1
|
Belloumi N, Habouria C, Bachouch I, Mersni M, Chermiti F, Fenniche S. Feasibility of a home-designed respiratory rehabilitation program for chronic obstructive pulmonary disease. Prim Health Care Res Dev 2024; 25:e7. [PMID: 38287510 PMCID: PMC10894720 DOI: 10.1017/s1463423623000324] [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: 01/31/2024] Open
Abstract
BACKGROUND According to international guidelines, respiratory rehabilitation (RR) for patients with chronic obstructive pulmonary disease (COPD) is a cornerstone of standard non-pharmacological treatment. AIMS To evaluate feasibility of a home-designed RR program and analyze its medium-term impact on respiratory parameters and quality of life. METHODS This was a prospective study involving 74 COPD patients enrolled in January 2019 and put on inhaled bronchodilator treatment associated with RR at home following a written protocol, for 16 weeks. The comparative statistical analysis highlights the difference before and after RR in terms of clinical and functional respiratory parameters as well as in terms of quality of life (assessed on the short form 36 (SF-36) questionnaire). The comparison involves RR-adherent patients versus non-adherent patients. RESULTS Mean age was 66.7 ± 8.3 years with a median of 67 years. All patients were smokers, out of which 42 patients (57%) did not quit yet. Forty-one percent of patients were frequent exacerbators. The average COPD assessment test (CAT) score in our patients was 23. The average 6-minutes walk distance (MWD) was 304 m. The BODE index in our patients was 4.11 on average. The RR program was followed by 36 patients (48%). Thirty patients (40%) applied it at least twice a week. RR-adherent patients had an average CAT score decreasing from 23 to 14.5 (P = 0.011). Their average 6-MWD was 444.6 m by the end of the study, which would be 64.2% of the calculated theoretical value. The average FEV1 increase after RR was 283 mL. The majority (69%) of RR-adherent patients were ranked as quartile 1; BODE index ≤2. The average scores of physical, psycho-social, and general dimensions assessed on the SF-36 questionnaire improved in RR-adherent patients. CONCLUSIONS RR is a key non-pharmacological treatment for COPD. Its interest originates from its multidisciplinary nature, hence its effectiveness in several respiratory parameters. Our study reflects the feasibility of home-designed protocols in the absence of contraindications. We highlight also the positive impact on quality of life after RR at home.
Collapse
Affiliation(s)
- Nidhal Belloumi
- Pulmonology Department Pavilion 4, Abderrahmen Mami Hospital, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Ariana, Tunisia
| | - Chaima Habouria
- Pulmonology Department Pavilion 4, Abderrahmen Mami Hospital, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Ariana, Tunisia
| | - Imen Bachouch
- Pulmonology Department Pavilion 4, Abderrahmen Mami Hospital, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Ariana, Tunisia
| | - Meriem Mersni
- Faculty of Medicine of Tunis, University of Tunis El Manar, Ariana, Tunisia
- Occupational and Environmental Medicine Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Fatma Chermiti
- Pulmonology Department Pavilion 4, Abderrahmen Mami Hospital, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Ariana, Tunisia
| | - Soraya Fenniche
- Pulmonology Department Pavilion 4, Abderrahmen Mami Hospital, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Ariana, Tunisia
| |
Collapse
|
2
|
Raju S, Woo H, Koehler K, Fawzy A, Liu C, Putcha N, Balasubramanian A, Peng RD, Lin CT, Lemoine C, Wineke J, Berger RD, Hansel NN, McCormack MC. Indoor Air Pollution and Impaired Cardiac Autonomic Function in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2023; 207:721-730. [PMID: 36288428 PMCID: PMC10037475 DOI: 10.1164/rccm.202203-0523oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
Rationale: Indoor air pollution represents a modifiable risk factor for respiratory morbidity in chronic obstructive pulmonary disease (COPD). The effects of indoor air pollution, as well as the impact of interventions to improve indoor air quality, on cardiovascular morbidity in COPD remain unknown. Objectives: To determine the association between indoor particulate matter (PM) and heart rate variability (HRV), a measure of cardiac autonomic function tied to cardiovascular morbidity and mortality, as well as the impact of household air purifiers on HRV. Methods: Former smokers with moderate-severe COPD were recruited from a 6-month randomized controlled trial of a portable air cleaner intervention to undergo paired assessment of both in-home PM and HRV using 24-hour Holter monitoring at up to five time points. Primary outcomes were HRV measures tied to cardiovascular morbidity (standard deviation of normal-to-normal intervals [SDNN] and root mean square of successive differences between normal-to-normal intervals [RMSSD]). Measurements and Results: Eighty-five participants contributed 317 HRV measurements. A twofold increase in household PM ⩽2.5 µm in aerodynamic diameter was associated with decreases in SDNN (β, -2.98% [95% confidence interval (CI), -5.12 to -0.78]) and RMSSD (β, -4.57% [95% CI, -10.1 to -1.60]). The greatest effects were observed with ultrafine particles (<100 nm) (RMSSD; β, -16.4% [95% CI, -22.3 to -10.1]) and among obese participants. Participants randomized to the active air cleaner saw improvements in RMSSD (β, 25.2% [95% CI, 2.99 to 52.1]), but not SDNN (β, 2.65% [95% CI, -10.8 to 18.1]), compared with the placebo group. Conclusions: This is the first U.S. study to describe the association between household PM and cardiac autonomic function among individuals with COPD, as well as the potential cardiovascular health benefits of household air cleaners.
Collapse
Affiliation(s)
| | | | - Kirsten Koehler
- Department of Environmental Health Sciences and Engineering and
| | | | | | | | | | - Roger D. Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Cheng Ting Lin
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chantal Lemoine
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and
| | - Jennifer Wineke
- Department of Psychiatry, University of Maryland Medical Center, Baltimore, Maryland
| | | | - Nadia N. Hansel
- Department of Medicine and
- Department of Environmental Health Sciences and Engineering and
| | - Meredith C. McCormack
- Department of Medicine and
- Department of Environmental Health Sciences and Engineering and
| |
Collapse
|
3
|
Camargo PF, Ditomaso-Luporini L, de Carvalho LCS, Goulart CDL, Batista Dos Santos P, Sebold R, Roscani MG, Mendes RG, Borghi-Silva A. Obstructive sleep apnea reduces functional capacity and impairs cardiac autonomic modulation during submaximal exercise in patients with chronic obstructive pulmonary disease: A follow-up study. Heart Lung 2023; 57:257-264. [PMID: 36332349 DOI: 10.1016/j.hrtlng.2022.10.007] [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: 05/09/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Functional capacity and heart rate variability (HRV) are important prognostic markers in chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSA). However, the impact of the overlap of these diseases and the one-year clinical follow-up has not yet been evaluated. OBJECTIVES To assess whether the presence of OSA can impair functional performance and cardiac autonomic control during exercise in patients with COPD; and to verify whether the overlap of these diseases could lead to worse clinical outcomes during the one-year follow-up. METHODS Thirty-four patients underwent pulmonary function tests, echocardiography and polysomnography for diagnostic confirmation, disease staging, exclusion of any cardiac changes, and allocation between groups. The patients underwent the six-minute walk test (6MWT) to assess functional capacity and HRV during exercise. Subsequently, patients were followed up for 12 months to record outcomes such as exacerbation, hospitalization, and deaths. At the end of this period, the patients were revaluated to verify the hypotheses of the study. RESULTS The OSA-COPD group showed greater functional impairment when compared to the COPD group (p=0.003) and showed worse cardiac autonomic responses during the 6MWT with greater parasympathetic activation (p=0.03) and less complexity of the autonomic nervous system, in addition to being more likely to exacerbate (p=0.03) during one year of follow-up. CONCLUSION OSA-COPD produces deleterious effects on functional performance and a greater autonomic imbalance that impairs clinical outcomes.
Collapse
Affiliation(s)
- Patrícia Faria Camargo
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Luciana Ditomaso-Luporini
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Luiz Carlos Soares de Carvalho
- Center for Science and Technology in Energy and Sustainability of Federal University of Reconcavo da Bahia, Feira de Santana, Bahia, Brazil
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Polliana Batista Dos Santos
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Rayane Sebold
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Meliza Goi Roscani
- Medicine Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil.
| |
Collapse
|
4
|
Hu J, Gao R, Wang Y, Li Y, Wang Y, Wang Z, Yang J. Effect of Liuzijue on pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: study protocol for a multicenter, non-randomized, prospective study. BMC Complement Med Ther 2022; 22:296. [PMID: 36397066 PMCID: PMC9670448 DOI: 10.1186/s12906-022-03789-6] [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: 05/26/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background Traditional Chinese exercise as a new pulmonary rehabilitation technique has been increasingly used and achieved good results in pulmonary rehabilitation of chronic obstructive pulmonary disease (COPD). The aim of this study is to investigate the protective effects of Liuzijue on exercise tolerance, lung function, and quality of life in patients with COPD. Methods This study is a multicenter, non-randomized, prospective study. Patients will be divided into a control group (CG) and a Liuzijue group (LG) based on their willingness to learn Liuzijue. None of the outcome assessors will know the grouping of patients. Participants in this study will be collected from stable COPD patients who are outpatients or inpatients in 3 centers in China since September 2021. Patients will meet the diagnostic criteria for GOLD stage I-II COPD (FEV1% ≥ 0.5 and FEV1/FVC < 0.7) and be aged 40 years or older. Patients voluntarily will take part in the clinical study and sign an informed consent form. All participants will follow their existing medication. For LG patients, Liuzijue training has been added. Patients will practice Liuzijue for more than 30 minutes a day, more than 5 days a week, and adhere to the training for 3 months. Outcome indicators are 6-minute walk test (6MWT), lung function (FEV1%, FEV1/FVC, MMEF, PEF), modified British Medical Research Council (mMRC) score, COPD assessment test score (CAT), acute exacerbations and changes in drug treatment. Discussion This study quantified the effect of Liuzijue on the pulmonary rehabilitation of COPD patients in the stable phase of the disease, and provided a basis for the use of Liuzijue in COPD patients. Trial registration Chinese clinical trial registry, ChiCTR2100048945. Date: 2021-07-19. http://www.chictr.org.cn/showproj.aspx?proj=129094 Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03789-6.
Collapse
Affiliation(s)
- Jiaming Hu
- grid.268505.c0000 0000 8744 8924Zhejiang Chinese Medical University, Binwen Road 548, Binjiang District, Zhejiang, 310053 Hangzhou China
| | - Rundi Gao
- grid.268505.c0000 0000 8744 8924The Second Clinical Medical College, Zhejiang Chinese Medical University, Binwen Road 548, Binjiang District, Zhejiang, 310053 Hangzhou China ,grid.417400.60000 0004 1799 0055Department of Respiration, The First Affiliated Hospital of Zhejiang Chinese Medical University, Youdian Road 54, Shangcheng District, Zhejiang, 310006 Hangzhou China
| | - Yiting Wang
- grid.268505.c0000 0000 8744 8924Zhejiang Chinese Medical University, Binwen Road 548, Binjiang District, Zhejiang, 310053 Hangzhou China
| | - Yan Li
- grid.268505.c0000 0000 8744 8924Zhejiang Chinese Medical University, Binwen Road 548, Binjiang District, Zhejiang, 310053 Hangzhou China
| | - Yaqin Wang
- grid.268505.c0000 0000 8744 8924Zhejiang Chinese Medical University, Binwen Road 548, Binjiang District, Zhejiang, 310053 Hangzhou China
| | - Zhen Wang
- grid.417400.60000 0004 1799 0055Department of Respiration, The First Affiliated Hospital of Zhejiang Chinese Medical University, Youdian Road 54, Shangcheng District, Zhejiang, 310006 Hangzhou China
| | - Junchao Yang
- grid.417400.60000 0004 1799 0055Department of Respiration, The First Affiliated Hospital of Zhejiang Chinese Medical University, Youdian Road 54, Shangcheng District, Zhejiang, 310006 Hangzhou China
| |
Collapse
|
5
|
Jao LY, Hsieh PC, Wu YK, Yang MC, Wu CW, Lee C, Tzeng IS, Lan CC. Different Responses to Pulmonary Rehabilitation in COPD Patients with Different Work Efficiencies. Int J Chron Obstruct Pulmon Dis 2022; 17:931-947. [PMID: 35502293 PMCID: PMC9056104 DOI: 10.2147/copd.s356608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/03/2022] [Indexed: 12/02/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) often involves the cardiopulmonary dysfunction that deteriorates health-related quality of life (HRQL) and exercise capacity. Work efficiency (WE) indicates the efficiency of overall oxygen consumption (VO2) during exercise. This study investigated whether different WEs have different effects on pulmonary rehabilitation (PR). Methods Forty-five patients with stable COPD were scheduled for PR. The PR programs consisted of twice-weekly sessions for three months. These patients were comprehensively evaluated by cardiopulmonary exercise testing and COPD assessment test (CAT) before and after PR. We compared these parameters between patients with a normal versus poor WE. Results Twenty-one patients had a normal WE and twenty-four patients had a poor WE (<8.6 mL/min/watt). Patients with a poor WE had earlier anaerobic metabolism, a poorer oxygen pulse, lower exercise capacity, more exertional dyspnea, and a poorer HRQL than those with a normal WE. PR improved exercise capacity, HRQL, anaerobic threshold, exertional dyspnea and leg fatigue in patients with either normal or poor WE. However, significant improvement of WE, oxygen pulse, respiratory frequency (Rf) during exercise, chest tightness, activity and sleepiness by CAT were noted only in patients with a poor WE. Among the patients with a poor WE, 29% patients had WE returned to normal after PR. Conclusion Patients with different WE had different responses to PR. PR improved exercise capacity and HRQL regardless of a normal or poor WE. However, WE, oxygen pulse, Rf during exercise, chest tightness, activity and sleepiness were only improved in patients with a poor WE.
Collapse
Affiliation(s)
- Lun-Yu Jao
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Chih-Wei Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Chung Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Tzu-Chi University, Hualien, Taiwan
- Correspondence: Chou-Chin Lan, Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289, Jianguo Road, Xindian District, New Taipei City, Taiwan, 23142, Tel +886-2-6628-9779 ext. 2259, Fax +886-2-6628-9009, Email
| |
Collapse
|
6
|
Yang Y, Li W, Kang Y, Guo Y, Yang K, Li Q, Liu Y, Yang C, Chen R, Chen H, Li X, Cheng L. A novel lung radiomics feature for characterizing resting heart rate and COPD stage evolution based on radiomics feature combination strategy. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:4145-4165. [PMID: 35341291 DOI: 10.3934/mbe.2022191] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The resting HR is an upward trend with the development of chronic obstructive pulmonary disease (COPD) severity. Chest computed tomography (CT) has been regarded as the most effective modality for characterizing and quantifying COPD. Therefore, CT images should provide more information to analyze the lung and heart relationship. The relationship between HR variability and PFT or/and COPD has been fully revealed, but the relationship between resting HR variability and COPD radiomics features remains unclear. 231 sets of chest high-resolution CT (HRCT) images from "COPD patients" (at risk of COPD and stage I to IV) are segmented by the trained lung region segmentation model (ResU-Net). Based on the chest HRCT images and lung segmentation images, 231 sets of the original lung parenchyma images are obtained. 1316 COPD radiomics features of each subject are calculated by the original lung parenchyma images and its derived lung parenchyma images. The 13 selected COPD radiomics features related to the resting HR are generated from the Lasso model. A COPD radiomics features combination strategy is proposed to satisfy the significant change of the lung radiomics feature among the different COPD stages. Results show no significance between COPD stage Ⅰ and COPD stage Ⅱ of the 13 selected COPD radiomics features, and the lung radiomics feature Y1-Y4 (P > 0.05). The lung radiomics feature F2 with the dominant selected COPD radiomics features based on the proposed COPD radiomics features combination significantly increases with the development of COPD stages (P < 0.05). It is concluded that the lung radiomics feature F2 with the dominant selected COPD radiomics features not only can characterize the resting HR but also can characterize the COPD stage evolution.
Collapse
Affiliation(s)
- Yingjian Yang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Wei Li
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Yan Kang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
- Engineering Research Centre of Medical Imaging and Intelligent Analysis, Ministry of Education, Shenyang 110169, China
| | - Yingwei Guo
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
| | - Kai Yang
- Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University, Shenzhen 518001, China
- The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518001, China
| | - Qiang Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Yang Liu
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Chaoran Yang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
| | - Rongchang Chen
- Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University, Shenzhen 518001, China
- The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518001, China
| | - Huai Chen
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xian Li
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Lei Cheng
- Shenzhen Happy-Growing Intelligent CO., Ltd, Shenzhen 518118, China
| |
Collapse
|
7
|
Alharbi MG, Kalra HS, Suri M, Soni N, Okpaleke N, Yadav S, Shah S, Iqbal Z, Hamid P. Pulmonary Rehabilitation in Management of Chronic Obstructive Pulmonary Disease. Cureus 2021; 13:e18414. [PMID: 34646587 PMCID: PMC8486403 DOI: 10.7759/cureus.18414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/30/2021] [Indexed: 11/21/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is an obstructive and progressive airway disorder that is linked with a significant loss in daily physical activity as well as psychological issues that contribute to the patient's impairment and poor health-related quality of life. Over the last two decades, however, the research and application of nonpharmacologic therapies such as lung rehabilitation have been expedited with increasing evidence of systemic events in COPD patient groups and their nugatory impact on their functioning pulmonary rehabilitation (PR). It is a key part of integrated treatment for COPD and other chronic breathing disorders and is helpful in supporting the recovery of patients following COPD hospitalization. In this paper, we summarize current evidence regarding the effectiveness of PR in the management of chronic COPD. A systematic review was carried out during June 2021, searching databases PubMed, Google Scholar, and EBSCO. The authors extracted qualitative data, and then the author's names, year, study type, methodology, and the result were reported. The search of the aforementioned databases returned a total of 127 studies that were included for title, abstract, and full-text screening, and nine studies were enrolled for final data extraction. PR alleviates tiredness and dyspnea, improves emotional function, and increases the ability to do daily activities. These benefits are relatively extensive and substantial clinically. Rehabilitation acts as an important component of COPD management and helps to improve the quality of life and training linked to health.
Collapse
Affiliation(s)
- Mohammed G Alharbi
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, Prince Mohammed Bin Abdulaziz Medical City, Aljouf, SAU
| | - Harjeevan S Kalra
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Firefield, USA
| | - Megha Suri
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nitin Soni
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nkiruka Okpaleke
- Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Shikha Yadav
- Internal Medicine, Kathmandu University, Kathmandu, NPL
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Suchitra Shah
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Zafar Iqbal
- Emergency Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Emergency Medicine, The Kidney Centre, Karachi, PAK
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
8
|
Naz İ, Şahin H, Aktaş B. Predictors of improvement in resting heart rate after exercise training in patients with chronic obstructive pulmonary disease. Ir J Med Sci 2021; 191:1613-1619. [PMID: 34510377 DOI: 10.1007/s11845-021-02771-4] [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: 07/29/2021] [Accepted: 09/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND High resting heart rate (RHR) is associated with multiple morbidity in chronic obstructive pulmonary disease (COPD) patients. Factors regarding the effectiveness of exercise training (ET) on RHR in COPD patients are unclear. AIMS The main objective of the current study is to determine the predictors of the eventual change in RHR after ET. METHODS One hundred and ten COPD patients (mean age: 63.1 ± 8.1 years, FEV1%: 43.6 ± 16.6) who participated in the ET program that consisted of supervised breathing, aerobic, strengthening, and stretching exercises for 8 weeks, 2 days a week, were included in the study. RHR, pulmonary functions, 6-min walk distance (6-MWD), Modified Medical Research Council Dyspnea Scale, St. George Respiratory Questionnaire, and Hospital Anxiety and Depression scores were compared before and after ET. Multivariate regression analysis was performed to correlate factors related to changes in RHR before and after exercise. RESULTS There was a significant improvement in RHR after the ET program (p < 0.001). Improvement in RHR was correlated with baseline RHR, 6-MWD, partial arterial oxygen pressure, dyspnea sensation, forced expiratory volume in the first second (r = 0.516, -0.388, -0.489, 0.369, -0.360, p < 0.05, respectively), and change in 6-MWD, partial arterial oxygen pressure, and symptom score (r = 0.523, 0.451, -0.325, p < 0.05, respectively) after ET. Baseline RHR, 6-MWD, and the change in 6-MWD were the independent factors that predicted the change in RHR after ET. CONCLUSIONS Patients with a high RHR and low functional capacity and whose functional capacity improves more have a greater decrease in RHR after the ET program. By considering these related factors, clinicians can focus on improving the cardiovascular system in COPD patients. CLINICAL TRIAL NUMBER NCT04890080 (retrospectively registered-date of registration: 05.17.2021).
Collapse
Affiliation(s)
- İlknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Kâtip Celebi University, 35620, Çiğli, İzmir, Turkey.
| | - Hülya Şahin
- Chest Diseases Clinic, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Büşra Aktaş
- Institute of Health Sciences, Izmir Kâtip Celebi University, Izmir, Turkey
| |
Collapse
|
9
|
Souto-Miranda S, Rodrigues G, Spruit MA, Marques A. Pulmonary rehabilitation outcomes in individuals with chronic obstructive pulmonary disease: a systematic review. Ann Phys Rehabil Med 2021; 65:101564. [PMID: 34329794 DOI: 10.1016/j.rehab.2021.101564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The magnitude of response to pulmonary rehabilitation (PR) is influenced by the selection of outcomes and measures. OBJECTIVES This systematic review aimed to review all outcomes and measures used in clinical trials of PR for individuals with chronic obstructive pulmonary disease (COPD). METHODS The review involved a search of Scopus, Web of Knowledge, Cochrane Library, EBSCO, Science Direct and PubMed databases for studies of stable individuals with COPD undergoing PR. Frequency of reporting for each domain, outcome and measure was synthesized by using Microsoft Excel. RESULTS We included 267 studies (43153 individuals with COPD). A broad range of domains (n=22), outcomes (n=163) and measures (n=217) were reported. Several measures were used for the same outcome. The most reported outcomes were exercise capacity (n=218) assessed with the 6-min walk test (n=140), health-related quality of life (n=204) assessed with the Saint George's respiratory questionnaire (n=99), and symptoms (n=158) assessed with the modified Medical Research Council dyspnea scale (n=56). The least reported outcomes were comorbidities, adverse events and knowledge. CONCLUSIONS This systematic review reinforces the need for a core outcome set for PR in individuals with COPD because of high heterogeneity in reported outcomes and measures. Future studies should assess the importance of each outcome for PR involving different stakeholders. PROSPERO ID CRD42017079935.
Collapse
Affiliation(s)
- Sara Souto-Miranda
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED: Institute of Biomedicine, University of Aveiro, Aveiro, Portugal; Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Guilherme Rodrigues
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
| | - Martijn A Spruit
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands; Department of Research and Development, CIRO, Horn, Netherlands
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; iBiMED: Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.
| |
Collapse
|
10
|
Jangalee JV, Ghasvareh P, Guenette JA, Road J. Incorporating remote patient monitoring in virtual pulmonary rehabilitation programs. ACTA ACUST UNITED AC 2021; 57:83-89. [PMID: 34345655 PMCID: PMC8297692 DOI: 10.29390/cjrt-2021-015] [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] [Indexed: 11/16/2022]
Abstract
Most pulmonary rehabilitation (PR) programs have had to adapt due to the COVID-19 pandemic and associated restrictions. Current alternative home-based programs have limitations and require modification. In this paper, we outline a novel method to monitor home-based PR programs, which has the potential to improve PR safety and efficacy. This new method is based on a remote patient monitoring (RPM) system with connected smart devices that enables the Respiratory Therapist (RT) to have real-time access to patient data including heart rate and peripheral oxygen saturation during exercise. The RPM system also monitors daily physical activity, sedentary time, sleep quality, rescue inhaler use, and maintenance inhaler adherence, among other variables, which has the added advantage of predicting patterns consistent with symptoms that may require medical intervention. To increase privacy, data are anonymized at all levels and only the RT has access to patient information. RPM systems have the potential to give practitioners a holistic view of the participants’ health status to better evaluate them during the entire PR program and to improve self-management. As this is not a formal research study, we cannot make definitive conclusions about the efficacy of the system, and further research is needed to examine safety and to compare our approach to other ways of conducting PR.
Collapse
Affiliation(s)
- Jenna V Jangalee
- Vancouver General Hospital Pulmonary Rehabilitation Program, Vancouver, BC, Canada
| | | | - Jordan A Guenette
- Centre for Heart and Lung Innovation, Providence Health Care Research Institute and The University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Jeremy Road
- The Lung Centre at Vancouver General Hospital, Vancouver, BC, Canada
| |
Collapse
|
11
|
Yang SH, Yang MC, Wu YK, Wu CW, Hsieh PC, Kuo CY, Tzeng IS, Lan CC. Poor Work Efficiency is Associated with Poor Exercise Capacity and Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:245-256. [PMID: 33603352 PMCID: PMC7882460 DOI: 10.2147/copd.s283005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/07/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) is a progressive disease with deteriorating cardiopulmonary function that decreases the health-related quality of life (HRQL) and exercise capacity. Patients with COPD often have cardiovascular and muscular problems that hinder oxygen uptake by peripheral tissues, resulting in poor oxygen consumption efficiency. It is important to develop new physiological parameters to evaluate oxygen consumption efficiency during activities and to evaluate its association with exercise capacity and HRQL. Work efficiency (WE) measures oxygen consumption efficiency during exercise. We hypothesize that patients with poor WE should have exercise intolerance and poor HRQL. Therefore, we aimed to evaluate the association between WE and exercise capacity, HRQL and other cardiopulmonary parameters. Patients and Methods Seventy-eight patients with COPD were evaluated with spirometry, cardiopulmonary exercise testing, and assessment of dyspnea score and HRQL (using the St. George’s Respiratory Questionnaire [SGRQ]). Cardiopulmonary exercise testing was performed using a cycle ergometer with an incremental protocol and exhaled breath analysis to assess oxygen consumption. WE was defined as the relationship between oxygen consumption and workload. Results There were 31 patients with normal WE (group I) and 47 patients (group II) with poor WE. Patients with poor WE had lower exercise capacity (maximal oxygen consumption, group I vs II as 1050±53 vs 845 ±34 mL/min, p=0.0011), poorer HRQL (SGRQ score 41.1±3.0 vs 55±2.2, p=0.0002), higher exertional dyspnea score (5.1±0.2 vs 6.1±0.2, p= 0.0034) and early anaerobic metabolism during exercise (anaerobic threshold, 672±27 vs 583 ±18 mL/min, p=0.0052). Conclusion WE is associated with exercise capacity and HRQL. Here, patients with poor WE also had exercise intolerance, poorer HRQL, and more exertional dyspnea.
Collapse
Affiliation(s)
- Shih-Hsing Yang
- Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Chih-Wei Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chan-Yen Kuo
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu-Chi University, Hualien, Taiwan
| |
Collapse
|
12
|
Gopakumar S, Valamparampil MJ, Manu MS, Nair S, Kamala R, Atulya AR, Gopal BK, Babu V, Vijayakumar K. The first state-level public health program for obstructive airway disease in India: An early field-level evaluation. J Family Med Prim Care 2020; 9:4998-5003. [PMID: 33209835 PMCID: PMC7652171 DOI: 10.4103/jfmpc.jfmpc_216_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/13/2020] [Accepted: 07/21/2020] [Indexed: 11/06/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is the second leading cause of mortality in India; however, there are no programs for COPD in India at primary care level. Kerala became the first state in India to implement a program at primary care for COPD, called the Step Wise Approach to Airway Syndrome program. Objective: The objective of the study was to evaluate and document the implementation status of a program for obstructive airway disease (OAD) in Trivandrum district of Kerala state in India and compare the treatment characteristics of patients with OAD seeking care from the centers implementing and not implementing this program for OADs. Methods: A cross-sectional study was done as early evaluation of a program for OAD implemented in Kerala state, India, from October 2018 to February 2019. Results: A reflection of the health-seeking behavior due to better facilities at the FHCs. There was no difference in the hospital visits or emergency department visits between the two groups. However, there was a statistically significant difference in the average number of visits per patient to health center for taking injectable drugs and visits for nebulization. Forty-nine (94%) of the COPD and 36 (100%) of the asthma patients underwent spirometry from implementing center itself. A higher proportion of patients receiving care from implementing centers (30.9%) never had to buy inhalers from outside. Conclusion: This is the first time that a public health programme for chronic respiratory disease management at primary care level was evaluated in India. The study has provided valuable insights on the need for strengthening the training for health care providers as well as patient education in bringing about a change in patient attitudes.
Collapse
Affiliation(s)
- Soumya Gopakumar
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India.,Health Action by People, Thiruvananthapuram, Kerala, India
| | - Mathew J Valamparampil
- Sree Chitra Tirunal Institute for Medical Science & Technology, Thiruvananthapuram, Kerala, India.,Directorate of Health Services, Government Medical College, Thiruvananthapuram, Kerala, India
| | - M S Manu
- Directorate of Health Services, Government Medical College, Thiruvananthapuram, Kerala, India.,Health Action by People, Thiruvananthapuram, Kerala, India
| | - Sanjeev Nair
- Department of Pulmonary Medicine, Government Medical College, Thiruvananthapuram, Kerala, India.,Health Action by People, Thiruvananthapuram, Kerala, India
| | - R Kamala
- Department of Pulmonary Medicine, Government Medical College, Thiruvananthapuram, Kerala, India.,Health Action by People, Thiruvananthapuram, Kerala, India
| | - A Raj Atulya
- Health Action by People, Thiruvananthapuram, Kerala, India
| | - Bipin K Gopal
- Directorate of Health Services, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Veena Babu
- Health Action by People, Thiruvananthapuram, Kerala, India
| | - K Vijayakumar
- Health Action by People, Thiruvananthapuram, Kerala, India
| |
Collapse
|
13
|
Combination of Acupoints in Treating Patients with Chronic Obstructive Pulmonary Disease: An Apriori Algorithm-Based Association Rule Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8165296. [PMID: 32595739 PMCID: PMC7256717 DOI: 10.1155/2020/8165296] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 05/06/2020] [Indexed: 12/16/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is highly prevalent and a major burden on the healthcare system worldwide. It has a severe impact on patients due to poor health-related quality of life (HRQL), dyspnea, and exertional intolerance. Our previous meta-analysis revealed that body acupuncture therapy had adjuvant benefits of improving HRQL in COPD patients undergoing optimal medical treatment. Previous studies indicated that treatment with combinations of acupoints was more effective than single acupoint treatment. The association rule analysis has been widely used to explore relationships in acupoint combination. Therefore, we aimed to investigate the potential core acupoint combination in COPD treatment by mining the association rules from the retrieved randomized control trials (RCTs) of the previous meta-analyses. This study was conducted based on Apriori algorithm-based association rule analysis, which is a popular data mining method available in software R. We extracted acupoints as binary data from the 12 included RCTs for analysis. There were 27 acupoints extracted from 12 RCTs. The top 10 frequently selected acupoints were BL12, BL13, BL20, BL23, BL43, CV17, EXB1, LU5, LU7, and ST36. We investigated 2444 association rules, and the results showed that {ST36, BL12} ≥ {CV17}, {ST36, BL12} ≥ {EXB1}, {CV17, BL12} ≥ {ST36}, and {EXB1, BL12} ≥ {ST36} were the most associated rules in the retrieved RCTs. The acupoint combinations of ST36, BL12, and CV17 and ST36, BL12, and EXB1 could be considered as the core of acupoint combination for further acupuncture treatment of COPD.
Collapse
|
14
|
Chiu KL, Hsieh PC, Wu CW, Tzeng IS, Wu YK, Lan CC. Exercise training increases respiratory muscle strength and exercise capacity in patients with chronic obstructive pulmonary disease and respiratory muscle weakness. Heart Lung 2020; 49:556-563. [PMID: 32199677 DOI: 10.1016/j.hrtlng.2020.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND How respiratory muscle strength influences the effectiveness of pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) is unclear. OBJECTIVE To investigate the benefits of PR in subjects with COPD according to respiratory muscle strength. METHODS Ninety-seven subjects with COPD were evaluated using maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), pulmonary function tests, the cardiopulmonary exercise test (CPET), and the St. George's Respiratory Questionnaire (SGRQ). Subjects were divided into four groups: 1 (normal MIP and MEP); 2 (low MIP); 3 (low MEP); and 4 (low MIP and MEP). Subjects underwent PR for 3 months; MIP, MEP, SGRQ, and CPET were evaluated post-PR. RESULTS Subjects with both poor MIP and MEP had the highest dyspnea score, lowest exercise capacity, and poorest health-related quality of life (HRQoL). PR improved exercise capacity and HRQoL in all groups, with more improvement in MIP, MEP, tidal volume (on exercise), and dyspnea (at rest) in subjects with both low MIP and MEP. CONCLUSIONS Patients with respiratory muscle weakness had worse dyspnea, lower exercise capacity, and poorer HRQoL at baseline. Exercise training improved respiratory muscle strength with concurrent improvement of exercise capacity, HRQoL, and dyspnea score. Subjects with both poor baseline MIP and MEP showed greater benefits of PR.
Collapse
Affiliation(s)
- Kuei-Ling Chiu
- Division of Respiratory Therapy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chih-Wei Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan.
| |
Collapse
|
15
|
Peña JB, Ávila Valencia JC, Assis JK, Gutiérrez HH, Córdoba VB. Benefits of Pulmonary Rehabilitation in Patients with COPD with Use and without the Use of Supplemental Oxygen During Exercise. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x15666191021122926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective:
To determine the effects of a pulmonary rehabilitation program in patients with
COPD who use and do not use supplemental oxygen during exercise.
Materials and Methods:
Prospective longitudinal descriptive study on 59 patients with COPD who
were part of a pulmonary rehabilitation program and who were classified into two groups: a group
that required supplemental oxygen during rehabilitation and another that did not.
Results:
31 patients were linked to the group that used oxygen during rehabilitation and 28 patients
who did not use it. The average age was 69.1 ± 10.6 years old. The mMRC dyspnea decreased 0.7 ±
0.2 (p = 0.000) in the group that used oxygen and 0.8 ± 0.1 (p = 0.000) in the group that did not use
it. The distance increased 45.9 meters ± 7.2 (p = 0.000) in the group that used oxygen and 65.2
meters ± 16.3 (p = 0.001) in the group that did not use it.
Conclusion:
Both groups showed significant improvements in dyspnea and aerobic capacity,
however, there was a greater increase in the group that did not use oxygen.
Collapse
Affiliation(s)
- Jhonatan Betancourt Peña
- Faculty of Health and Rehabilitation at Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia, School of Human Rehabilitation of the Faculty of Health at Universidad del Valle, Cali, Colombia
| | - Juan Carlos Ávila Valencia
- Faculty of Health and Rehabilitation at Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia, Universidad Santiago de Cali (Cali, Colombia). Clínica de Occidente S.A, Cali, Colombia
| | | | - Hugo Hurtado Gutiérrez
- Msc Public Health. Msc Biostatistics, Faculty of Health at Universidad del Valle, Cali, Colombia
| | - Vicente Benavides Córdoba
- Faculty of Health and Rehabilitation at Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia
| |
Collapse
|
16
|
Machado A, Quadflieg K, Oliveira A, Keytsman C, Marques A, Hansen D, Burtin C. Exercise Training in Patients with Chronic Respiratory Diseases: Are Cardiovascular Comorbidities and Outcomes Taken into Account?-A Systematic Review. J Clin Med 2019; 8:E1458. [PMID: 31540240 PMCID: PMC6780679 DOI: 10.3390/jcm8091458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 12/16/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD), asthma and interstitial lung diseases (ILD) frequently suffer from cardiovascular comorbidities (CVC). Exercise training is a cornerstone intervention for the management of these conditions, however recommendations on tailoring programmes to patients suffering from respiratory diseases and CVC are scarce. This systematic review aimed to identify the eligibility criteria used to select patients with COPD, asthma or ILD and CVC to exercise programmes; assess the impact of exercise on cardiovascular outcomes; and identify how exercise programmes were tailored to CVC. PubMed, Scopus, Web of Science and Cochrane were searched. Three reviewers extracted the data and two reviewers independently assessed the quality of studies with the Quality Assessment Tool for Quantitative Studies. MetaXL 5.3 was used to calculate the individual and pooled effect sizes (ES). Most studies (58.9%) excluded patients with both stable and unstable CVC. In total, 26/42 studies reported cardiovascular outcomes. Resting heart rate was the most reported outcome measure (n = 13) and a small statistically significant effect (ES = -0.23) of exercise training on resting heart rate of patients with COPD was found. No specific adjustments to exercise prescription were described. Few studies have included patients with CVC. There was a lack of tailoring of exercise programmes and limited effects were found. Future studies should explore the effect of tailored exercise programmes on relevant outcome measures in respiratory patients with CVC.
Collapse
Affiliation(s)
- Ana Machado
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
| | - Kirsten Quadflieg
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Ana Oliveira
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON M6M 2J5, Canada
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Charly Keytsman
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810 Aveiro, Portugal
| | - Dominique Hansen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium
- Jessa hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium
| | - Chris Burtin
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium.
| |
Collapse
|
17
|
Lin F, Yeh M, Lai Y, Lin K, Yu C, Chang J. Two‐month breathing‐based walking improves anxiety, depression, dyspnoea and quality of life in chronic obstructive pulmonary disease: A randomised controlled study. J Clin Nurs 2019; 28:3632-3640. [DOI: 10.1111/jocn.14960] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 01/27/2023]
Affiliation(s)
- Feng‐Lien Lin
- Department of Nursing National Taiwan University Hospital Taipei Taiwan, ROC
| | - Mei‐Ling Yeh
- Department of Nursing National Taipei University of Nursing and Health Sciences Taipei Taiwan, ROC
| | - Yeur‐Hur Lai
- School of Nursing National Taiwan University Taipei Taiwan, ROC
- Department of Nursing National Taiwan University Cancer Center Taipei Taiwan, ROC
| | - Kuan‐Chia Lin
- Institute of Hospital and Health Care Administration National Yang Ming University Taipei Taiwan, ROC
| | - Chong‐Jen Yu
- National Taiwan University Hospital Taipei Taiwan, ROC
- Department of Internal Medicine, College of Medicine National Taiwan University Taipei Taiwan, ROC
| | - Jung‐San Chang
- Department of Renal Care Kaohsiung Medical University Kaohsiung Taiwan, ROC
- Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung Taiwan, ROC
| |
Collapse
|
18
|
Hsieh PC, Yang MC, Wu YK, Chen HY, Tzeng IS, Hsu PS, Lee CT, Chen CL, Lan CC. Acupuncture therapy improves health-related quality of life in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Complement Ther Clin Pract 2019; 35:208-218. [PMID: 31003660 DOI: 10.1016/j.ctcp.2019.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/14/2019] [Accepted: 02/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is highly prevalent around the world and has a large impact on its patients, leading to a poor health-related quality of life (HRQL) and exercise capacity. Even under optimal medications, there are still many patients with poor HRQL. Body acupuncture therapy (BAT) is a non-invasive and a popular therapy. Therefore, we aimed to comprehensively analyze the effects of BAT in COPD. MATERIALS AND METHODS Eight electronic databases were searched. We included randomized controlled trials (RCTs) that evaluated the effect of BAT, medication (M), and pulmonary rehabilitation (PR). The primary outcome was HRQL evaluated by St. George's respiratory questionnaire (SGRQ) or COPD assessment test (CAT). RESULTS Of the 922 articles, 12 studies were included with attesting a total of 798 participants. The result obtained indicated a significant improvement that favored the BAT + M group over the M group in CAT scores (MD: -4.77; 95% CI: -6.53 to -3.01; p < 0.00001). CONCLUSIONS BAT is an effective adjunctive non-pharmacological treatment to improve HRQL in patients under medical treatment for COPD. We suggested that BAT should be considered as one of the methods of management in patients with COPD.
Collapse
Affiliation(s)
- Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Hsin-Yi Chen
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Pei-Shan Hsu
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chang-Ti Lee
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chien-Lin Chen
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan.
| |
Collapse
|
19
|
Effects of Water-Based Aerobic Interval Training in Patients With COPD: A RANDOMIZED CONTROLLED TRIAL. J Cardiopulm Rehabil Prev 2019; 39:105-111. [PMID: 30720640 DOI: 10.1097/hcr.0000000000000352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Chronic obstructive pulmonary disease promotes systemic repercussions, which can be minimized with physical exercise. This study investigated the effects of a water-based aerobic interval training program on the autonomic modulation of heart rate (HR), quality of life (QoL), and functional capacity (FC) of patients with chronic obstructive pulmonary disease. METHODS Nineteen patients with chronic obstructive pulmonary disease were enrolled in this randomized clinical trial and allocated to either the usual care group (n = 9) or training group (n = 10). Before and after 24 sessions of water-based physical training, the patients underwent evaluation of autonomic modulation of HR by analyzing the HR variability, QoL using the St George's Respiratory Questionnaire, and FC using 6-min walk test distance. RESULTS The results showed significant improvement when comparing the variables of HR variability, QoL, and FC in the training group in the pre- and post-training conditions (P < .05). In the usual care group, there was no significant difference for any of the variables. Negative correlations were found between HR variability and QoL (r =-0. 55; P = .01) and 6-min walk test distance and QoL (r =-0.49; P = .02). CONCLUSION Water-based physical training promoted beneficial adaptations in the autonomic modulation of HR, QoL, and FC of patients with chronic obstructive pulmonary disease.
Collapse
|
20
|
Leite MR, Ramos EMC, Freire APCF, de Alencar Silva BS, Nicolino J, Vanderlei LCM, Ramos D. Analysis of Autonomic Modulation in Response to a Session of Aerobic Exercise at Different Intensities in Patients With Moderate and Severe COPD. COPD 2018; 15:245-253. [PMID: 30375894 DOI: 10.1080/15412555.2018.1529744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Despite the many benefits of performing physical exercise in patients with chronic obstructive pulmonary disease (COPD), information on the response of acute cardiac autonomic modulation in subjects with moderate and severe COPD during and after an aerobic exercise session at different intensities is unknown. The aim of this study was to evaluate the response of cardiac autonomic modulation in patients with moderate and severe COPD during and after an aerobic exercise session at different intensities. Twenty-seven patients with COPD, divided into: Moderate Group and Severe Group, underwent an aerobic exercise sessions with intensities equivalent to 60% and 90% of velocity corresponding to peak oxygen consumption. The heart rate variability (HRV) indices were analyzed in the time and frequency domains at the following times: at rest, during exercise, immediately after, and 5, 10, and 15 minutes after exercise. In the comparison analysis between the two groups, no differences were observed in any of the HRV indices at different intensities applied. However, it was observed that the exercise caused autonomic changes when the groups were analyzed separately. Sessions of aerobic exercise influence the autonomic modulation in patients with COPD. However, COPD severity did not influence the autonomic nervous system response to exercise and recovery moments; and there was no difference between the exercise intensities.
Collapse
Affiliation(s)
- Marceli Rocha Leite
- a Department of Physiotherapy , Universidade Estadual Paulista (UNESP) , São Paulo , Brazil
| | - Ercy Mara Cipulo Ramos
- a Department of Physiotherapy , Universidade Estadual Paulista (UNESP) , São Paulo , Brazil
| | | | | | - Juliana Nicolino
- a Department of Physiotherapy , Universidade Estadual Paulista (UNESP) , São Paulo , Brazil
| | | | - Dionei Ramos
- a Department of Physiotherapy , Universidade Estadual Paulista (UNESP) , São Paulo , Brazil
| |
Collapse
|
21
|
Lan CC, Yang MC, Huang HC, Wu CW, Su WL, Tzeng IS, Wu YK. Serial changes in exercise capacity, quality of life and cardiopulmonary responses after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. Heart Lung 2018; 47:477-484. [PMID: 30201226 DOI: 10.1016/j.hrtlng.2018.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 06/08/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients with chronic obstructive pulmonary disease (COPD) often have poor health-related quality of life (HRQL), exercise capacity and cardiopulmonary function. Pulmonary rehabilitation (PR) is beneficial to improve exercise capacity and HRQL. However, series changes of these parameters remain unclear. METHODS Forty-three subjects participated in a 3-months PR program. Subjects were evaluated at baseline and at 8, 16, and 24 sessions after PR. RESULTS After 8 sessions, there were significant improvements in the SGRQ-symptom domain, exertional dyspnea, and oxygen pulse (all p < 0.05). Maximal VO2, SGRQ-activity and SGRQ-impact domains, and respiratory muscle strength were significantly improved after 16 and 24 sessions (all p < 0.05). CONCLUSIONS Eight sessions of exercise training lead to improvement of symptoms and exertional dyspnea. 16 to 24 sessions result in further improvement. We suggest patients receive 16 to 24 sessions of PR.
Collapse
Affiliation(s)
- Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Hui-Chuan Huang
- College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Chih-Wei Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Wen-Lin Su
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan.
| |
Collapse
|
22
|
Mohammed J, Derom E, Van Oosterwijck J, Da Silva H, Calders P. Evidence for aerobic exercise training on the autonomic function in patients with chronic obstructive pulmonary disease (COPD): a systematic review. Physiotherapy 2018; 104:36-45. [DOI: 10.1016/j.physio.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/12/2017] [Indexed: 02/04/2023]
|
23
|
Mohammed J, Derom E, De Backer T, De Wandele I, Calders P. Cardiac Autonomic Function and Reactivity Tests in Physically Active Subjects with Moderately Severe COPD. COPD 2018; 15:51-59. [DOI: 10.1080/15412555.2017.1412414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jibril Mohammed
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
- Department of Physiotherapy, Bayero University Kano, Kano, Nigeria
| | - Eric Derom
- Department of Internal Medicine, Ghent University – Ghent University Hospital, Ghent, Belgium
| | - Tine De Backer
- Department of Internal Medicine, Ghent University – Ghent University Hospital, Ghent, Belgium
| | - Inge De Wandele
- Center for Medical Genetics, Ghent University – Ghent University Hospital, Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| |
Collapse
|
24
|
Management of Dyspnea and Anxiety in Chronic Obstructive Pulmonary Disease: A Critical Review. J Am Med Dir Assoc 2017; 18:1096.e1-1096.e17. [DOI: 10.1016/j.jamda.2017.09.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 11/19/2022]
|
25
|
Kabbach EZ, Mazzuco A, Borghi-Silva A, Cabiddu R, Agnoleto AG, Barbosa JF, de Carvalho Junior LCS, Mendes RG. Increased parasympathetic cardiac modulation in patients with acute exacerbation of COPD: how should we interpret it? Int J Chron Obstruct Pulmon Dis 2017; 12:2221-2230. [PMID: 28814850 PMCID: PMC5546179 DOI: 10.2147/copd.s134498] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Cardiac autonomic modulation (CAM) is impaired in patients with stable COPD. Exacerbation aggravates the patients’ health status and functional capacity. While the clinical and functional effects of exacerbation are known, no studies investigated CAM during exacerbation and whether there is a relationship between CAM and functional capacity and dyspnea. Methods Thirty-two patients with moderate to severe COPD were enrolled into two groups: stable COPD (GSta, n=16) and acute exacerbation of COPD (GAE, n=16). The GAE patients were evaluated 24–48 hours after starting standard therapy for COPD exacerbation during hospitalization; the GSta patients were evaluated in an outpatient clinic and included in the study if no decompensation episodes had occurred during the previous month. The heart rate (HR) and R-wave peak detection intervals in ms (RRi) were registered using a heart rate monitor (Polar® system) at rest in seated position during 10 minutes. CAM was assessed by heart rate variability (HRV) linear and non-linear analysis. Functional capacity was evaluated by handgrip strength test, performed by Jamar® dynamometer, and dyspnea was scored using the modified scale of the Medical Research Council. Results GAE presented higher parasympathetic CAM values compared with GSta for square root of the mean squared differences of successive RRi (RMSSD; 17.8±5.6 ms vs 11.7±9.5 ms); high frequency (HF; 111.3±74.9 ms2 vs 45.6±80.7 ms2) and standard deviation measuring the dispersion of points in the plot perpendicular to the line of identity (SD1; 12.7±3.9 ms vs 8.3±6.7 ms) and higher CAM values for standard deviation of the mean of all of RRi (STD RRi; 19.3±6.5 ms vs 14.3±12.5 ms); RRi tri (5.2±1.7 ms vs 4.0±3.0 ms); triangular interpolation of NN interval histogram (TINN; 88.7±26.9 ms vs 70.6±62.2 ms); low frequency (LF; 203±210.7 ms2 vs 101.8±169.7 ms2) and standard deviation measuring the dispersion of points along the line of identity (SD2; 30.4±14.8 ms vs 16.2±12.54 ms). Lower values were observed for the complexity indices: approximate entropy (ApEn; 0.9±0.07 vs 1.06±0.06) and sample entropy (SampEn; 1.4±0.3 vs 1.7±0.3). Significant and moderate associations were observed between HF (nu) and handgrip strength (r=−0.58; P=0.01) and between LF (ms2) and subjective perception of dyspnea (r=−0.53; P=0.03). Conclusion COPD exacerbated patients have higher parasympathetic CAM than stable patients. This should be interpreted with caution since vagal influence on the airways determines a narrowing and not a better clinical condition. Additionally, functional capacity was negatively associated with parasympathetic CAM in COPD exacerbation.
Collapse
Affiliation(s)
- Erika Zavaglia Kabbach
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Adriana Mazzuco
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Audrey Borghi-Silva
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Ramona Cabiddu
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Aline Galvão Agnoleto
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Jessica Fernanda Barbosa
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | | | - Renata Gonçalves Mendes
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| |
Collapse
|
26
|
Xu J, He S, Han Y, Pan J, Cao L. Effects of modified pulmonary rehabilitation on patients with moderate to severe chronic obstructive pulmonary disease: A randomized controlled trail. Int J Nurs Sci 2017; 4:219-224. [PMID: 31406744 PMCID: PMC6626181 DOI: 10.1016/j.ijnss.2017.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/19/2017] [Accepted: 06/26/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jingjuan Xu
- Department of Scientific Research and Education, The Third Hospital Affiliated to Soochow University, Changzhou, People's Republic of China
| | - Shengnan He
- Department of Respiratory Diseases, The Third Hospital Affiliated to Soochow University, Changzhou, People's Republic of China
| | - Ying Han
- Department of Respiratory Diseases, The Third Hospital Affiliated to Soochow University, Changzhou, People's Republic of China
| | - Jingya Pan
- Department of Respiratory Diseases, The Third Hospital Affiliated to Soochow University, Changzhou, People's Republic of China
| | - Ling Cao
- Department of Respiratory Diseases, The Third Hospital Affiliated to Soochow University, Changzhou, People's Republic of China
| |
Collapse
|
27
|
Ney M, Haykowsky MJ, Vandermeer B, Shah A, Ow M, Tandon P. Systematic review: pre- and post-operative prognostic value of cardiopulmonary exercise testing in liver transplant candidates. Aliment Pharmacol Ther 2016; 44:796-806. [PMID: 27539029 DOI: 10.1111/apt.13771] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/15/2016] [Accepted: 07/28/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET) is the gold standard for the objective assessment of functional status. In many conditions, CPET outperforms the traditional variables in predicting mortality. AIM In patients with cirrhosis listed for liver transplantation, our primary aim was to determine the prognostic value of CPET for pre-and post-transplant mortality and, in particular, whether CPET remained predictive after adjustment for liver disease severity. METHODS A systematic literature review was conducted in databases Medline, Scopus, Embase and PubMed. Where possible, data were pooled for meta-analyses using a DerSimonian and Laird random effects model. RESULTS A total of seven studies were retrieved, including 1107 patients with a mean MELD of 14.2 (standard deviation 1.6) and peak baseline VO2 of 17.4 mL/kg/min. In all of the studies in which multivariable analysis was performed, CPET variables were independent predictors of pre-transplant mortality (three studies) and post-transplant mortality (four studies). In the three studies where we could aggregate post-transplant mortality data, post-transplant mortality was predicted by AT with a mean difference of 2.0 (95% confidence interval, CI: 0.42-3.59; Z = 2.48, P = 0.01) between survivors and nonsurvivors. The peak VO2 was not significant (0.77 95% CI: -1.36 to 2.90; Z = 0.71, P = 0.48). CONCLUSIONS Patient's listed for liver transplant have significant functional limitations, with a weighted mean VO2 below the threshold level required for independent living. Although heterogeneity in study designs with respect to timing, CPET variables, and cut-off values precluded the determination of CPET mortality thresholds, the studies support CPET as an objective and independent predictor of pre- and post-transplant mortality.
Collapse
Affiliation(s)
- M Ney
- Cirrhosis Care Clinic, Department of Medicine, University of Alberta, Edmonton, AB, Canada.,Centre of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR), University of Alberta, Edmonton, AB, Canada
| | - M J Haykowsky
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | - B Vandermeer
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - A Shah
- Cirrhosis Care Clinic, Department of Medicine, University of Alberta, Edmonton, AB, Canada.,Centre of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR), University of Alberta, Edmonton, AB, Canada
| | - M Ow
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - P Tandon
- Cirrhosis Care Clinic, Department of Medicine, University of Alberta, Edmonton, AB, Canada. .,Centre of Excellence for Gastrointestinal Inflammation and Immunity Research (CEGIIR), University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
28
|
Goulart CDL, Simon JC, Schneiders PDB, San Martin EA, Cabiddu R, Borghi-Silva A, Trimer R, da Silva ALG. Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients. Int J Chron Obstruct Pulmon Dis 2016; 11:1671-7. [PMID: 27555757 PMCID: PMC4968685 DOI: 10.2147/copd.s108860] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities, including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders. We investigated whether alterations in respiratory muscle strength (RMS) would affect cardiac autonomic modulation in COPD patients. Methods This study was a cross-sectional study done in ten COPD patients affected by moderate to very severe disease. The heart rate variability (HRV) signal was recorded using a Polar cardiofrequencimeter at rest in the sitting position (10 minutes) and during a respiratory sinus arrhythmia maneuver (RSA-M; 4 minutes). Linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals. RMS was assessed using a digital manometer, which provided the maximum inspiratory pressure (PImax) and the maximum expiratory pressure (PEmax). Results During the RSA-M, patients presented an HRV power increase in the low-frequency band (LFnu) (46.9±23.7 vs 75.8±27.2; P=0.01) and a decrease in the high-frequency band (HFnu) (52.8±23.5 vs 24.0±27.0; P=0.01) when compared to the resting condition. Significant associations were found between RMS and HRV spectral indices: PImax and LFnu (r=−0.74; P=0.01); PImax and HFnu (r=0.74; P=0.01); PEmax and LFnu (r=−0.66; P=0.01); PEmax and HFnu (r=0.66; P=0.03); between PEmax and sample entropy (r=0.83; P<0.01) and between PEmax and approximate entropy (r=0.74; P=0.01). Using a linear regression model, we found that PImax explained 44% of LFnu behavior during the RSA-M. Conclusion COPD patients with impaired RMS presented altered cardiac autonomic control, characterized by marked sympathetic modulation and a reduced parasympathetic response; reduced HRV complexity was observed during the RSA-M.
Collapse
Affiliation(s)
- Cássia Da Luz Goulart
- Course of Physiotherapy, Department of Health and Physical Education, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Julio Cristiano Simon
- Course of Physiotherapy, Department of Health and Physical Education, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Paloma De Borba Schneiders
- Course of Physiotherapy, Department of Health and Physical Education, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Elisabete Antunes San Martin
- Course of Physiotherapy, Department of Health and Physical Education, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Ramona Cabiddu
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Renata Trimer
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Andréa Lúcia Gonçalves da Silva
- Course of Physiotherapy, Department of Health and Physical Education, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Rio Grande do Sul, Brazil
| |
Collapse
|
29
|
Taranto-Montemurro L, Messineo L, Perger E, Salameh M, Pini L, Corda L, Ferliga M, Tantucci C. Cardiac Sympathetic Hyperactivity in Patients with Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea. COPD 2016; 13:706-711. [DOI: 10.1080/15412555.2016.1199668] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Luigi Taranto-Montemurro
- Respiratory Pathophysiology and Sleep Laboratory, Department of Medicine, M. Mellini Hospital, Chiari, Italy
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts
| | - Ludovico Messineo
- Respiratory Medicine and Sleep Laboratory, Department of Internal Medicine, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Elisa Perger
- Respiratory Medicine and Sleep Laboratory, Department of Internal Medicine, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Maroon Salameh
- Respiratory Medicine and Sleep Laboratory, Department of Internal Medicine, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Laura Pini
- Respiratory Medicine and Sleep Laboratory, Department of Internal Medicine, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Luciano Corda
- Respiratory Medicine and Sleep Laboratory, Department of Internal Medicine, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Mauro Ferliga
- Respiratory Pathophysiology and Sleep Laboratory, Department of Medicine, M. Mellini Hospital, Chiari, Italy
| | - Claudio Tantucci
- Respiratory Medicine and Sleep Laboratory, Department of Internal Medicine, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| |
Collapse
|
30
|
Le Gal C, Vandervelde L, Poncin W, Reychler G. [Impact of physical exercise in cystic fibrosis patients: A systematic review]. Rev Mal Respir 2016; 33:573-82. [PMID: 27209116 DOI: 10.1016/j.rmr.2015.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/20/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Beneficial effects of physical exercise have been previously demonstrated in patients with chronic obstructive pulmonary disease. The aim of this systematic review was to summarize the evidence supporting physical exercise to improve on lung function, exercise capacity and quality of life in cystic fibrosis patients. METHODS Medline database was used to search clinical studies from 2000 to 2015. We also analyzed the bibliographic section of the included studies, in order to identify additional references. RESULTS A total of 17 studies were identified. A great disparity was found in the results of the different studies. No systematic benefit was found on lung function, exercise capacity or quality of life. No relationship between the type of program and the benefits achieved was observed. CONCLUSIONS Evidence that physical exercise benefits lung function, exercise capacity and quality of life in cystic fibrosis patient is inconsistent and evidence does not support a particular standardized program for all patients.
Collapse
Affiliation(s)
- C Le Gal
- Département de kinésithérapie, Parnasse-ISEI, 1200 Bruxelles, Belgique
| | - L Vandervelde
- Département de kinésithérapie, Parnasse-ISEI, 1200 Bruxelles, Belgique
| | - W Poncin
- Service de pneumologie, cliniques universitaires Saint-Luc, 1200 Bruxelles, Belgique
| | - G Reychler
- Département de kinésithérapie, Parnasse-ISEI, 1200 Bruxelles, Belgique; Service de pneumologie, cliniques universitaires Saint-Luc, 1200 Bruxelles, Belgique; Service de médecine physique et réadaptation, cliniques universitaires Saint-Luc, 1200 Bruxelles, Belgique; Institut de recherche expérimentale et clinique (IREC), pôle de pneumologie, ORL et dermatologie, université catholique de Louvain, 1200 Bruxelles, Belgique.
| |
Collapse
|
31
|
Bianchim MS, Sperandio EF, Martinhão GS, Matheus AC, Lauria VT, da Silva RP, Spadari RC, Gagliardi ART, Arantes RL, Romiti M, Dourado VZ. Correlation between heart rate variability and pulmonary function adjusted by confounding factors in healthy adults. Braz J Med Biol Res 2016; 49:S0100-879X2016000300702. [PMID: 26840706 PMCID: PMC4763812 DOI: 10.1590/1414-431x20154435] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 10/01/2015] [Indexed: 11/22/2022] Open
Abstract
The autonomic nervous system maintains homeostasis, which is the state of balance in the body. That balance can be determined simply and noninvasively by evaluating heart rate variability (HRV). However, independently of autonomic control of the heart, HRV can be influenced by other factors, such as respiratory parameters. Little is known about the relationship between HRV and spirometric indices. In this study, our objective was to determine whether HRV correlates with spirometric indices in adults without cardiopulmonary disease, considering the main confounders (e.g., smoking and physical inactivity). In a sample of 119 asymptomatic adults (age 20-80 years), we evaluated forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). We evaluated resting HRV indices within a 5-min window in the middle of a 10-min recording period, thereafter analyzing time and frequency domains. To evaluate daily physical activity, we instructed participants to use a triaxial accelerometer for 7 days. Physical inactivity was defined as <150 min/week of moderate to intense physical activity. We found that FVC and FEV1, respectively, correlated significantly with the following aspects of the RR interval: standard deviation of the RR intervals (r =0.31 and 0.35), low-frequency component (r =0.38 and 0.40), and Poincaré plot SD2 (r =0.34 and 0.36). Multivariate regression analysis, adjusted for age, sex, smoking, physical inactivity, and cardiovascular risk, identified the SD2 and dyslipidemia as independent predictors of FVC and FEV1 (R2=0.125 and 0.180, respectively, for both). We conclude that pulmonary function is influenced by autonomic control of cardiovascular function, independently of the main confounders.
Collapse
Affiliation(s)
- M S Bianchim
- Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - E F Sperandio
- Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - G S Martinhão
- Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - A C Matheus
- Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - V T Lauria
- Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - R P da Silva
- Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - R C Spadari
- Departamento de Biociências, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - A R T Gagliardi
- AngioCorpore Instituto de Medicina Cardiovascular, Santos, SP, Brasil
| | - R L Arantes
- AngioCorpore Instituto de Medicina Cardiovascular, Santos, SP, Brasil
| | - M Romiti
- AngioCorpore Instituto de Medicina Cardiovascular, Santos, SP, Brasil
| | - V Z Dourado
- Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| |
Collapse
|
32
|
Abstract
Chronic obstructive pulmonary disease (COPD), characterized by chronic airways inflammation and progressive airflow limitation, is a common, preventable and treatable disease. Worldwide, COPD is a major cause of morbidity and mortality; smoking tobacco is the most important risk factor. This translational review of recent updates in COPD care for the primary care audience, includes recommendations from the 2015 Global Initiative for chronic obstructive lung disease (GOLD) report on diagnosis, pharmacological and non-pharmacological treatment, prevalence of comorbidities, management of exacerbations and the asthma and COPD overlap syndrome, with a focus on the importance and benefit of physical activity and exercise in COPD patients. Exacerbations and comorbidities contribute to the overall severity of COPD in individual patients. Management of exacerbations includes reducing the impact of the current exacerbation and preventing development of subsequent episodes. Healthcare professionals need to be alert to comorbidities, such as cardiovascular disease, anxiety/depression, lung cancer, infections and diabetes, which are common in COPD patients and can have a significant impact on HRQoL and prognosis. Pulmonary rehabilitation is recommended by a number of guidelines for all symptomatic COPD patients, regardless of severity, and involves exercise training, patient education, nutritional advice and psychosocial support. At all stages of COPD, regular physical activity and exercise can aid symptom control, improve HRQoL, reduce rates of hospitalization, and improve morbidity and respiratory mortality. Healthcare professionals play a pivotal role in improving HRQoL and health-related outcomes in COPD patients to meet their specific needs and in providing appropriate diagnosis, management and advice on smoking cessation.
Collapse
Affiliation(s)
- Christine Garvey
- a Department of Sleep Disorders and Pulmonary Rehabilitation, University of California San Francisco , San Francisco , CA , USA
| |
Collapse
|
33
|
Wireless Sensor-Based Smart-Clothing Platform for ECG Monitoring. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2015; 2015:295704. [PMID: 26640512 PMCID: PMC4659963 DOI: 10.1155/2015/295704] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 10/05/2015] [Accepted: 10/19/2015] [Indexed: 11/18/2022]
Abstract
The goal of this study is to use wireless sensor technologies to develop a smart clothes service platform for health monitoring. Our platform consists of smart clothes, a sensor node, a gateway server, and a health cloud. The smart clothes have fabric electrodes to detect electrocardiography (ECG) signals. The sensor node improves the accuracy of QRS complexes detection by morphology analysis and reduces power consumption by the power-saving transmission functionality. The gateway server provides a reconfigurable finite state machine (RFSM) software architecture for abnormal ECG detection to support online updating. Most normal ECG can be filtered out, and the abnormal ECG is further analyzed in the health cloud. Three experiments are conducted to evaluate the platform's performance. The results demonstrate that the signal-to-noise ratio (SNR) of the smart clothes exceeds 37 dB, which is within the “very good signal” interval. The average of the QRS sensitivity and positive prediction is above 99.5%. Power-saving transmission is reduced by nearly 1980 times the power consumption in the best-case analysis.
Collapse
|
34
|
Sant Anna Junior MD, Carneiro JRI, Carvalhal RF, Torres DDFM, Cruz GGD, Quaresma JCDV, Lugon JR, Guimarães FS. Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity. Arq Bras Cardiol 2015; 105:580-7. [PMID: 26536979 PMCID: PMC4693662 DOI: 10.5935/abc.20150125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/27/2015] [Indexed: 11/29/2022] Open
Abstract
Background Morbid obesity is directly related to deterioration in cardiorespiratory capacity,
including changes in cardiovascular autonomic modulation. Objective This study aimed to assess the cardiovascular autonomic function in morbidly obese
individuals. Methods Cross-sectional study, including two groups of participants: Group I, composed by
50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The
autonomic function was assessed by heart rate variability in the time domain
(standard deviation of all normal RR intervals [SDNN]; standard deviation of the
normal R-R intervals [SDNN]; square root of the mean squared differences of
successive R-R intervals [RMSSD]; and the percentage of interval differences of
successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent
interval), and in the frequency domain (high frequency [HF]; low frequency [LF]:
integration of power spectral density function in high frequency and low frequency
ranges respectively). Between-group comparisons were performed by the Student’s
t-test, with a level of significance of 5%. Results Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ±
27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p =
0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF
(30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean
LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p =
0.0189), indicating changes in the sympathovagal balance. No statistical
difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz
vs. 40.9 ± 23.9 Hz; p = 0.9013). Conclusion morbidly obese individuals have increased sympathetic activity and reduced
parasympathetic activity, featuring cardiovascular autonomic dysfunction.
Collapse
Affiliation(s)
- Maurício de Sant Anna Junior
- Programa de Tratamento Multidisciplinar da Obesidade, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - João Regis Ivar Carneiro
- Programa de Tratamento Multidisciplinar da Obesidade, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Renata Ferreira Carvalhal
- Programa de Tratamento Multidisciplinar da Obesidade, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Diego de Faria Magalhães Torres
- Programa de Tratamento Multidisciplinar da Obesidade, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gustavo Gavina da Cruz
- Programa de Tratamento Multidisciplinar da Obesidade, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - José Carlos do Vale Quaresma
- Programa de Tratamento Multidisciplinar da Obesidade, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jocemir Ronaldo Lugon
- Divisão de Nefrologia, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Fernando Silva Guimarães
- Departamento de Fisioterapia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
35
|
Mahananto F, Igasaki T, Murayama N. Potential force dynamics of heart rate variability reflect cardiac autonomic modulation with respect to posture, age, and breathing pattern. Comput Biol Med 2015. [DOI: 10.1016/j.compbiomed.2015.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
36
|
Roque AL, Valenti VE, Massetti T, da Silva TD, Monteiro CBDM, Oliveira FR, de Almeida Junior ÁD, Lacerda SNB, Pinasco GC, Nascimento VG, Granja Filho LG, de Abreu LC, Garner DM, Ferreira C. Chronic obstructive pulmonary disease and heart rate variability: a literature update. Int Arch Med 2014; 7:43. [PMID: 25945125 PMCID: PMC4414304 DOI: 10.1186/1755-7682-7-43] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 09/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The literature indicates that chronic obstructive pulmonary disease (COPD) affects cardiac autonomic control. In this study, we conducted a literature review in order to investigate the heart rate variability (HRV) in COPD subjects. METHODS A search was performed in Medline database, using the link between the keywords: "autonomic nervous system", "cardiovascular system", "COPD" and "heart rate variability". RESULTS The search resulted in a total of 40 references. Amongst these references, the first exclusion resulted in the barring of 29 titles and abstracts, which were not clearly related to the purpose of review. This resulted in a total of 11 articles that were then read and utilized in the review. The selected studies indicated that there is significant reduction of HRV in patients with COPD, characterized by reduction of indices that assess parasympathetic activity in addition to dealing with the global autonomic modulation. We also established that supervised exercise can reduce these harmful effects in COPD patients. Also, it was reported that the use of non-invasive ventilation in these patients may contribute to the improvement of respiratory symptoms, with no impairing, and may even induce positive responses in cardiac autonomic regulation. CONCLUSION The studies indicate a need for further investigations to guide future therapies to improve the treatment of cardiovascular system in the respiratory diseases.
Collapse
Affiliation(s)
- Adriano L Roque
- />Post-graduate Program in Cardiology, Federal University of São Paulo – Paulista School of Medicine, 715, Pedro de Toledo St, Vila Clementino, São Paulo, SP 04039-032 Brazil
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Vitor E Valenti
- />Post-graduate Program in Physical Therapy - Faculty of Science and Technology UNESP, Presidente Prudente, SP Brazil
| | - Thais Massetti
- />Post-graduate Program in Rehabilitation Sciences - Faculty of Medicine, University of São Paulo, São Paulo, SP Brazil
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Talita Dias da Silva
- />Post-graduate Program in Cardiology, Federal University of São Paulo – Paulista School of Medicine, 715, Pedro de Toledo St, Vila Clementino, São Paulo, SP 04039-032 Brazil
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
- />Department of Environmental Health, Harvard School of Public Health, Boston, MA USA
| | - Carlos Bandeira de Mello Monteiro
- />Post-graduate Program in Rehabilitation Sciences - Faculty of Medicine, University of São Paulo, São Paulo, SP Brazil
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Fernando R Oliveira
- />Post-graduate Program in Cardiology, Federal University of São Paulo – Paulista School of Medicine, 715, Pedro de Toledo St, Vila Clementino, São Paulo, SP 04039-032 Brazil
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Álvaro Dantas de Almeida Junior
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Sheylla Nadjane Batista Lacerda
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Gustavo Carreiro Pinasco
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Viviane Gabriela Nascimento
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Luiz Gonzaga Granja Filho
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - Luiz Carlos de Abreu
- />Post-graduate Program in Cardiology, Federal University of São Paulo – Paulista School of Medicine, 715, Pedro de Toledo St, Vila Clementino, São Paulo, SP 04039-032 Brazil
- />Department of Public Health, Laboratory Design of Studies and Scientific Writing, School of Medicine of ABC, FMABC, Santo André, SP Brazil
| | - David M Garner
- />Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Oxford OX3 0BP UK
| | - Celso Ferreira
- />Post-graduate Program in Cardiology, Federal University of São Paulo – Paulista School of Medicine, 715, Pedro de Toledo St, Vila Clementino, São Paulo, SP 04039-032 Brazil
| |
Collapse
|
37
|
Yasar Z, Erdem F, Talay F. Benefit of Metformin in COPD: An Effect on Autonomic Nervous System? COPD 2014; 12:344-5. [DOI: 10.3109/15412555.2014.949003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
38
|
Yeh GY, Wayne PM, Litrownik D, Roberts DH, Davis RB, Moy ML. Tai chi mind-body exercise in patients with COPD: study protocol for a randomized controlled trial. Trials 2014; 15:337. [PMID: 25168853 PMCID: PMC4158042 DOI: 10.1186/1745-6215-15-337] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 07/22/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic, progressively debilitating condition that is prevalent in the US and worldwide. Patients suffer from progressive dyspnea and exercise intolerance. Physical exercise is beneficial, but conventional pulmonary rehabilitation programs are underutilized. There remains a need for novel interventions that improve symptoms, quality-of-life, and functional capacity. Tai chi is an increasingly popular mind-body exercise that includes physical exercise, breathing training, mindful awareness, and stress management--components that are essential to the self-management of COPD. There are, however, limited data on the effectiveness of tai chi as a therapeutic intervention in this population. METHODS/DESIGN The Primary Aims are to evaluate the efficacy, safety, and feasibility of a 12-week tai chi program for patients with COPD. We utilize a randomized controlled trial design, with participants assigned in a 2:1 ratio to either a group tai chi program (N = 63) or a time/attention-matched education control (N = 31). Our primary outcomes are COPD-specific quality-of-life and exercise capacity. Secondary outcomes include dyspnea, mood, functional status, self-efficacy, and lung function. Cardiopulmonary exercise testing is done in a subset of patients (N = 50). To explore optimal training duration, a subgroup of patients in tai chi are randomly assigned to complete an additional 12 weeks training (total 24 weeks) (Exploratory Aim 1). To explore the impact of a simplified seated intervention including only a subset of tai chi's training components, a third randomly assigned group (N = 31) receives a 12- week mind-body breathing program (N = 31) (Exploratory Aim 2). DISCUSSION Results of the BEAM study (Breathing, Education, Awareness, Movement) will provide preliminary evidence regarding the value of tai chi for improving quality of life and exercise capacity in patients with COPD, including information regarding optimal duration. They will also inform the feasibility and potential benefit of an alternative mind-body breathing intervention, and provide insight regarding how isolated mind-body exercise components contribute to the overall effects of tai chi. Should the results be positive, tai chi and related mind-body practices may offer a novel exercise option that is potentially accessible to a large proportion of patients with COPD. TRIAL REGISTRATION This trial is registered in Clinical Trials.gov, ID number NCT01551953. Date of Registration March 1 2012.
Collapse
Affiliation(s)
- Gloria Y Yeh
- />Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, 1309 Beacon Street, Brookline, MA 02446 USA
| | - Peter M Wayne
- />Osher Center for Integrative Medicine, Harvard Medical School, 900 Commonwealth Ave, Boston, MA 02446 USA
- />Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, MA USA
| | - Daniel Litrownik
- />Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, 1309 Beacon Street, Brookline, MA 02446 USA
| | - David H Roberts
- />Division of Pulmonary, Sleep and Critical Care Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA
| | - Roger B Davis
- />Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, 1309 Beacon Street, Brookline, MA 02446 USA
| | - Marilyn L Moy
- />Pulmonary and Critical Care Section, Department of Medicine, Veterans Administration Boston Healthcare System, 1400 VFW Parkway, Boston, MA 02132 USA
| |
Collapse
|