zhangyuting Shang
- College of Physical Education and Health Management, Chongqing University of Education, Chongqing 400065, China;
| | - Kaixiang Zhou
- College of Physical Education and Health Science, Chongqing Normal University, Chongqing 401331, China
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Junhong Zhou
- Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA 02115, USA;
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O'Sullivan O, Felton J, Mclean S, Bennett AN. Six-minute walk test in healthy British service personnel. BMJ Mil Health 2024:e002720. [PMID: 38754972 DOI: 10.1136/military-2024-002720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION The 6 min walk test (6MWT) is a widely used, safe and effective submaximal exercise test. The primary outcome is the distance walked, but additional physiological and patient-reported metrics can be recorded. It is used to assess function and is commonly used within UK Defence Rehabilitation. However, there are no published British military 6MWT data in a non-injured population. This study reports the 6MWT procedure and results from healthy British service personnel. METHODS A convenience sample of 46 individuals (male n=40) undertook 95 6MWTs over three study visits throughout a year. They were performed on a 20 m straight-line route, administered by an exercise rehabilitation instructor and preceded by anthropometric measurements (height, weight). Physiological measures (HR, oxygen saturations (SpO2)) and patient-reported measures (Borg shortness of breath (SoB), rate of perceived exertion (RPE) and fatigue) were taken before and after the assessment. Statistical tests were performed between pre-test and post-test measures, and sex and body mass, and concurrent cardiopulmonary exercise tests (CPET) with 6MWT distance. RESULTS The mean 6MWT distance was 705.5±86 m; males 709.4±86.9 m and females 685.9±81.9 m (p=0.32), with a median Borg SoB of 1 (IQR: 0-2) and RPE 9 (IQR: 7-11), and a negative correlation between body mass index and 6MWT distance, p=0.007. There were no significant differences between pre-test and post-test measures. Peak workload and VO2 Max correlated weakly with 6MWT distance (0.336, p=0.01 and 0.375, p=0.09, respectively), but submaximal CPET measures did not. CONCLUSION These results provide a benchmark for British military 6MWT data to guide clinical and research use. However, a larger dataset is required for validation and normative values.
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Affiliation(s)
- Oliver O'Sullivan
- Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, UK
- Academic Unit of Injury, Recovery and Inflammation Science, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - J Felton
- DMRC Stanford Hall, Loughborough, UK
| | - S Mclean
- DMRC Stanford Hall, Loughborough, UK
| | - A N Bennett
- Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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Wickerson LM, de Paula Ferreira M, Rozenberg D, Mathur S, Singer LG. In-Person Versus Remote 6-Minute Walk and Incremental Shuttle Walk Distances in Advanced Lung Disease. Respir Care 2024; 69:557-565. [PMID: 38649272 PMCID: PMC11147615 DOI: 10.4187/respcare.11417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Field-based walk tests conducted remotely may provide an alternative method to a facility-based assessment of exercise capacity for people with advanced lung disease. This prospective study evaluated the level of agreement in the distance walked between a 6-min walk test (6MWT) and an incremental shuttle walk test performed by using standard in-person procedures and test variations and settings. METHODS Adults with advanced lung disease underwent 4 study visits: (i) one in-person standard 6MWT (30-m corridor) and one in-person treadmill 6MWT, (ii) a remote 6MWT in a home setting (10-m corridor), (iii) 2 in-person standard incremental shuttle walk tests (10-m corridor), and (iv) a remote incremental shuttle walk test in a home setting (10-m corridor). A medical-grade oximeter measured heart rate and oxygen saturation before, during, and for 2 min after the tests. RESULTS Twenty-eight participants were included (23 men [82%]; 64 (57-67) y old; 19 with interstitial lung disease [68%] and 9 with COPD [32%]; and 26 used supplemental oxygen (93%) [exertional [Formula: see text] of 0.46 ± 0.1]). There was no agreement between the tests. Greater walking distances were achieved with standard testing procedures: in-person 6MWT versus treadmill 6MWT (355 ± 68 vs 296 ± 97; P = .001; n = 28), in-person 6MWT versus remote 6MWT (349 ± 68 vs 293 ± 84; P = .001; n = 24), and in-person incremental shuttle walk test versus remote incremental shuttle walk test (216 ± 62 vs 195 ± 63; P = .03; n = 22). CONCLUSIONS Differences in the distance walked may have resulted from different track lengths, widths, and walking surfaces. This should be considered in test interpretation if tests are repeated under different conditions.
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Affiliation(s)
- Lisa M Wickerson
- Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
- Department of Physical Therapy, University of Toronto, Ontario, Canada
- Canadian Donation and Transplantation Research Program, University of Alberta, Li Ka Shing Centre for Health Research Innovation, Edmonton, Alberta, Canada
| | - Manoela de Paula Ferreira
- Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Ontario, Canada
- Canadian Donation and Transplantation Research Program, University of Alberta, Li Ka Shing Centre for Health Research Innovation, Edmonton, Alberta, Canada
| | - Dmitry Rozenberg
- Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Respirology, Toronto, Ontario, Canada
| | - Sunita Mathur
- Canadian Donation and Transplantation Research Program, University of Alberta, Li Ka Shing Centre for Health Research Innovation, Edmonton, Alberta, Canada
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Lianne G Singer
- Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Respirology, Toronto, Ontario, Canada
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15
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Dignam JP, Sharma S, Stasinopoulos I, MacLean MR. Pulmonary arterial hypertension: Sex matters. Br J Pharmacol 2024; 181:938-966. [PMID: 37939796 DOI: 10.1111/bph.16277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 11/10/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a complex disease of multifactorial origin. While registries have demonstrated that women are more susceptible to the disease, females with PAH have superior right ventricle (RV) function and a better prognosis than their male counterparts, a phenomenon referred to as the 'estrogen paradox'. Numerous pre-clinical studies have investigated the involvement of sex hormones in PAH pathobiology, often with conflicting results. However, recent advances suggest that abnormal estrogen synthesis, metabolism and signalling underpin the sexual dimorphism of this disease. Other sex hormones, such as progesterone, testosterone and dehydroepiandrosterone may also play a role. Several non-hormonal factor including sex chromosomes and epigenetics have also been implicated. Though the underlying pathophysiological mechanisms are complex, several compounds that modulate sex hormones levels and signalling are under investigation in PAH patients. Further elucidation of the estrogen paradox will set the stage for the identification of additional therapeutic targets for this disease.
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Affiliation(s)
- Joshua P Dignam
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK
| | - Smriti Sharma
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK
| | - Ioannis Stasinopoulos
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Margaret R MacLean
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK
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Al Yammahi RJ, Alaparthi GK, de Sá Ferreira A, Bairapareddy KC, Hegazy FA. Cardiopulmonary Response in Post-COVID-19 Individuals: A Cross-Sectional Study Comparing the Londrina Activities of Daily Living Protocol, 6-Minute Walk Test, and Glittre Activities of Daily Living Test. Healthcare (Basel) 2024; 12:712. [PMID: 38610135 PMCID: PMC11011697 DOI: 10.3390/healthcare12070712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
This study addresses the imperative need for reliable assessment protocols in guiding rehabilitation interventions for individuals post-COVID-19, considering the enduring physiological effects of the virus. A cohort of 40 post-COVID-19 individuals underwent assessments using the Londrina ADL protocol, Glittre ADL test, and the 6-minute walk test (6MWT). Physiological parameters were recorded during and after each test, including heart rate, respiratory rate, and oxygen saturation. The post hoc comparisons between the pre-test and post-test cardiopulmonary response of the three tests showed significant differences, except diastolic blood pressure (6MWT vs. Londrina ADL protocol), heart rate (6MWT vs. Londrina ADL protocol), respiratory rate (6MWT vs. Londrina ADL protocol), blood oxygen level (SpO2) (6MWT vs. Londrina ADL protocol), dyspnea (Londrina ADL protocol vs. Glittre ADL test), and fatigue (Londrina ADL protocol vs. Glittre ADL test). The Londrina ADL protocol demonstrated cardio-pulmonary responses comparable to the Glittre ADL test, as well as the 6MWT, emphasizing its effectiveness in evaluating walking-related outcomes. The study concludes that the Londrina ADL protocol is a robust and practical tool for the routine clinical testing of daily living activities in post-COVID-19 individuals. While the 6MWT remains valuable for assessing walking-related outcomes, a combined approach employing the Londrina ADL protocol and 6MWT offers a comprehensive strategy for evaluating multifaceted functional capacities in this population.
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Affiliation(s)
- Reem Jasim Al Yammahi
- Department of Physiotherapy, College of Health Science, University of Sharjah, Sharjah 27272, United Arab Emirates; (R.J.A.Y.); (G.K.A.); (K.C.B.)
| | - Gopala Krishna Alaparthi
- Department of Physiotherapy, College of Health Science, University of Sharjah, Sharjah 27272, United Arab Emirates; (R.J.A.Y.); (G.K.A.); (K.C.B.)
- Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester M15 6BX, UK
| | - Arthur de Sá Ferreira
- Postgraduate Program in Rehabilitation Sciences, Augusto Motta University Center (UNISUAM), Rua Dona Isabel 94, Bonsucesso, Rio de Janeiro 21032-060, Brazil;
| | - Kalyana Chakravarthy Bairapareddy
- Department of Physiotherapy, College of Health Science, University of Sharjah, Sharjah 27272, United Arab Emirates; (R.J.A.Y.); (G.K.A.); (K.C.B.)
| | - Fatma A. Hegazy
- Department of Physiotherapy, College of Health Science, University of Sharjah, Sharjah 27272, United Arab Emirates; (R.J.A.Y.); (G.K.A.); (K.C.B.)
- Faculty of Physical Therapy, Cairo University, Cairo 12613, Egypt
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Li C, Feng X, Li S, He X, Luo Z, Cheng X, Yao J, Xiao J, Wang X, Wen D, Liu D, Li Y, Zhou H, Ma L, Lin T, Cai X, Lin Y, Guo L, Yang M. Tetrahedral DNA loaded siCCR2 restrains M1 macrophage polarization to ameliorate pulmonary fibrosis in chemoradiation-induced murine model. Mol Ther 2024; 32:766-782. [PMID: 38273656 PMCID: PMC10928155 DOI: 10.1016/j.ymthe.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/05/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic lethal disease in the absence of demonstrated efficacy for preventing progression. Although macrophage-mediated alveolitis is determined to participate in myofibrotic transition during disease development, the paradigm of continuous macrophage polarization is still under-explored due to lack of proper animal models. Here, by integrating 2.5 U/kg intratracheal Bleomycin administration and 10 Gy thorax irradiation at day 7, we generated a murine model with continuous alveolitis-mediated fibrosis, which mimics most of the clinical features of our involved IPF patients. In combination with data from scRNA-seq of patients and a murine IPF model, a decisive role of CCL2/CCR2 axis in driving M1 macrophage polarization was revealed, and M1 macrophage was further confirmed to boost alveolitis in leading myofibroblast activation. Multiple sticky-end tetrahedral framework nucleic acids conjunct with quadruple ccr2-siRNA (FNA-siCCR2) was synthesized in targeting M1 macrophages. FNA-siCCR2 successfully blocked macrophage accumulation in pulmonary parenchyma of the IPF murine model, thus preventing myofibroblast activation and leading to the disease remitting. Overall, our studies lay the groundwork to develop a novel IPF murine model, reveal M1 macrophages as potential therapeutic targets, and establish new treatment strategy by using FNA-siCCR2, which are highly relevant to clinical scenarios and translational research in the field of IPF.
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Affiliation(s)
- Chen Li
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Xiaorong Feng
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Songhang Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xing He
- School of Clinical Medicine, Chengdu Medical College, Chengdu 610500, China
| | - Zeli Luo
- Department of Pulmonary and Critical Care Medicine, Wenjiang Hospital of Sichuan Provincial People's, Chengdu 611138, China
| | - Xia Cheng
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Jie Yao
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Jie Xiao
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Xiaofei Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Dingke Wen
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Duanya Liu
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Yanfei Li
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Hong Zhou
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610056, China
| | - Lu Ma
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tongyu Lin
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Xiaoxiao Cai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; College of Biomedical Engineering, Sichuan University, Chengdu 610041, China
| | - Yunfeng Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; College of Biomedical Engineering, Sichuan University, Chengdu 610041, China.
| | - Lu Guo
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
| | - Mu Yang
- Centre for Translational Research in Cancer, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China.
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Ferrari F, Stein R. Is There an Association Between Timed Up and Go Test Performance Results and Directly Measured Peak Oxygen Consumption in Patients with Heart Disease? Arq Bras Cardiol 2024; 120:e20230832. [PMID: 38451619 PMCID: PMC11021033 DOI: 10.36660/abc.20230832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Filipe Ferrari
- Universidade Federal do Rio Grande do SulHospital de Clínicas de Porto AlegrePorto AlegreRSBrasilPrograma de Pós-Graduação em Cardiologia e Ciências Cardiovasculares – Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS – Brasil
- Universidade Federal do Rio Grande do SulHospital de Clínicas de Porto AlegreGrupo de Pesquisa em Cardiologia do ExercícioPorto AlegreRSBrasilGrupo de Pesquisa em Cardiologia do Exercício (CardioEx) – Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS – Brasil
| | - Ricardo Stein
- Universidade Federal do Rio Grande do SulHospital de Clínicas de Porto AlegrePorto AlegreRSBrasilPrograma de Pós-Graduação em Cardiologia e Ciências Cardiovasculares – Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS – Brasil
- Universidade Federal do Rio Grande do SulHospital de Clínicas de Porto AlegreGrupo de Pesquisa em Cardiologia do ExercícioPorto AlegreRSBrasilGrupo de Pesquisa em Cardiologia do Exercício (CardioEx) – Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS – Brasil
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Tainta M, Ecay-Torres M, de Arriba M, Barandiaran M, Otaegui-Arrazola A, Iriondo A, Garcia-Sebastian M, Estanga A, Saldias J, Clerigue M, Gabilondo A, Ros N, Mugica J, Barandiaran A, Mangialasche F, Kivipelto M, Arrospide A, Mar J, Martinez-Lage P. GOIZ ZAINDU study: a FINGER-like multidomain lifestyle intervention feasibility randomized trial to prevent dementia in Southern Europe. Alzheimers Res Ther 2024; 16:44. [PMID: 38413990 PMCID: PMC10898038 DOI: 10.1186/s13195-024-01393-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND GOIZ ZAINDU ("caring early" in Basque) is a pilot study to adapt the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) methodology to the Basque population and evaluate the feasibility and adherence to a FINGER-like multidomain intervention program. Additional aims included the assessment of efficacy on cognition and data collection to design a large efficacy trial. METHOD GOIZ ZAINDU is a 1-year, randomized, controlled trial of a multidomain intervention in persons aged 60+ years, with Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score ≥ 6, no diagnosis of dementia, and below-than-expected performance in at least one of three cognitive screening tests. Randomization to a multidomain intervention (MD-Int) or regular health advice (RHA) was stratified by sex, age (>/≤ 75), and cognitive status (mild cognitive impairment (MCI)/normal cognition). MD-Int included cardiovascular risk factor control, nutritional counseling, physical activity, and cognitive training. The primary outcomes were retention rate and adherence to the intervention program. Exploratory cognitive outcomes included changes in the Neuropsychological Test Battery z-scores. Analyses were performed according to the intention to treat. RESULTS One hundred twenty-five participants were recruited (mean age: 75.64 (± 6.46); 58% women). The MD-Int (n = 61) and RHA (n = 64) groups were balanced in terms of their demographics and cognition. Fifty-two (85%) participants from the RHA group and 56 (88%) from the MD-Int group completed the study. More than 70% of the participants had high overall adherence to the intervention activities. The risk of cognitive decline was higher in the RHA group than in the MD-Int group in terms of executive function (p =.019) and processing speed scores (p =.026). CONCLUSIONS The GOIZ-ZAINDU study proved that the FINGER methodology is adaptable and feasible in a different socio-cultural environment. The exploratory efficacy results showed a lower risk of decline in executive function and processing speed in the intervention group. These results support the design of a large-scale efficacy trial. TRIAL REGISTRATION GOIZ ZAINDU feasibility trial was approved and registered by the Euskadi Drug Research Ethics Committee (ID: PI2017134) on 23 January 2018. Retrospectively registered in ClinicalTrials.gov (NCT06163716) on 8 December 2023.
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Affiliation(s)
- Mikel Tainta
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | | | - Maria de Arriba
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | - Myriam Barandiaran
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | | | - Ane Iriondo
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | | | - Ainara Estanga
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | - Jon Saldias
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | | | - Alazne Gabilondo
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Bidasoa, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | - Naia Ros
- University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
| | - Justo Mugica
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
| | - Aitziber Barandiaran
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Arantzazu Arrospide
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | - Javier Mar
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
- Instituto de Investigación en Servicios Sanitarios Kronikgune, Barakaldo, Spain
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Kang A, Regmi B, Cornelissen C, Smith J, Daher A, Dreher M, Spiesshoefer J. Persistence of Diffusion Capacity Impairment and Its Relationship with Dyspnea 12 Months after Hospitalization for COVID-19. J Clin Med 2024; 13:1234. [PMID: 38592095 PMCID: PMC10931668 DOI: 10.3390/jcm13051234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/07/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Dyspnea is a common persistent symptom after acute coronavirus disease 2019 illness (COVID-19). One potential explanation for post-COVID-19 dyspnea is a reduction in diffusion capacity. This longitudinal study investigated diffusion capacity and its relationship with dyspnea on exertion in individuals previously hospitalized with COVID-19. Methods: Eligible participants had been hospitalized for the treatment of acute COVID-19 and were assessed at 6 weeks, 6 months, and 12 months after discharge. Pulmonary function testing, diffusion capacity of carbon monoxide (DLCO), blood gas analysis and the level of dyspnea (Borg scale; before and after a 6 min walk test [6 MWT]) were performed. Participants were divided into subgroups based on the presence or absence of dyspnea during the 6 MWT at 12 months after hospitalization. Results: Seventy-two participants (twenty-two female, mean age 59.8 ± 13.5 years) were included. At 12 months after discharge, 41/72 participants (57%) had DLCO below the lower limit of normal and 56/72 (78%) had DLCO < 80% of the predicted value. Individuals with exertional dyspnea had significantly lower DLCO than those without exertional dyspnea (p = 0.001). In participants with DLCO data being available at three timepoints over 12 months (baseline, 6 months, and 12 months) after discharge (n = 25), DLCO improved between 6 weeks and 6 months after hospital discharge, but not thereafter (p = 0.017). Conclusions: About 2/3 of the post-COVID individuals in this study had impaired diffusion capacity at 12 months after hospital discharge. There was an association between persisting dyspnea on exertion and significantly reduced DLCO. Impaired diffusion capacity improved over the first 6 months after hospitalization but not thereafter.
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Affiliation(s)
- Alice Kang
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.K.)
| | - Binaya Regmi
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.K.)
| | - Christian Cornelissen
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.K.)
| | - Judith Smith
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.K.)
| | - Ayham Daher
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.K.)
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.K.)
| | - Jens Spiesshoefer
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, 52074 Aachen, Germany; (A.K.)
- Interdisciplinary Health Science Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
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21
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Liang Y, Chen S, Song J, Deng T, Yang J, Long Y, Suen LKP, Luo X. The effect of incentive spirometry in perioperative patients with lung cancer-a systematic review and meta-analysis. BMC Pulm Med 2024; 24:88. [PMID: 38360672 PMCID: PMC10870616 DOI: 10.1186/s12890-024-02878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Incentive spirometry (IS) as a routine respiratory therapy during the perioperative period has been widely used in clinical practice. However, the impact of IS on patients with perioperative lung cancer remains controversial. This review aimed to evaluate the efficacy of IS in perioperative pulmonary rehabilitation for patients with lung cancer. METHODS Cochrane Library, PubMed, Web of Science, Ovid, CINAHL, Chinese National Knowledge Infrastructure, Weipu, and Wanfang Databases were searched from inception to 30 November 2023. Only randomized controlled trials were included in this systematic review. The PRISMA checklist served as the guidance for conducting this review. The quality assessment of the included studies was assessed by the Cochrane risk-of-bias tool. The meta-analysis was carried out utilizing Review Manager 5.4. Furthermore, sensitivity analysis and subgroup analysis were also performed. RESULTS Nine studies recruited 1209 patients met our inclusion criteria. IS combined with other respiratory therapy techniques was observed to reduce the incidence of postoperative pulmonary complications, enhance pulmonary function, curtail the length of hospital stay, and lower the Borg score. Nevertheless, no improvements were found in the six-minute walk distance or quality of life score. CONCLUSIONS Although IS demonstrates benefits as a component of comprehensive intervention measures for perioperative patients with lung cancer, it proves challenging to determine the precise impact of IS as a standalone component within the comprehensive intervention measures. Therefore, further researches are required to better understand the effectiveness of IS isolation and its interactions when integrated with additional respiratory therapies for these patients. CLINICAL TRIAL REGISTRATION PROSPERO, https://www.crd.york.ac.uk/prospero/ , registry number: CRD42022321044.
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Affiliation(s)
- Yan Liang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi City, Guizhou Province, 563000, China
- School of Nursing, Zunyi Medical University, No 6, Xuefu West Road, Zunyi City, Guizhou Province, 563000, China
| | - Shaolin Chen
- Nursing Department, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi City, Guizhou Province, 563000, China
- School of Nursing, Zunyi Medical University, No 6, Xuefu West Road, Zunyi City, Guizhou Province, 563000, China
| | - Jiamei Song
- Nursing Department, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi City, Guizhou Province, 563000, China
- School of Nursing, Zunyi Medical University, No 6, Xuefu West Road, Zunyi City, Guizhou Province, 563000, China
| | - Ting Deng
- Nursing Department, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi City, Guizhou Province, 563000, China
- School of Nursing, Zunyi Medical University, No 6, Xuefu West Road, Zunyi City, Guizhou Province, 563000, China
| | - Jinfen Yang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi City, Guizhou Province, 563000, China
- School of Nursing, Zunyi Medical University, No 6, Xuefu West Road, Zunyi City, Guizhou Province, 563000, China
| | - Yangyang Long
- School of Nursing, Zunyi Medical University, No 6, Xuefu West Road, Zunyi City, Guizhou Province, 563000, China
| | | | - Xu Luo
- School of Medical Informatics and Engineering, Zunyi Medical University, No 6, Xuefu West Road, Zunyi City, Guizhou Province, 563000, China.
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22
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Tuğral A, Arıbaş Z, Akyol M, Bakar Y. Understanding changes in pulmonary function and functional status in breast cancer patients after systemic chemotherapy and radiotherapy: a prospective study. BMC Pulm Med 2024; 24:83. [PMID: 38355489 PMCID: PMC10865615 DOI: 10.1186/s12890-024-02890-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Respiratory complications in breast cancer (BC) patients after chemotherapy (CT) and radiotherapy (RT) have been well acquainted and these complications should be investigated to prevent secondary problems and/or improve BC patients' clinical outcomes. Therefore, this study aimed to assess the potential acute effect of systemic chemotherapy and radiotherapy on respiratory function and functional status of patients with breast cancer. METHODS A total of 25 BC patients who were candidates for systemic chemotherapy and radiotherapy were recruited after oncological examination and included in this study. Respiratory function and functional status were assessed with the Pulmonary Function Test (PFT) and the Six-Minute Walk Test (6MWT), respectively. Patients were assessed before CT (c0), after CT (c1), and after RT (r1). RESULTS 25 BC patients were assessed in c0 and c1 while only 15 out of 25 patients (60%) were assessed in r1. The actual values of Forced vital capacity (FVC) (t = 2.338, p =.028), Forced expiratory volume in 1s (FEV1 (t = 2.708, p =.012), and the forced expiratory flow of between 25% and 75% of vital capacity (FEF25-75%) (t = 2.200, p =.038) were found significantly different after systemic CT. Inspiratory (MIP) and expiratory (MEP) muscle strength also did not show a significant change from c0 to c1. A significant effect of the type of surgery was found (Wilks' lambda, F [1, 19] = 6.561, p =.019, ηp2 = 0.25) between c0 and c1 in actual FVC value. The main effect of time was found significant in FVC (F [2, 28] = 4.840, p =.016, ηp2 = 0.25) from c0 to r1. Pairwise comparisons with Bonferroni correction showed that there was a significant difference between c0 and r1 (p =.037). DISCUSSION The present study showed decreased FVC and FEV1 actual values and percent predicted rates from baseline to the completion of treatment. Since the interactional effect of the type of surgery was significant, we suggest that clinical and demographic factors such as age should be considered when interpreting the early changes in PFT. In addition, the significant linear trend of decreasing in some specific outcomes in respiratory function also highlighted the need for continuous monitoring of potential respiratory problems in patients with BC from baseline to the completion of chemotherapy and radiotherapy.
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Affiliation(s)
- Alper Tuğral
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Bakırçay University, Izmir, Turkey.
| | - Zeynep Arıbaş
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Trakya University, Edirne, Turkey
| | - Murat Akyol
- Faculty of Medicine, Department of Medical Oncology, Izmir Bakırçay University, Izmir, Turkey
| | - Yeşim Bakar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Bakırçay University, Izmir, Turkey
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23
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Ramli AA, Liu X, Berndt K, Chuah CN, Goude E, Kaethler LB, Lopez A, Nicorici A, Owens C, Rodriguez D, Wang J, Aranki D, McDonald CM, Henricson EK. Gait Event Detection and Travel Distance Using Waist-Worn Accelerometers across a Range of Speeds: Automated Approach. SENSORS (BASEL, SWITZERLAND) 2024; 24:1155. [PMID: 38400313 PMCID: PMC10891633 DOI: 10.3390/s24041155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/03/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
Estimation of temporospatial clinical features of gait (CFs), such as step count and length, step duration, step frequency, gait speed, and distance traveled, is an important component of community-based mobility evaluation using wearable accelerometers. However, accurate unsupervised computerized measurement of CFs of individuals with Duchenne muscular dystrophy (DMD) who have progressive loss of ambulatory mobility is difficult due to differences in patterns and magnitudes of acceleration across their range of attainable gait velocities. This paper proposes a novel calibration method. It aims to detect steps, estimate stride lengths, and determine travel distance. The approach involves a combination of clinical observation, machine-learning-based step detection, and regression-based stride length prediction. The method demonstrates high accuracy in children with DMD and typically developing controls (TDs) regardless of the participant's level of ability. Fifteen children with DMD and fifteen TDs underwent supervised clinical testing across a range of gait speeds using 10 m or 25 m run/walk (10 MRW, 25 MRW), 100 m run/walk (100 MRW), 6-min walk (6 MWT), and free-walk (FW) evaluations while wearing a mobile-phone-based accelerometer at the waist near the body's center of mass. Following calibration by a trained clinical evaluator, CFs were extracted from the accelerometer data using a multi-step machine-learning-based process and the results were compared to ground-truth observation data. Model predictions vs. observed values for step counts, distance traveled, and step length showed a strong correlation (Pearson's r = -0.9929 to 0.9986, p < 0.0001). The estimates demonstrated a mean (SD) percentage error of 1.49% (7.04%) for step counts, 1.18% (9.91%) for distance traveled, and 0.37% (7.52%) for step length compared to ground-truth observations for the combined 6 MWT, 100 MRW, and FW tasks. Our study findings indicate that a single waist-worn accelerometer calibrated to an individual's stride characteristics using our methods accurately measures CFs and estimates travel distances across a common range of gait speeds in both DMD and TD peers.
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Affiliation(s)
- Albara Ah Ramli
- Department of Computer Science, School of Engineering, University of California, 1 Shields Ave, Davis, CA 95616, USA; (A.A.R.); (X.L.)
| | - Xin Liu
- Department of Computer Science, School of Engineering, University of California, 1 Shields Ave, Davis, CA 95616, USA; (A.A.R.); (X.L.)
| | - Kelly Berndt
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Chen-Nee Chuah
- Department of Electrical and Computer Engineering, School of Engineering, University of California, 1 Shields Ave, Davis, CA 95616, USA
| | - Erica Goude
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Lynea B. Kaethler
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Amanda Lopez
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Alina Nicorici
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Corey Owens
- UC Davis Center for Health and Technology, School of Medicine, University of California Davis, 1 Shields Ave, Davis, CA 95616, USA;
| | - David Rodriguez
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Jane Wang
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Daniel Aranki
- Berkeley School of Information, University of California Berkeley, 1 Shields Ave, Berkeley, CA 94720, USA;
| | - Craig M. McDonald
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
| | - Erik K. Henricson
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of California, 1 Shields Ave, Davis, CA 95616, USA; (K.B.); (E.G.); (L.B.K.); (A.L.); (A.N.); (D.R.); (J.W.); (C.M.M.)
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24
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Ruiz-Margáin A, Macías-Rodríguez RU, Flores-García NC, Román Calleja BM, Fierro-Angulo OM, González-Regueiro JA. Assessing nutrition status, sarcopenia, and frailty in adult transplant recipients. Nutr Clin Pract 2024; 39:14-26. [PMID: 38097210 DOI: 10.1002/ncp.11107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 01/13/2024] Open
Abstract
The assessment of nutrition status, sarcopenia, and frailty holds significant relevance in the context of adult transplantation, as these factors are associated with an unfavorable prognosis; thus, transplant candidates must undergo a full nutrition assessment. Screening tools may be used to prioritize patients, this can be done using the Nutrition Risk Screening 2002 or Royal Free Hospital-Nutritional Prioritizing Tool. Subsequently, a thorough nutrition-focused physical examination should be conducted to evaluate clinical signs of nutrition deficiencies, fat and muscle loss, and fluid overload; dietary history and current intake must also be assessed. Apart from physical examination, specific testing for sarcopenia and frailty are recommended. For sarcopenia assessment, specifically for muscle quantification, the gold standard is the cross-sectional measurement of the muscle at L3 obtained from a computed tomography scan or magnetic resonance imaging; dual-energy x-ray absorptiometry is also a good tool especially when appendicular skeletal muscle index is calculated. Other more readily available options include phase angle from bioelectrical impedance or bioimpedance spectroscopy. In the sarcopenia assessment, muscle function evaluation is required, handgrip strength stands as the primary test for this purpose; this test is also part of the subjective global assessment and is included in some frailty scores. Finally, for frailty assessment, the Short Physical Performance Battery is useful for evaluating physical frailty, and for a multidimensional evaluation, the Fried frailty phenotype can be used. Specifically for liver transplant candidates, the use of Liver Frailty Index is recommended.
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Affiliation(s)
- Astrid Ruiz-Margáin
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ricardo U Macías-Rodríguez
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Nayelli C Flores-García
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Berenice M Román Calleja
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Oscar M Fierro-Angulo
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José A González-Regueiro
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Lanéelle D, Hughes M, Stacey BS, Bashir M, Williams IM, Lewis MH, Bailey DM. Supervised exercise training improves cardiorespiratory fitness and reduces perioperative risk in peripheral artery disease patients with intermittent claudication. Ann R Coll Surg Engl 2024; 106:185-194. [PMID: 37128857 PMCID: PMC10846411 DOI: 10.1308/rcsann.2022.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION This study examined to what extent supervised aerobic and resistance exercise combined with continued unsupervised exercise training improves cardiorespiratory fitness and corresponding perioperative risk in peripheral artery disease (PAD) patients with intermittent claudication. METHODS A total of 106 patients (77% male) were enrolled into the study, alongside 155 healthy non-PAD control participants. Patients completed supervised exercise therapy (aerobic and resistance exercises of the upper and lower limbs) twice a week for 10 weeks. Thereafter, 52 patients completed 12 weeks of an unsupervised tailored home-based exercise. Pain-free walking distance (PWD), maximum walking distance (MWD), peak oxygen uptake ([Formula: see text]) and perioperative risk were assessed before and after both exercise interventions. RESULTS Patients were highly unconditioned relative to healthy controls ([Formula: see text]=11.9 vs 24.2ml/kg/min, p=<0.001) with 91% classified as high perioperative risk (peak oxygen uptake <15ml/kg/min). Supervised exercise increased PWD (+44±81m, p=<0.001), MWD (+44±71m, p=<0.001) and [Formula: see text] (+1.01±1.63ml/kg/min, p=<0.001) and lowered perioperative risk (91% to 85%, p=<0.001). When compared with supervised exercise, the improvements in PWD were maintained following unsupervised exercise (+11±91m vs supervised exercise, p=0.572); however, MWD and [Formula: see text] decreased (-15±48m, p=0.030 and -0.34±1.11ml/kg/min, p=0.030, respectively) and perioperative risk increased (+3%, p=<0.001) although still below baseline (p=<0.001). CONCLUSIONS Supervised aerobic and resistance exercise training and, to a lesser extent, unsupervised tailored exercise improves walking capacity and cardiorespiratory fitness and reduces perioperative risk in PAD patients with intermittent claudication.
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Affiliation(s)
| | - M Hughes
- Department of Physiotherapy, Prince Charles Hospital, Merthyr Tydfil, UK
| | - BS Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | | | | | - MH Lewis
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - DM Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
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Chen X, Jiang X, Zhang X, Ren D, Wei C, Xu A, Yang H, Bai R, Li C, Yue F, Bao S, Shi J, Fan J. Assessing the impact of diverse mask types on COPD patients: a randomised controlled trial study protocol. BMJ Open 2024; 14:e080721. [PMID: 38199633 PMCID: PMC10806656 DOI: 10.1136/bmjopen-2023-080721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Wearing masks has proven beneficial in preventing respiratory pathogen infections in individuals with chronic obstructive pulmonary disease (COPD). However, the impact of different mask types on physiological indicators and daily physical activity in COPD patients remains uncertain. This study aims to assess the immediate effects of various mask types on cardiopulmonary function indicators, subjective perceptions and the 6-minute walking distance (6MWD) in individuals with COPD. METHODS AND ANALYSIS This randomised controlled trial will enrol 129 stable COPD patients. Participants will be randomly divided into three groups: control, N95 mask and surgical mask groups. Each group will undergo both a 6-minute seated test and a 6-minute walk test (6MWT), without or with their respective masks. A 10-minute interval will be provided between the two phases. The primary indicators of the study include the 6MWD and blood oxygen saturation. Secondary outcomes encompass blood pressure, pulse rate, Borg score, Rate of Perceived Exertion (RPE) score and subjective perception score. Oxygen saturation, pulse rate and blood pressure will be recorded four times during the trial, while Borg and RPE scores will be compared before and after the 6MWT. Additionally, subjective perception scores will be collected after each mask-wearing stage. ETHICS AND DISSEMINATION This study has received approval from the Ethics Committee of the Affiliated Hospital of Gansu University of Chinese Medicine (approval number: 202335). We plan to disseminate research results through publication in a peer-reviewed journal or presentation at a conference. TRIAL REGISTRATION NUMBER ChiCTR2300074554.
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Affiliation(s)
- Xuwen Chen
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiaomei Jiang
- Department of Psychosomatic and Sleep Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Xuhui Zhang
- Department of Pulmonary Diseases, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Dong Ren
- Department of Psychosomatic and Sleep Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Caihong Wei
- Pulmonary and Critical Care Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Aihong Xu
- Pulmonary and Critical Care Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Hong Yang
- Department of Rehabilitation Medicine, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Ruijia Bai
- Department of Pulmonary Diseases, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Caiyun Li
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Feiyan Yue
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Shisan Bao
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jungang Shi
- Pulmonary and Critical Care Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu, China
| | - Jingchun Fan
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
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Betancourt-Peña J, Portela-Pino I, Amaral-Figueroa M. Factors related to non-adherence to cardiac rehabilitation in patients with heart failure. Rev Clin Esp 2024; 224:24-33. [PMID: 38142975 DOI: 10.1016/j.rceng.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/26/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION In heart failure, cardiac rehabilitation has been recommended as an intervention strategy that improves functional capacity, health-related quality of life and survival. However, adherence to these programs is low. The objective was to determine the factors related to non-adherence to cardiac rehabilitation in patients with heart failure in Colombia. METHOD Observational and retrospective study. Patients with heart failure were linked in a clinic in Colombia, adherence to cardiac rehabilitation was measured with ≥80% of scheduled sessions. Sociodemographic and clinical variables, functional aerobic capacity (Sit to Stand and 6-minute walk test), Duke Activity Status Index (DASI), quality of life Minnesota Living with Heart Failure Questionnaire (MLFHQ) and depression Patient health questionnaire 9 (PHQ-9) were taken into account. RESULTS 300 patients were linked with heart failure with age 63.16 ± 12.87 men 194 (64.7%). adherence to cardiac rehabilitation was 66.67%, there were statistically significant differences between the groups in arterial hypertension, LVEF, cholesterol, LDL, Triglycerides, SBP, DBP, distance traveled, VO2e, METs, DASI and PHQ-9 p-value =<0.05. The logistic regression model adjusted for sex and age showed OR for non-adherence to CR arterial hypertension 2.23[1.22-4.07], LDL outside of goals 2.15[1.20-3.88], triglycerides outside goals 2.34[1.35-4.07], DASI<4METs 2.38 [1.04-5.45] and PHQ-9 1.06[1.00-1.12]. CONCLUSION High blood pressure, LDL, triglycerides, DASI and depression with the PHQ-9 questionnaire are related factors for not having adherence to cardiac rehabilitation in patients with heart failure.
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Affiliation(s)
- J Betancourt-Peña
- Facultad de Salud y Rehabilitación, Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia; Facultad de Salud, Escuela de Rehabilitación Humana Universidad del Valle, Cali, Colombia; Universidad de Vigo, Vigo, Spain.
| | - I Portela-Pino
- Departamento de Ciencias de la Salud, Universidad Isabel I, Burgos, Castilla y León, Spain
| | - M Amaral-Figueroa
- Departamento de Educación Física y Recreación, Universidad de Puerto Rico-Recinto de Rio Piedras, San Juan, Puerto Rico
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del Valle MF, Valenzuela J, Bascour-Sandoval C, Marzuca-Nassr GN, del Sol M, Díaz Canales C, Escobar-Cabello M, Lizama-Pérez R, Valenzuela-Aedo F, Muñoz-Cofré R. Effects of a pulmonary rehabilitation program on pulmonary function, exercise performance, and quality of life in patients with severe COVID-19. Ther Adv Respir Dis 2024; 18:17534666231212431. [PMID: 38660953 PMCID: PMC11047239 DOI: 10.1177/17534666231212431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/19/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Severe coronavirus 2019 disease (COVID-19) causes acute hypoxemic respiratory failure requiring invasive mechanical ventilation (IMV). Once these symptoms are resolved, patients can present systemic deterioration. OBJECTIVE The two objectives of this study were as follows: to describe the results of a pulmonary rehabilitation program (PRP), which is divided into three groups with different numbers of sessions (12, 24, and 36), and to associate the variables of pulmonary function, exercise performance, and functionality with the number of sessions and functional improvement. DESIGN Prospective, observational study. METHODS PRP consisted of aerobic + strength + flexibility exercises under the supervision and individualized into 12, 24, or 36 sessions (12s, 24s, and 36s), depending on the evolution of each patient. At the beginning of the study and immediately after the intervention, forced vital capacity (FVC), maximal inspiratory pressure, 6-minute walk test (6MWT), sit-to-stand test (STS), maximal handgrip strength (HGS), Fatigue Assessment Scale, Post-COVID-19 Functional Status (PCFS), and health-related quality of life (HRQoL) were measured. RESULTS The proposed PRP demonstrated a positive effect on pulmonary function, exercise performance, and HRQoL, regardless of the number of sessions. A higher score on the PCFS and more days on IMV were associated with the increased likelihood of needing more sessions, whereas more meters on the 6MWT in the initial evaluation was associated with a reduced likelihood of needing more sessions. Finally, more repetitions on the STS and less distance covered on the initial 6MWT were associated with a greater improvement in exercise performance evaluated with the 6MWT. CONCLUSION Supervised and individualized PRP for patients with severe post-COVID-19 improves pulmonary function, exercise performance, functionality, and quality of life. Functionality, distance covered on the 6MWT, and the days on IMV are central to the scheduling of the number of sessions for these patients.
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Affiliation(s)
| | - Jorge Valenzuela
- Servicio de Medicina Física y Rehabilitación, Hospital el Carmen, Maipú, Chile
| | - Claudio Bascour-Sandoval
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Gabriel Nasri Marzuca-Nassr
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Mariano del Sol
- Centro de Excelencia en Estudios Morfológicos y Quirúrgicos, Universidad de La Frontera. Temuco, Chile
- Doctorado en Ciencias Morfológicas, Universidad de La Frontera. Temuco, Chile
| | | | - Máximo Escobar-Cabello
- Laboratorio de Función Disfunción Ventilatoria, Departamento de Kinesiología, Universidad Católica del Maule, Talca, Chile
| | - Rodrigo Lizama-Pérez
- Department of Physical Education and Sport, Faculty of Sport Science, University of Granada, Granada, Spain
| | - Fernando Valenzuela-Aedo
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
- Doctorado en Ciencias Morfológicas, Universidad de La Frontera. Temuco, Chile
| | - Rodrigo Muñoz-Cofré
- Posdoctorado en Ciencias Morfológicas, Universidad de La Frontera, Av. Francisco Salazar 01145, Temuco 4811230, Chile
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Skvortsov D, Altukhova A, Kaurkin S, Akhpashev A. The nature of gait biomechanics changes with walking speed increase in patients with anterior cruciate ligament injury. J Back Musculoskelet Rehabil 2024; 37:99-109. [PMID: 37718774 DOI: 10.3233/bmr-220415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND This study on gait biomechanics is based on a functional test (FT) performed at free and fast walking speeds. OBJECTIVE We investigated the pattern of changes in gait biomechanical parameters and the knee function in patients after anterior cruciate ligament (ACL) injury or its reconstruction. METHODS The study included 51 patients (33 males, 18 females) with a confirmed recent or old history of ACL tear, before or after reconstruction (26 patients). Mocap data was obtained using an inertial system. All patients were divided into three groups: 41 patients with physiological response (compensation), 6 patients with signs of decompensation, and 4 non-assessable patients. RESULTS Increase in gait speed was associated with decrease in the walking cycle duration, stance and double support phases. In the compensation group, the physiological response of the knee was manifested in increased amplitudes. In the decompensation group, the amplitudes remained unchanged or decreased. In the compensation group, there were increases in the symmetrical muscle activity. The decompensation group was characterized by electromyography asymmetry. CONCLUSION The observed universal physiological mechanism limiting the load on the damaged joint can be used for accurate assessment of the knee functional state in various periods of rehabilitation.
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Affiliation(s)
- Dmitry Skvortsov
- Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Moscow, Russia
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - Alyona Altukhova
- Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Moscow, Russia
| | - Sergey Kaurkin
- Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Moscow, Russia
- Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia
| | - Alexander Akhpashev
- Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Moscow, Russia
- Department of Traumatology and Orthopedics, Academy of Postgraduate Education, Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Moscow, Russia
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Yu Z, He J, Wu J, Di X, Wang X, Dong M, Li Q, Yu L, Liu J, Wang L. Individualised monitoring programme for pulmonary rehabilitation of patients with chronic obstructive pulmonary disease-study protocol for a randomised controlled trial. J Thorac Dis 2023; 15:7100-7111. [PMID: 38249927 PMCID: PMC10797334 DOI: 10.21037/jtd-23-964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/17/2023] [Indexed: 01/23/2024]
Abstract
Background Chronic obstructive pulmonary disease (COPD) is characterised mainly by exertional dyspnoea, which may lead to activity reduction. Pulmonary rehabilitation (PR) is considered capable of mitigating these impairments. However, access to PR is limited to specialised centres, especially during the coronavirus disease 2019 pandemic. Moreover, low-cost home rehabilitation programmes have non-individualised prescriptions, which might lead to inconsistent clinical effects in patients with COPD. Therefore, it is important to develop new, low-cost protocols involving individualised prescriptions and staff supervision. Methods This is a descriptive protocol for a randomised controlled study at the Grade III A Hospital in Tianjin. The sample size was calculated according to a described formula. Fifty-six participants will be selected and randomly allocated into two groups: (I) control (traditional PR training, medication, and nursing interventions); and (II) intervention [PR training in the hospital and at home by the Cardiopulmonary Rehabilitation System Management Platform (CSM)]. The protocol will be performed twice a week for 8 consecutive weeks in the outpatient clinic, and the training will be performed by the application of the CSM system in the final 6 months of the trial. The study will assess lung function and physical fitness and analyse the scores of the modified Medical Research Council Dyspnoea Scale, the COPD assessment test, the International Classification of Functioning, Disability, and Health, and the 6-minute walk test before and after the training protocol. Comparison of differences will be performed using repeated measures analysis of variance, a linear mixed effects analysis, or a non-parametric test, which will include only participants who completed all outcome measures and followed the intervention protocol. The study results will be disseminated through presentations at scientific conferences and publications in peer-reviewed journals. Discussion The new, low-cost supervised rehabilitation programmes are expected to present positive results, making PR programmes more accessible and effective for patients with COPD. Trial Registration The study was registered in the Chinese Clinical Trial Registry: ChiCTR2000040723.
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Affiliation(s)
- Zhenjie Yu
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jingchun He
- Department of Respiratory and Critical Care Medicine, Tianjin Fourth Central Hospital, Tianjin, China
| | - Jie Wu
- Department of Ultrasound, Tianjin Fourth Central Hospital, Tianjin, China
| | - Xia Di
- Department of Medical Insurance, Tianjin Fourth Central Hospital, Tianjin, China
| | - Xiaohui Wang
- Department of Critical Care Medicine, Tianjin Fourth Central Hospital, Tianjin, China
| | - Ming Dong
- Department of Pulmonary External Oncology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qi Li
- Department of Respiratory, Tianjin Third Central Hospital, Tianjin, China
| | - Lili Yu
- Department of Respiratory and Critical Care Medicine, Tianjin Fourth Central Hospital, Tianjin, China
| | - Jun Liu
- Department of Radiology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Lan Wang
- School of Nursing, Tianjin Medical University, Tianjin, China
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Pramhas S, Thalhammer T, Terner S, Pickelsberger D, Gleiss A, Sator S, Kress HG. Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial. THE LANCET REGIONAL HEALTH. EUROPE 2023; 35:100777. [PMID: 38033459 PMCID: PMC10682664 DOI: 10.1016/j.lanepe.2023.100777] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023]
Abstract
Background Painful knee osteoarthritis (KOA) is common, pharmacological treatment, however, is often hampered by limited tolerability. Cannabidiol, which preclinically showed anti-inflammatory, analgesic activity, could supplement established analgesics, but robust clinical trials are lacking. The aim of our study was to investigate the effects of oral high-dose CBD administered over 8 weeks on pain, function and patient global assessment as an add-on to continued paracetamol in chronic symptomatic KOA. Methods Prospective, randomized, placebo-controlled, double-blind, parallel-group study. Single center, Outpatient Clinic, Department of Special Anaesthesia and Pain Therapy at Medical University of Vienna, Austria. Eligibility criteria included: age: 18-98 years; painful KOA; score ≥5 on the pain subscale of the Western Ontario and McMasters Universities Osteoarthritis (WOMAC) Index; KOA confirmed by imaging. Participants were on continued dosage of paracetamol 3 g/d and randomly assigned by web-based software 1:1 to oral cannabidiol 600 mg/d (n = 43) or placebo (n = 43). Study period: 8 weeks. Primary outcome: Change in WOMAC pain subscale scores (0 = no pain, 10 = worst possible pain) from baseline to week 8 of treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT04607603. Trial is completed. Findings The trial was conducted from October 1, 2020 to March 29, 2022. 159 patients screened, 86 randomized. Among 86 participants (mean age, 62.8 [SD 20.3] years; 60 females [69.8%]), 58 (67.4%) completed the trial. Mean baseline WOMAC pain subscale was 6.0 ± 1.1. Analysis: Intention-to-treat principal. Mean reduction in WOMAC pain subscale was 2.5 (95% CI: 1.8-3.3) in the cannabidiol group and 2.4 (95% CI: 1.7-3.2) in the placebo group with no significant group difference (p = 0.80). Adverse events were significantly more frequent with cannabidiol (cannabidiol: 135 [56%]; placebo: 105 [44%]) (p = 0.008). Rise above baseline of liver aminotransferases and gamma-glutamyltransferase was significantly more common in the cannabidiol (n = 15) than the placebo group (n = 5) (p = 0.02). Interpretation In KOA patients, oral high-dose add-on cannabidiol had no additional analgesic effect compared to adding placebo to continued paracetamol. Our results do not support the use of cannabidiol as an analgesic supplement in KOA. Funding Trigal Pharma GmbH.
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Affiliation(s)
- Sibylle Pramhas
- Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Teresa Thalhammer
- Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Sebastian Terner
- Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Daniel Pickelsberger
- Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Andreas Gleiss
- Center for Medical Data Science, Medical University of Vienna, Spitalgasse 23, Vienna 1090, Austria
| | - Sabine Sator
- Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Hans G. Kress
- Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
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Sharma M, Wyszkiewicz PV, Matheson AM, McCormack DG, Parraga G. Chest MRI and CT Predictors of 10-Year All-Cause Mortality in COPD. COPD 2023; 20:307-320. [PMID: 37737132 DOI: 10.1080/15412555.2023.2259224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
Pulmonary imaging measurements using magnetic resonance imaging (MRI) and computed tomography (CT) have the potential to deepen our understanding of chronic obstructive pulmonary disease (COPD) by measuring airway and parenchymal pathologic information that cannot be provided by spirometry. Currently, MRI and CT measurements are not included in mortality risk predictions, diagnosis, or COPD staging. We evaluated baseline pulmonary function, MRI and CT measurements alongside imaging texture-features to predict 10-year all-cause mortality in ex-smokers with (n = 93; 31 females; 70 ± 9years) and without (n = 69; 29 females, 69 ± 9years) COPD. CT airway and vessel measurements, helium-3 (3He) MRI ventilation defect percent (VDP) and apparent diffusion coefficients (ADC) were quantified. MRI and CT texture-features were extracted using PyRadiomics (version2.2.0). Associations between 10-year all-cause mortality and all clinical and imaging measurements were evaluated using multivariable regression model odds-ratios. Machine-learning predictive models for 10-year all-cause mortality were evaluated using area-under-receiver-operator-characteristic-curve (AUC), sensitivity and specificity analyses. DLCO (%pred) (HR = 0.955, 95%CI: 0.934-0.976, p < 0.001), MRI ADC (HR = 1.843, 95%CI: 1.260-2.871, p < 0.001), and CT informational-measure-of-correlation (HR = 3.546, 95% CI: 1.660-7.573, p = 0.001) were the strongest predictors of 10-year mortality. A machine-learning model trained on clinical, imaging, and imaging textures was the best predictive model (AUC = 0.82, sensitivity = 83%, specificity = 84%) and outperformed the solely clinical model (AUC = 0.76, sensitivity = 77%, specificity = 79%). In ex-smokers, regardless of COPD status, addition of CT and MR imaging texture measurements to clinical models provided unique prognostic information of mortality risk that can allow for better clinical management.Clinical Trial Registration: www.clinicaltrials.gov NCT02279329.
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Affiliation(s)
- Maksym Sharma
- Robarts Research Institute, Western University, London, Canada
- Department of Medical Biophysics, Western University, London, Canada
| | - Paulina V Wyszkiewicz
- Robarts Research Institute, Western University, London, Canada
- Department of Medical Biophysics, Western University, London, Canada
| | - Alexander M Matheson
- Robarts Research Institute, Western University, London, Canada
- Department of Medical Biophysics, Western University, London, Canada
| | - David G McCormack
- Division of Respirology, Department of Medicine, Western University, London, Canada
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Canada
- Department of Medical Biophysics, Western University, London, Canada
- Division of Respirology, Department of Medicine, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
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Reinmann A, Koessler T, Bodmer A, Baud-Grasset A, Mentha G, Gligorov J, Bruyneel AV. Feasibility, criterion and construct convergent validity of the 2-minute walk test and the 10-meter walk test in an oncological context. Heliyon 2023; 9:e22180. [PMID: 38045222 PMCID: PMC10692807 DOI: 10.1016/j.heliyon.2023.e22180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To examine the feasibility, the criterion, and the construct convergent validity of the 2-Minute Walk Test (2MWT) and the 10-Meter Walk Test (10MeWT) against the 6-Minute Walk Test (6MWT) to assess walking capacity in people with cancer. The criterion concurrent validity of a self-test version of the 10MeWT (10MeWTself-test) was also evaluated against the 10MeWT. Methods Fifty-six people with cancer performed the 2MWT, the 10MeWT at comfortable and fast speeds, the 6MWT, and the 10MeWTself-test. The feasibility of the tests was assessed using safety, adverse events, space requirements, time taken to administer and interpret the tool, equipment or training required, cost, and portability as criteria. Validity was assessed using Pearson correlation coefficients and Bland Altman plots. Results The 2MWT, 6MWT, 10MeWT, and 10MeWTself-test were feasible for people with cancer. The 2MWT and the 10MeWT results were moderately to strongly correlated with the 6MWT results (0.61 < r < 0.84, p < 0.001). The 10MeWTself-test results were strongly correlated with the 10MeWT results at comfortable and fast speeds (r = 0.99, p < 0.001). Conclusions The 2MWT, 10MeWT, and 10MeWTself-test are simple, rapid, and feasible tests for use in people with cancer. The strong correlation between the 2MWT and 6MWT results indicates that the 2MWT can be used as an alternative walking capacity assessment tool. The 10MeWT results moderately correlated with those of the other two tests, suggesting that it partially measures the same construct of walking capacity in walking-independent outpatients with cancer. The 10MeWTself-test showed promising results but needs further investigations in ecological settings.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
| | - Thibaud Koessler
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Alexandre Bodmer
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Axelle Baud-Grasset
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Géraldine Mentha
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Joseph Gligorov
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
- University Institute of Cancerology AP-HP Sorbonne University, Medical Oncology site Tenon, Paris, France
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
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Chen Q, Chen GY, Chen JM, Yang FF, Han Y, Wang LH, Wu JH, Ji DD, Yuan SQ, Zhang MQ, Ma LL, Zhu F, Wang QS, Ouyang XL, Zhang LW. Effect of large volume red blood cell apheresis on cardiovascular functions in healthy donors. Eur J Clin Invest 2023; 53:e14047. [PMID: 37386687 DOI: 10.1111/eci.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Requirements of blood transfusions rise rapidly in China. Improving the efficiency of blood donation could help maintaining sufficient blood supplement. We conducted a pilot research to investigate the reliability and safety of collecting more units of red blood cell by apheresis. METHODS Thirty-two healthy male volunteers were randomized into two groups: red blood cell apheresis (RA) (n = 16) and whole blood (WB) donation (n = 16). RA group donated individualized RBC volumes by apheresis according to the volunteers' basal total blood volumes and haematocrit levels, WB group donated 400 mL whole blood. All volunteers were scheduled seven visit times in 8 weeks' study period. The cardiovascular functions were assessed by laboratory examinations, echocardiography and cardiopulmonary functional tests. All results were compared between groups at the same visit time and compared between visit 1(before donation) and other visit times within the same group. RESULTS The average donated RBC volume in RA group and in WB group was 627.25 ± 109.74 mL and 175.28 ± 8.85 mL, respectively(p < 0.05); the RBC, haemoglobin and haematocrit levels changed significantly between times and between groups (p < 0.05). Cardiac biomarker levels such as NT-proBNP, hs-TnT and CK-MB did not change significantly between times or between groups (p > 0.05). The echocardiographic and cardiopulmonary results did not change significantly between times or between groups during the whole study period(p > 0.05). CONCLUSIONS We provided an efficient and secure method for RBC apheresis. By harvesting more RBC volumes at one single-time, the cardiovascular functions did not change significantly compared with traditional whole blood donation.
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Affiliation(s)
- Qiang Chen
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Guan Yi Chen
- Department of Blood Transfusion, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Jian Mei Chen
- Department of Health medicine, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Fei Fei Yang
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Yue Han
- Department of Blood Transfusion, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Li Hua Wang
- Department of Blood Transfusion, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Jing Hui Wu
- Department of Blood Transfusion, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Dong Dong Ji
- Department of Health medicine, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Su Qin Yuan
- Department of Health medicine, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Mei Qing Zhang
- Department of Health medicine, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Ling Ling Ma
- Department of Health medicine, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Fei Zhu
- Department of Health medicine, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Qiu Shuang Wang
- Department of Health medicine, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Xi Lin Ouyang
- Department of Blood Transfusion, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Li Wei Zhang
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
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Skolka MP, Naddaf E. Exploring challenges in the management and treatment of inclusion body myositis. Curr Opin Rheumatol 2023; 35:404-413. [PMID: 37503813 PMCID: PMC10552844 DOI: 10.1097/bor.0000000000000958] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
PURPOSE OF REVIEW This review provides an overview of the management and treatment landscape of inclusion body myositis (IBM), while highlighting the current challenges and future directions. RECENT FINDINGS IBM is a slowly progressive myopathy that predominantly affects patients over the age of 40, leading to increased morbidity and mortality. Unfortunately, a definitive cure for IBM remains elusive. Various clinical trials targeting inflammatory and some of the noninflammatory pathways have failed. The search for effective disease-modifying treatments faces numerous hurdles including variability in presentation, diagnostic challenges, poor understanding of pathogenesis, scarcity of disease models, a lack of validated outcome measures, and challenges related to clinical trial design. Close monitoring of swallowing and respiratory function, adapting an exercise routine, and addressing mobility issues are the mainstay of management at this time. SUMMARY Addressing the obstacles encountered by patients with IBM and the medical community presents a multitude of challenges. Effectively surmounting these hurdles requires embracing cutting-edge research strategies aimed at enhancing the management and treatment of IBM, while elevating the quality of life for those affected.
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Fuentes Artiles R, Euler S, Auschra B, da Silva HB, Niederseer D, Schmied C, von Känel R, Jellestad L. Predictors of gain in exercise capacity through cardiac rehabilitation: Sex and age matter. Heart Lung 2023; 62:200-206. [PMID: 37562338 DOI: 10.1016/j.hrtlng.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Cardiac rehabilitation (CR) is a cornerstone of secondary prevention that improves cardiovascular outcomes. However, the determinants of treatment success are poorly understood. OBJECTIVES We investigated the associations of health-related quality of life (HRQoL), sex, age, employment status and housing situation with improvement in exercise capacity throughout CR. METHODS We analyzed data from 392 CR outpatients (81% men and 19% women). Exercise capacity at baseline and upon completion of the program was measured with the 6-minute walk distance (6MWD). HRQoL at CR entry was assessed with the Short Form 36 Health Survey (SF-36). RESULTS A multivariable regression analysis revealed that both men and women showed significant improvement in exercise capacity (p < .001). Female sex (B = 18.118, 95% CI 0.341 - 36.035, p = .046) and younger age (B = -0.887, 95% CI -1.463 - -0.312, p = .003) emerged as predictors of greater improvement, while HRQoL, employment status, and housing situation were not associated with significant change in exercise capacity. The final model explained 25% of the variance in exercise capacity change (adjusted R2 = 0.25, p < .001). CONCLUSIONS Our results indicate that women and younger participants benefit from CR by improving their exercise capacity. Employment status, housing situation and HRQoL showed no effects on CR outcome.
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Affiliation(s)
- Rubén Fuentes Artiles
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Medicine, Limmattal Hospital, Schlieren, Switzerland.
| | - Sebastian Euler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hadassa Brito da Silva
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Aljazeeri J, Almusally R, Wert Y, Abdelhalim M, Klinger C, Ramesh N, Rahman T. Pulmonary Rehabilitation for Post-COVID-19. J Cardiopulm Rehabil Prev 2023; 43:438-443. [PMID: 37535550 DOI: 10.1097/hcr.0000000000000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
PURPOSE Patients with COVID-19 often report persistent respiratory symptoms. Limited data exist on how to mitigate long-term sequelae of exercise intolerance and dyspnea. We aimed to study the role of pulmonary rehabilitation (PR) in patients with post-COVID-19. METHODS This was an observational study. Consecutive patients with post-COVID-19, admitted to three separate outpatient PR programs, were enrolled. The program consisted of 8-12 wk of PR sessions (3 times/wk). Data were gathered at the initial visit and discharge. The primary outcome was the change in the 6-min walk test (6MWT) distance. Secondary outcomes included the Shortness of Breath Questionnaire (SOBQ), modified Borg dyspnea scale, Patient Health Questionnaire-9 (PHQ-9), and Lung Information Needs Questionnaire (LINQ). RESULTS A total of 56 patients completed the PR program (age 62.8 ± 14.7 yr, 57% were men). At baseline, the mean 6MWT was 313.3 ± 193.8 m. On average, the 6MWT improved by 84.3 m after PR ( P < .0001). Apart from the modified Borg dyspnea scale, there was improvement across secondary outcomes: SOBQ (-16.9 points), PHQ-9 (-2.6 points), and LINQ (-4.2 points); all P < .05. CONCLUSION Pulmonary rehabilitation showed a promising positive effect on patients with with post-COVID-19. It improved exercise capacity, perception of dyspnea, depressive symptoms, and patient knowledge needed to manage their lung disease. Pulmonary rehabilitation should be considered for post-COVID-19 patients.
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Affiliation(s)
- Jafar Aljazeeri
- University of Pittsburgh Medical Center, Central Pennsylvania the United States (Drs Aljazeeri, Ramesh, and Rahman and Mss Wert and Klinger); Drexel University College of Medicine, Philadelphia, Pennsylvania, the United States (Drs Aljazeeri, Abdelhalim, and Ramesh); and Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia (Dr Almusally)
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Oosterbos C, Rummens S, Bogaerts K, Van Hoylandt A, Hoornaert S, Weyns F, Dubuisson A, Ceuppens J, Schuind S, Groen JL, Lemmens R, Theys T. A randomized controlled trial comparing conservative versus surgical treatment in patients with foot drop due to peroneal nerve entrapment: results of an internal feasibility pilot study. Pilot Feasibility Stud 2023; 9:181. [PMID: 37908016 PMCID: PMC10617035 DOI: 10.1186/s40814-023-01407-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Based on the lack of literature to support any treatment strategy in patients with foot drop due to peroneal nerve entrapment, a prospective study randomizing patients between surgery and conservative treatment is warranted. Since studies comparing surgery to no surgery are often challenging, we first examined the feasibility of such a randomized controlled trial. METHODS/DESIGN An internal feasibility pilot study was conducted to assess several aspects of process, resource, management, and scientific feasibility. The main objective was the assessment of the recruitment rate. The criterion to embark on a full study was the recruitment of at least 14 patients in 6 participating centers within 6 months. Cross-over rate, blinding measures, training strategies, and trial assessments were evaluated. The trial was entirely funded by the KCE Trials public funding program of the Belgian Health Care Knowledge Centre (ID KCE19-1232). RESULTS The initial duration was prolonged due to the COVID-19 pandemic. Between April 2021 and October 2022, we included 19 patients of which 15 were randomized. Fourteen patients were treated as randomized. One drop-out occurred after randomization, prior to surgery. We did not document any cross-over or accidental unblinding. Training strategies were successful. Patients perceived the quality of life questionnaire as the least relevant assessment. Assessment of ankle dorsiflexion range of motion was prone to interobserver variability. All other trial assessments were adequate. DISCUSSION Recruitment of the anticipated 14 patients was feasible although slower than expected. The Short-Form Health Survey (SF-36) and assessment of ankle dorsiflexion range of motion will no longer be included in the full-scale FOOTDROP trial. CONCLUSION The FOOTDROP study is feasible. TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT04695834 . Registered 4 January 2021.
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Affiliation(s)
- Christophe Oosterbos
- Research Group experimental Neurosurgery and Neuroanatomy KULeuven and the Leuven Brain Institute, Leuven, Belgium.
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium.
| | - Sofie Rummens
- Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Kris Bogaerts
- Department of Public Health and Critical Care, I-BioStat, KU Leuven, Belgium and I-BioStat, UHasselt, Belgium
| | - Anaïs Van Hoylandt
- Research Group experimental Neurosurgery and Neuroanatomy KULeuven and the Leuven Brain Institute, Leuven, Belgium
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Sophie Hoornaert
- Research Group experimental Neurosurgery and Neuroanatomy KULeuven and the Leuven Brain Institute, Leuven, Belgium
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Frank Weyns
- Department of Neurosurgery, Ziekenhuis-Oost Limburg, Genk, Belgium
- Neurosciences, Faculty of Medicine and Life Sciences, UHasselt, Hasselt, Belgium
| | - Annie Dubuisson
- Department of Neurosurgery, University Hospitals Liège, Liège, Belgium
| | - Jeroen Ceuppens
- Department of Neurosurgery, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium
| | - Sophie Schuind
- Department of Neurosurgery, Erasme Hospital, Brussels, Belgium
| | - Justus L Groen
- Leiden Nerve Center, Department of Neurosurgery, University of Leiden, Leiden, the Netherlands
| | - Robin Lemmens
- KU Leuven-University of Leuven, Department of Neurosciences, Experimental Neurology, Leuven, Belgium
- VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Tom Theys
- Research Group experimental Neurosurgery and Neuroanatomy KULeuven and the Leuven Brain Institute, Leuven, Belgium
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
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Pieczyńska A, Zasadzka E, Pilarska A, Procyk D, Adamska K, Hojan K. Rehabilitation Exercises Supported by Monitor-Augmented Reality for Patients with High-Grade Glioma Undergoing Radiotherapy: Results of a Randomized Clinical Trial. J Clin Med 2023; 12:6838. [PMID: 37959303 PMCID: PMC10648373 DOI: 10.3390/jcm12216838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Exercise has been shown to improve quality of life (QoL) and even treatment outcomes in cancer patients. However, the evidence to support the benefits of exercise in patients with high-grade glioma (HGG) is limited. Therefore, we performed a randomized clinical trial (RCT) to examine the effect of augmented-reality-based rehabilitation exercises on physical and functional fitness, cognitive function, fatigue, mood, QoL, selected blood parameters, brain derived neurotrophic factor (BDNF), and S100 protein in patients with HGG. METHODS Adult patients with HGG scheduled to undergo radiotherapy after tumor resection were randomized to participate in an exercise program (experimental group, n = 25) or to receive usual care (controls, n = 22). Physical and mental fitness was measured at baseline, after the completion of radiotherapy, and at 3 months. The following tests were administered: Handgrip Strength Test; 6-Minute Walk Test; Time Up and Go test; Functional Independent Measure scale; Addenbrooke's Cognitive Examination III (ACE III); Hospital Anxiety and Depression Scale; Functional Cancer Therapy Assessment-Brain; and Functional Assessment of Chronic Illness Therapy-Fatigue. We also measured blood parameters, BDNF, and S100 protein levels. RESULTS No significant changes were observed in the exercise group. However, the controls experienced a significant decrease in HGS and in the ACE III attention domain. No significant changes were observed in QoL, fatigue, BDNF, or S100 levels in either group. CONCLUSIONS Augmented-reality-based exercise during radiation therapy may prevent loss of muscle strength and attention in patients with HGG.
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Affiliation(s)
- Anna Pieczyńska
- Department of Occupational Therapy, Poznan University of Medical Sciences, 61-781 Poznan, Poland; (A.P.); (K.H.)
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Ewa Zasadzka
- Department of Occupational Therapy, Poznan University of Medical Sciences, 61-781 Poznan, Poland; (A.P.); (K.H.)
| | - Agnieszka Pilarska
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Danuta Procyk
- Central Laboratory, Greater Poland Cancer Centre, 15, 61-866 Poznan, Poland;
| | - Krystyna Adamska
- Chair and Department of Electroradiology, Poznan University of Medical Science, 61-781 Poznan, Poland;
- 3rd Radiotherapy Department, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Katarzyna Hojan
- Department of Occupational Therapy, Poznan University of Medical Sciences, 61-781 Poznan, Poland; (A.P.); (K.H.)
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
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Qi R, Liu S, Wang H, He X, Liu W, Huang F, Zhao Y, Yang B, Xu S, Zeng H. Effects of perioperative exercise on cardiorespiratory endurance in children with congenital heart disease in plateau areas after surgical repair. Sci Rep 2023; 13:18088. [PMID: 37872227 PMCID: PMC10593799 DOI: 10.1038/s41598-023-45310-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023] Open
Abstract
We aimed to explore the effects of perioperative exercise on cardiorespiratory endurance in children with congenital heart disease (CHD) in plateau areas after surgical repair. Fifty children with CHD in the plateau admitted to our hospital were randomly divided into the exercise and control groups. The exercise group received a perioperative exercise intervention beginning within 24 h postoperatively, while the control group received routine nursing and treatment alone. To assess the 6 min walk distance (6MWD) at baseline and at end of intervention, children participated in a 6-min walk test before cardiac repair and at 1 week after general ward transfer. A subset of children in the study underwent the cardiopulmonary exercise test pre-operatively. The 6MWD of children with CHD at baseline was positively correlated with the peak oxygen uptake pre-operatively. No significant difference was reported in the preoperative baseline data of both groups. The 6MWD of the exercise group was significantly higher than that of the control group. Early exercise therapy after cardiac repair could significantly improve the cardiorespiratory endurance and exercise capacity of children with CHD in plateau areas.
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Affiliation(s)
- Ruixue Qi
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Centre of Vascular Interventional Therapy, Wuhan, China
- Department of Cardiology, Zhengzhou Cardiovascular Hospital, Henan Medical Key Laboratory of Arrhythmia, Zhengzhou, China
| | - Shijie Liu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Centre of Vascular Interventional Therapy, Wuhan, China
| | - Hongjie Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Centre of Vascular Interventional Therapy, Wuhan, China
| | - Xingwei He
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Centre of Vascular Interventional Therapy, Wuhan, China
| | - Wanjun Liu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Centre of Vascular Interventional Therapy, Wuhan, China
| | - Fen Huang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Provincial Engineering Research Centre of Vascular Interventional Therapy, Wuhan, China
| | - Yujie Zhao
- Department of Cardiology, Zhengzhou Cardiovascular Hospital, Henan Medical Key Laboratory of Arrhythmia, Zhengzhou, China
| | - Bin Yang
- Department of Cardiology, Zhengzhou Cardiovascular Hospital, Henan Medical Key Laboratory of Arrhythmia, Zhengzhou, China
| | - Shunlin Xu
- Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 49 North Garden Road, Beijing, 100191, China.
| | - Hesong Zeng
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, Hubei, China.
- Hubei Provincial Engineering Research Centre of Vascular Interventional Therapy, Wuhan, China.
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Zeng Q, Liao W, Fang W, Liu S, Duan C, Dai Y, Wei C. Clinical effect of aerobic exercise training in chronic obstructive pulmonary disease: A retrospective study. Medicine (Baltimore) 2023; 102:e35573. [PMID: 37861566 PMCID: PMC10589605 DOI: 10.1097/md.0000000000035573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 09/19/2023] [Indexed: 10/21/2023] Open
Abstract
Aerobic exercise training is a kind of pulmonary rehabilitation for lung diseases. This was a retrospective study to assess the efficacy of aerobic exercise training in chronic obstructive pulmonary disease (COPD) at a stable stage. A total of one hundred and fifty-six stable COPD patients who had accepted self-education only or self-education combined with an aerobic exercise training between January 2017 to January 2019 were reviewed retrospectively. A total of 79 patients who had received self-education combined with an aerobic exercise training schedule comprised the aerobic exercise training group (AET group) and 77 patients who had received self-education only were regarded as the education group (EDU group). The acute incidence rate in AET group was 7.6% better than that in EDU group 20.7% (P < .05). The AET group patients expressed higher levels of 6 minutes walking distance (6MWD) (P < .05) and better evaluations of both lung function (P < .05) and T lymphocyte immune response (P < .05), as well as significantly decreased chronic obstructive pulmonary disease assessment test (CAT) scores and modified British medical research council (mMRC) grades (P < .05). Patients in EDU group did not report any changes in any of these characteristics. The aerobic exercise training intervention contributed to an increasing in 6MWD and decrease in CAT scores and mMRC grades, as well as improving the T lymphocyte immune response in stable COPD patients.
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Affiliation(s)
- Qigang Zeng
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong Province, China
| | - Wangwang Liao
- Guangzhou University of Chinese Medicine, Guangdong Province, China
- Affiliated Guangdong Hospital of Integrated Traditional Chinese and Western Medicine of Guangzhou University of Chinese Medicine, Guangdong Province, China
| | - Wentao Fang
- Guangzhou University of Chinese Medicine, Guangdong Province, China
- Affiliated Guangdong Hospital of Integrated Traditional Chinese and Western Medicine of Guangzhou University of Chinese Medicine, Guangdong Province, China
| | - Shuling Liu
- Guangzhou University of Chinese Medicine, Guangdong Province, China
- Affiliated Guangdong Hospital of Integrated Traditional Chinese and Western Medicine of Guangzhou University of Chinese Medicine, Guangdong Province, China
| | - Chenxia Duan
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong Province, China
| | - Yong Dai
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong Province, China
| | - Chenggong Wei
- Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong Province, China
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Beykumül A, Ersoy Y, Gülbaş G, Neselioglu S. Can Blood Biomarkers Be Used to Assess Oxidative Stress in COPD Patients After Pulmonary Rehabilitation. Int J Chron Obstruct Pulmon Dis 2023; 18:2179-2186. [PMID: 37818173 PMCID: PMC10561608 DOI: 10.2147/copd.s400415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 08/21/2023] [Indexed: 10/12/2023] Open
Abstract
Purpose To determine the level of oxidative stress in the body due to pulmonary rehabilitation (PR) with thiols and disulfide and to investigate their relationship with indirect markers such as creatine kinase (CK), creatine kinase - MB (CK-MB), and lactate dehydrogenase (LDH), which show cell destruction. Patients and Methods Patients with chronic obstructive pulmonary disease (COPD) are included in inpatient and outpatient care. They were evaluated before and after for PR, and an exercise program was prescribed. In addition, native thiol (NT), total thiol (TT), disulfide (DS), LDH, CK, and CK-MB values were tested. Results The mean age of 21 patients was 63±7.31 years. Eleven of them were outpatients and 10 of them were inpatients. Most of the patients were male (M/F=20/1, 95.2/4.8%). There was a significant difference in pulmonary function tests (PFT), St. George Respiratory Questionnaire (SGRQ), and 1 repetition maximum (1RM) before and after the treatment (p<0.001). There was a correlation between PFT and 1RM upper extremity. While there was no significant difference between thiols and disulfide, according to GOLD scores, there was a significant difference in patients with level 3-MMRC. No correlation was found between LDH, CK, CK-MB, and thiols, DS. ΔCK was found to be associated with ΔDS, and ΔCK-MB with ΔNT, and ΔTT. Conclusion PR contributes to the antioxidant process by improving respiration and reducing oxidative stress. The decrease in LDH, CK with PR, increase in CK-MB, and correlation of CK with thiols and DS gave a different interpretation. In this case, it should be considered that oxidative stress may also be increased in people with high CK values.
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Affiliation(s)
- Ayşegül Beykumül
- Pulmonary Rehabilitation Unit, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - Yuksel Ersoy
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Gazi Gülbaş
- Department of Chest Diseases, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Salim Neselioglu
- Department of Medical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
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Hassanein M, Tageldien A, Badran H, Samir H, Elshafey WE, Hassan M, Magdy M, Louis O, Abdel‐Hameed T, Abdelhamid M. Current status of outpatient heart failure management in Egypt and recommendations for the future. ESC Heart Fail 2023; 10:2788-2796. [PMID: 37559352 PMCID: PMC10567665 DOI: 10.1002/ehf2.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 05/27/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
Heart failure (HF) represents one of the greatest healthcare burdens worldwide, and Egypt is no exception. HF healthcare programmes in Egypt still require further optimization to enhance diagnosis and management of the disease. Development of specialized HF clinics (HFCs) and their incorporation in the healthcare system is expected to reduce HF hospitalization and mortality rates and improve quality of care in Egypt. We conducted a literature search on PubMed on the requirements and essential infrastructure of HFCs. Retrieved articles deemed relevant were discussed by a panel of 10 expert cardiologists from Egypt and a basic HFC model for the Egyptian settings was proposed. A multidisciplinary team managing the HFC should essentially be composed of specialized HF cardiologists and nurses, clinical pharmacists, registered nutritionists, physiotherapists, and psychologists. Other clinical specialists should be included according to patients' needs and size and structure of individual clinics. HFCs should receive patients referred from primary care settings, emergency care units, and physicians from different specialties. A basic HFC should have the following fundamental investigations available: resting electrocardiogram, basic transthoracic echocardiogram, and testing for N-terminal pro-B-type natriuretic peptide. Fundamental patients' functional assessments are assessing the New York Heart Association functional classification and quality of life and conducting the 6 min walking test. guideline-directed medical therapy should be implemented, and device therapy should be utilized when available. In the first visit, once HF is diagnosed and co-morbidities assessed, guideline-directed medical therapy should be started immediately. Comprehensive patient education sessions should be delivered by HF nurses or clinical pharmacists. The follow-up visit should be scheduled during the initial visit rather than over the phone, and time from the initial visit to the first follow-up visit should be determined based on the patient's health status and needs. Home and virtual visits are only recommended in limited and emergency situations. In this paper, we provide a practical and detailed review on the essential components of HFCs and propose a preliminary model of HFCs as part of a comprehensive HF programme model in Egypt. We believe that other low-to-middle income countries could also benefit from our proposed model.
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Huang WJ, Pellegrini CA, Chen MD, Huang WY, Kao T, Lee CF, Chien YC. The correlates and reference values for the 6-minute walk distance in Taiwanese adults with schizophrenia. Disabil Rehabil 2023; 45:3567-3572. [PMID: 36151891 DOI: 10.1080/09638288.2022.2125592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 09/13/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The study aimed to identify the factors associated with the 6-min walk distance (6MWD) and to provide reference values for the 6MWD in individuals with schizophrenia (SCZ) in Taiwan. METHODS A proportional stratified sampling method was utilized based on distribution of gender, age and body mass index (BMI) at the study hospital. The 6-minute walk test was conducted according to the American Thoracic Society protocol. RESULTS A total of 237 patients with SCZ completed the 6-minute walk test. The 6MWD was significantly associated with age, height, weight, and length of the onset of SCZ. Stepwise linear regression revealed that height and age were significant determinants of 6MWD. The reference values for males and females at different age groups were determined. Notably, females over 60 walked substantially shorter than the age younger than 60. CONCLUSIONS Height and age were the main predictors for 6MWD among people with SCZ in Taiwan. The established reference values can be used to identify those at risk of poor cardiorespiratory fitness and as a target outcome during exercise programs in psychiatric rehabilitation. Our results highlight that older females with SCZ may be a priority group to target with exercise interventions to mitigate the faster decline in cardiorespiratory fitness.IMPLICATIONS FOR REHABILITATIONHeight and age were predictors of 6-min walk distance (6MWD) in schizophrenia (SCZ).The established age- and gender reference values for the 6MWD can be used to identify those at risk of poor cardiorespiratory fitness.Females with SCZ over age 60 may be a priority group to target with exercise interventions to mitigate the faster decline in cardiorespiratory fitness.
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Affiliation(s)
- Wan-Ju Huang
- Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Christine A Pellegrini
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ming-De Chen
- Department of Occupational Therapy, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Wen-Yi Huang
- Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Ting Kao
- Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Chou-Fang Lee
- Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Ying-Chun Chien
- Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City, Taiwan
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Huang Y, Wang X, Steffens D, Young J, Solomon M, Koh C. Grading Complications in Pelvic Exenteration: Limitations of Current Classification Systems. Dis Colon Rectum 2023; 66:e1023-e1031. [PMID: 35067502 DOI: 10.1097/dcr.0000000000002396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To comprehensively report complications associated with pelvic exenteration and to determine the strength of associations between 3 different grading methodologies and length of stay, quality of life, and physical outcomes. BACKGROUND It is generally accepted that pelvic exenteration is associated with high rates of surgical morbidity. However, methods of reporting in the literature are inconsistent, making it difficult to compare surgical outcomes across studies to determine the impact of surgery on patients. DESIGN A retrospective study. SETTINGS This study was conducted at Royal Prince Alfred Hospital, Sydney, Australia. PATIENTS It included patients who underwent pelvic exenteration between December 2016 and August 2019. MAIN OUTCOME MEASURES Complications were classified according to the Clavien-Dindo classification, Comprehensive Complication Index, and number of postoperative complications. Correlations between length of stay, physical component score, 6-minute walk test, and sit-to-stand test, and complications as graded using the Clavien-Dindo classification, Comprehensive Complication Index, and the number of complications were explored using Pearson's or point biserial correlation tests. RESULTS In this study, 198 patients were included. The Clavien-Dindo classification was moderately positively correlated with length of stay ( r = 0.519; p < 0.0001), whereas Comprehensive Complication Index ( r = 0.744; p < 0.0001) and the number of complications ( r = 0.751; p < 0.0001) showed a strong correlation with length of stay. All these methodologies were moderately inversely correlated with a predischarge 6-minute walk test (Clavien-Dindo classification: r = -0.359, p = 0.008; Comprehensive Complication Index: r = -0.388, p = 0.007; number of complications: r = -0.467, p < 0.0001). LIMITATIONS This single-center retrospective study involves a small sample size. Classification of grade I and II complications in this cohort of patients who tend to have complex postoperative recovery was challenging and therefore incomplete. The incomplete data may have affected the correlations. CONCLUSIONS Comprehensive Complication Index and the number of postoperative complications were more strongly correlated with length of stay than the Clavien-Dindo classification in patients undergoing pelvic exenteration. Comprehensive Complication Index may be a better grading system to classify postoperative complications following pelvic exenteration. See Video Abstract at http://links.lww.com/DCR/B906 . CLASIFICACIN DE LAS COMPLICACIONES EN LA EXENTERACIN PLVICA LIMITACIONES DE LOS SISTEMAS DE CLASIFICACIN ACTUALES OBJETIVO:Este estudio tuvo como objetivo informar de manera integral las complicaciones asociadas con la exanteración pélvica y determinar la rlacion de las asociaciones entre tres metodologías de clasificación diferentes y la duración de la estadía, la calidad de vida y los resultados físicos.ANTECEDENTES:En general, se acepta que la exanteración pélvica se asocia con altas tasas de morbilidad quirúrgica. Sin embargo, los métodos de notificación en la literatura son inconsistentes, lo que dificulta la comparación de los resultados quirúrgicos entre estudios para determinar el impacto de la cirugía en los pacientes.DISEÑO:Este fue un estudio retrospectivo.AJUSTES:Este estudio se realizó en el Royal Prince Alfred Hospital, Sydney. Australia.PACIENTES:Se incluyeron pacientes a las que se les realizó exenteración pélvica entre diciembre de 2016 y agosto de 2019.PRINCIPALES MEDIDAS DE RESULTADO:Las complicaciones se clasificaron de acuerdo con la Clasificación de Clavien-Dindo, el Índice Integral de Complicaciones y el número de complicaciones posoperatorias. Correlaciones entre la duración de la estadía, la puntuación del componente físico, la prueba de caminata de 6 minutos y la prueba de sentarse y levantarse; y las complicaciones según la clasificación de Clavien-Dindo, el CCI y el número de complicaciones se exploraron mediante las pruebas de correlación biserial de Pearson o Point.RESULTADOS:Un total de 198 pacientes fueron incluidos en este estudio. La clasificación de Clavien-Dindo se correlacionó moderadamente positivamente con la duración de la estancia ( r = 0,519, p < 0,0001), mientras que el índice de complicaciones integrales ( r = 0,744, p < 0,0001) y el número de complicaciones ( r = 0,751, p < 0,0001) mostraron una fuerte correlación con la duración de la estancia. Todas estas metodologías se correlacionaron moderadamente inversamente con la prueba de caminata de 6 minutos antes del alta (Clasificación de Clavien-Dindo: r = -0,359, p = 0,008; Índice de Complicaciones Integrales: r = -0,388, p = 0,007; número de complicaciones: r = -0,467, p < 0,0001).LIMITACIONES:Un estudio retrospectivo de un solo centro incluye un tamaño de muestra pequeño. La clasificación de las complicaciones de grado I y II en esta cohorte de pacientes que tienden a tener una recuperación postoperatoria compleja fue un desafío y, por lo tanto, incompleta. Los datos incompletos pueden haber afectado las correlaciones.CONCLUSIONES:El Índice Integral de Complicaciones y el número de complicaciones postoperatorias se correlacionaron más con la duración de la estancia que la Clasificación de Clavien-Dindo en pacientes con exenteración pélvica. El Índice Integral de Complicaciones puede ser un mejor sistema de clasificación para clasificar las complicaciones posoperatorias después de la exenteración pélvica. Consulte Video Resumen en http://links.lww.com/DCR/B906 . (Traducción-Dr. Yolanda Colorado ).
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Affiliation(s)
- Yeqian Huang
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown. New South Wales, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Xiaomeng Wang
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown. New South Wales, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Jane Young
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown. New South Wales, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Cherry Koh
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown. New South Wales, Australia
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
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46
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Pullia M, Ciatto L, Andronaco G, Donato C, Aliotta RE, Quartarone A, De Cola MC, Bonanno M, Calabrò RS, Cellini R. Treadmill Training Plus Semi-Immersive Virtual Reality in Parkinson's Disease: Results from a Pilot Study. Brain Sci 2023; 13:1312. [PMID: 37759913 PMCID: PMC10526302 DOI: 10.3390/brainsci13091312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative disorders that causes postural instability and gait alterations, such as reduced walking speed, shorter step length, and gait asymmetry, exposing patients to a higher risk of falling. Recently, virtual reality (VR) was added to a treadmill, in order to promote motor functional recovery and neuroplastic processes. Twenty PD patients were enrolled and randomly assigned to two groups: the experimental group (EG) and the control group (CG). In particular, patients in the EG were trained with the C-Mill, an innovative type of treadmill, which is equipped with semi-immersive VR, whereas the CG performed conventional physiotherapy. Patients in both groups were evaluated through a specific motor assessment battery at baseline (T0) and after the training (T1). Comparing pre-(T0) and post-(T1) treatment scores, in the EG, we found statistical significances in the following outcome measures: 6 Minutes Walking Test (6MWT) (p < 0.0005), Timed up and go (TUG right) (p < 0.03), Berg Balance Scale (BBS) (p < 0.006), Tinetti Scale (TS) (p < 0.002), Falls Efficacy Scale- International (FES-I), (p < 0.03) Unified PD Rating Scale-III (UPDRS) (p < 0.002), and Functional Independence Measure (FIM) (p < 0.004). Also, the CG showed statistical significances after the training. Between-group (EG and CG) analysis showed significative statistical differences in 6MWT (p < 0.006), BBS (p < 0.006), TS (p < 0.008), FES-I (p < 0.01), and FIM (p < 0.009). From our results it emerges that both groups (EG and CG) achieved better outcome scores after the treatment, suggesting that both physiotherapy interventions were effective. However, the EG training using VR seemed to have induced more improvements, especially in gait and balance skills. Then, C-Mill could be a valid adjunctive treatment in the context of gait and balance disturbances, which are very common in the PD population.
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Affiliation(s)
| | | | | | | | | | | | | | - Mirjam Bonanno
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (M.P.); (L.C.); (G.A.); (C.D.); (R.E.A.); (A.Q.); (M.C.D.C.); (R.C.)
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47
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Moqri M, Herzog C, Poganik JR, Justice J, Belsky DW, Higgins-Chen A, Moskalev A, Fuellen G, Cohen AA, Bautmans I, Widschwendter M, Ding J, Fleming A, Mannick J, Han JDJ, Zhavoronkov A, Barzilai N, Kaeberlein M, Cummings S, Kennedy BK, Ferrucci L, Horvath S, Verdin E, Maier AB, Snyder MP, Sebastiano V, Gladyshev VN. Biomarkers of aging for the identification and evaluation of longevity interventions. Cell 2023; 186:3758-3775. [PMID: 37657418 PMCID: PMC11088934 DOI: 10.1016/j.cell.2023.08.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/03/2023]
Abstract
With the rapid expansion of aging biology research, the identification and evaluation of longevity interventions in humans have become key goals of this field. Biomarkers of aging are critically important tools in achieving these objectives over realistic time frames. However, the current lack of standards and consensus on the properties of a reliable aging biomarker hinders their further development and validation for clinical applications. Here, we advance a framework for the terminology and characterization of biomarkers of aging, including classification and potential clinical use cases. We discuss validation steps and highlight ongoing challenges as potential areas in need of future research. This framework sets the stage for the development of valid biomarkers of aging and their ultimate utilization in clinical trials and practice.
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Affiliation(s)
- Mahdi Moqri
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Genetics, School of Medicine, Stanford University, Stanford, CA, USA; Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Chiara Herzog
- European Translational Oncology Prevention and Screening Institute, Universität Innsbruck, Innsbruck, Austria
| | - Jesse R Poganik
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jamie Justice
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Daniel W Belsky
- Department of Epidemiology, Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Alexey Moskalev
- Institute of Biogerontology, Lobachevsky University, Nizhny Novgorod, Russia
| | - Georg Fuellen
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock University Medical Center, Rostock, Germany; School of Medicine, University College Dublin, Dublin, Ireland
| | - Alan A Cohen
- Department of Environmental Health Sciences, Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ivan Bautmans
- Gerontology Department, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Martin Widschwendter
- European Translational Oncology Prevention and Screening Institute, Universität Innsbruck, Innsbruck, Austria; Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, UK; Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, Stockholm, Sweden
| | - Jingzhong Ding
- Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | | | - Jing-Dong Jackie Han
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Center for Quantitative Biology, Peking University, Beijing, China
| | - Alex Zhavoronkov
- Insilico Medicine Hong Kong, Pak Shek Kok, New Territories, Hong Kong SAR, China
| | - Nir Barzilai
- Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Matt Kaeberlein
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Steven Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Brian K Kennedy
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | | | - Eric Verdin
- Buck Institute for Research on Aging, Novato, CA, USA
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore
| | - Michael P Snyder
- Department of Genetics, School of Medicine, Stanford University, Stanford, CA, USA.
| | - Vittorio Sebastiano
- Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, CA, USA.
| | - Vadim N Gladyshev
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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48
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Crispim Carvalho NN, Martins VJB, Filho JM, de Arruda Neta ADCP, Pimenta FCF, de Brito Alves JL. Effects of preoperative sarcopenia-related parameters on the musculoskeletal and metabolic outcomes after bariatric surgery: a one-year longitudinal study in females. Sci Rep 2023; 13:13373. [PMID: 37591922 PMCID: PMC10435473 DOI: 10.1038/s41598-023-40681-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/16/2023] [Indexed: 08/19/2023] Open
Abstract
Reduced muscle mass and/or strength are risk factors for metabolic and musculoskeletal impairment. The present study evaluated anthropometric, metabolic, and musculoskeletal outcomes in females with and without sarcopenic-obesity parameters who underwent bariatric surgery during a 1-year follow-up. A prospective, single-center cohort study was conducted in females with obesity undergoing preoperative evaluation for surgery. In the preoperative period, females were allocated into obesity with sarcopenic-obesity parameters (SOP group, n = 15) and without sarcopenic-obesity parameters (obesity group, n = 21). Sarcopenic obesity parameters were defined as lower appendicular skeletal mass adjusted for weight (ASM/wt) and/or low handgrip strength (HGS). Anthropometric, metabolic, and musculoskeletal parameters were assessed before surgery and at 3 months, 6 months, and a 1-year after bariatric surgery. Weight loss was similar between groups (p > 0.05). Weight, body mass index, fat mass, body fat percentage, skeletal muscle mass, fat-free mass, fat-free mass index, HGS were reduced in both groups during the 1-year follow-up (p < 0.05). However, when muscle mass and strength were analyzed relative to body size, an improvement after bariatric surgery was found in both groups (p < 0.05). Total cholesterol, LDL-c, triglycerides, fasting glucose, glycated hemoglobin, insulin, and insulin resistance were reduced in both groups during the 1-year follow-up (p < 0.05). In addition, HDL-c serum concentration increased in females with and without sarcopenic-obesity parameters over the 1-year follow-up (p < 0.05). Both groups had decreased bone mineral density (BMD) at all sites (lumbar spine, femoral neck, and total femur) over the 1-year follow-up (p < 0.05). The highest quartile of ASM/wt was positively associated with BMD variables in a longitudinal analysis, suggesting that preserved ASM/wt in pre-surgery may be beneficial for BMD after 1 year of bariatric surgery. The results showed that bariatric surgery promotes similar musculoskeletal and metabolic changes in females with preserved muscle mass and strength or in females with sarcopenia-related parameters.
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Affiliation(s)
- Nara Nóbrega Crispim Carvalho
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, Campus I - Jd. Cidade Universitária, Joao Pessoa, PB, 58051-900, Brazil
- Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Vinícius José Baccin Martins
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, Campus I - Jd. Cidade Universitária, Joao Pessoa, PB, 58051-900, Brazil
| | - João Modesto Filho
- Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, Joao Pessoa, Brazil
| | | | | | - José Luiz de Brito Alves
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, Campus I - Jd. Cidade Universitária, Joao Pessoa, PB, 58051-900, Brazil.
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49
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Ernst R, Bouteleux B, Malhouitre M, Grassion L, Zysman M, Henrot P, Delorme M. The Non-Paced 3-Minute Sit-to-Stand Test: Feasibility and Clinical Relevance for Pulmonary Rehabilitation Assessment. Healthcare (Basel) 2023; 11:2312. [PMID: 37628511 PMCID: PMC10454867 DOI: 10.3390/healthcare11162312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/26/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Pulmonary rehabilitation (PR) improves health-related quality-of-life (HRQoL) in individuals with chronic obstructive pulmonary disease (COPD), notably by increasing exercise tolerance. Easy-to-implement sit-to-stand tests can facilitate the assessment of exercise tolerance in routine practice. This retrospective study conducted in a real-life setting was designed to describe the non-paced 3-min sit-to-stand test (3-STST) and to evaluate its relationship with HRQoL (VQ11 questionnaire) to identify the determinants of 3-STST performance and to analyze the evolution of 3-STST performance and HRQoL over the course of a community-based PR program. Seventy-one COPD patients (age 69 ± 10 years old; 51% with GOLD spirometric stages III-IV) were included. Mean ± SD 3-STST performance at the initial PR assessment was 43 ± 15 repetitions. This performance was significantly associated with HRQoL and other indicators of clinical severity (lung function, dyspnea, and functional capacities). During the multivariate analysis, younger age, exertional dyspnea with mMRC ≤ 1, and better HRQoL were significantly associated with better 3-STST performance. From the initial to second PR assessment, changes in 3-STST performance were significantly associated with changes in HRQoL. This study provides evidence that the non-paced 3-STST is feasible and might be clinically relevant in the assessment of patients with COPD referred for community-based PR. This test deserves to be prospectively validated.
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Affiliation(s)
| | | | | | - Léo Grassion
- Département de Pneumologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
| | - Maéva Zysman
- Département de Pneumologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, INSERM U1045, CIC1401, 33604 Pessac, France
| | - Pauline Henrot
- Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, INSERM U1045, CIC1401, 33604 Pessac, France
- Service des Explorations Fonctionnelles Respiratoires, Département de Physiologie, CHU de Bordeaux, 33604 Pessac, France
| | - Mathieu Delorme
- Resp’Air, 33400 Talence, France
- Direction des Actions Médicales, AFM-Téléthon, 91000 Evry, France
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50
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Santos-Martínez LE, Osegueda-Palomera N, Montoya-Landa C, Reséndiz-Herrera R, Ordóñez-Reyna A, Arroyo-González JJ, Quevedo-Paredes J, Moreno-Ruiz LA. [Six minute walk test: From normal to morbid obesity subject]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2023; 93:284-293. [PMID: 36693218 PMCID: PMC10406474 DOI: 10.24875/acm.22000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/13/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Morbid obesity is associated with alterations in the ability to walk, however, the behavior of the 6-minute walk test in subjects with increases in body mass index is unknown. Objective To describe the behavior of the 6-minute walk test in subjects with normal body mass index to morbid obesity. Methods Through an analytical cross-sectional design, subjects of both genders from 18 to 60 years old with body mass index were studied: Normal (BMI:18.5-24.9); overweight (BMI:25-29.9); obesity (BMI:30-39.9); morbid obesity (BMI:>40) kg/m2. A 6-minute walk test was performed, demographic variables and pathological personal history were delimited. BMI categories were analyzed with one-way ANOVA and Bonferroni adjustment, and gender with t-test, both for independent groups, and Pearson's correlations for the various variables. Results 480 subjects of both genders were studied in four groups. Age: men 43 ± 11 and women 45 ± 10 years old. Percentage diabetes mellitus (6.7%), arterial hypertension (18.3%). Meters walked men vs. women by body mass index (normal: 483 ± 56 vs. 449 ± 61; overweight: 471 ± 55 vs. 441 ± 44; obesity: 455 ± 70 vs. 421 ± 47; morbid obesity: 443 ± 49 vs. 403 ± 54, p < 0.05). Correlation body mass index-meters walked: r: -0.446 (p < 0.0001). Conclusions Meters walked in the 6-minute walk test decreased as body mass index increased. The male gender walked more meters in all categories.
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Affiliation(s)
- Luís E. Santos-Martínez
- Departamento de Hipertensión Pulmonar y Corazón Derecho, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social
- Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares, Secretaría de Salubridad y Asistencia, Instituto Nacional de Cardiología Ignacio Chávez
| | - Noé Osegueda-Palomera
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Caleb Montoya-Landa
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Raúl Reséndiz-Herrera
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Adriana Ordóñez-Reyna
- Departamento de Hipertensión Pulmonar y Corazón Derecho, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social
| | - Juan J. Arroyo-González
- Departamento de Hipertensión Pulmonar y Corazón Derecho, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social
| | - Javier Quevedo-Paredes
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Luís A. Moreno-Ruiz
- Departamento de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Ciudad de México, México
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