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Kochamat A, Harnirattisai T, Juratovac E. The effects of a symptom management program on symptom experience and physical function in Thai adults with chronic obstructive pulmonary disease: A single-blind randomized controlled trial study. BELITUNG NURSING JOURNAL 2024; 10:378-388. [PMID: 39211460 PMCID: PMC11350348 DOI: 10.33546/bnj.3393] [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: 04/16/2024] [Revised: 05/23/2024] [Accepted: 06/24/2024] [Indexed: 09/04/2024] Open
Abstract
Background Adults with Chronic Obstructive Pulmonary Disease (COPD) experience a range of unpleasant symptoms, including fatigue, dyspnea, sleep disturbances, anxiety, and depression, that are interrelated and impact one another. Developing a program to handle simultaneous symptoms poses challenges but offers advantages for adults with COPD in efficiently managing symptoms. Objective This study aimed to determine the effects of a symptom management program on symptom experience and physical function in Thai adults with COPD. Methods A randomized controlled trial (RCT) with a Repeated Measures design was performed. One hundred and two participants were allocated randomly to either the control group (n = 51) or the experimental group (n = 51). The experimental group received eight weeks of the symptom management program and usual care, while the control care group received only usual care. Data were collected from January 2023 to August 2023 at baseline, 4th weeks, and 8th weeks using the demographic data, the modified Medical Research Council (mMRC), the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Assessment of Fatigue (MAF), the Hospital Anxiety and Depression Assessment Scale (HADS), the COPD Assessment Test (CAT), and 6-Minute Walk Distance (6-MWD). The hypotheses were analyzed using Repeated Measures Multivariate Analysis of Variance (MANOVA). Results The symptom management program significantly impacted the experimental group's symptom experience and physical function at Weeks 4 and 8 (F = 5.257, p <0.001). There were significantly improved mean scores for the mMRC, MAF, 6MWD, and CAT (p <0.001, p <0.05). No statistically significant differences were observed in the PSQI, HADS-Anxiety, and HADS-Depression over time. Conclusion Implementing a symptom management program can help patients with COPD efficiently manage their symptoms. In clinical settings, nurses should integrate this program into routine nursing care to enhance the quality of life for patients suffering from COPD. The program can help patients preserve physical functionality while reducing dependence on family and society. Trial Registry Number Thai Clinical Trials Registry (TCTR20230111006).
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Affiliation(s)
- Apinya Kochamat
- Faculty of Nursing, Thammasat University, Pathum Thani, Thailand
| | | | - Evanne Juratovac
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- University Center on Aging and Health, Case Western Reserve University, Cleveland, Ohio, USA
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Boruch A, Branchaw G, O'Connor PJ, Cook DB. Physical Activity and Fatigue Symptoms: Neurotypical Adults and People with Chronic Multisymptom Illnesses. Curr Top Behav Neurosci 2024. [PMID: 39037494 DOI: 10.1007/7854_2024_502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
For neurotypical adults, a single bout of low-to-moderate intensity physical activity usually transiently improves feelings of energy. Similar bouts of exercise have the opposite effect of increased feelings of fatigue when performed by samples with chronic multisymptom illnesses (CMIs) such as Long-COVID, Gulf War Illness (GWI), or Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The short-term adoption of regular moderate intensity physical activity (typical experiments are 1 to 6 months) among neurotypical adults results in small-to-moderate improvements in self-reported feelings of fatigue, energy, and vitality. Small improvements in these feelings, or no change at all, occur for CMIs, but limited data precludes strong conclusions. The mechanisms of exercise effects on fatigue, whether acute or chronic, are poorly understood but likely involve multiple neural circuits and associated transmitters. For CMIs, the mechanisms of acute worsening of fatigue with exercise may be driven by the yet unknown pathophysiological mechanisms of the disease (perhaps involving brain, immune and autonomic system dysfunction, and their interactions). Likewise, fatigue improvements may depend on whether chronic physical activity is a disease-modifying treatment.
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Affiliation(s)
- Alex Boruch
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Grace Branchaw
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Dane B Cook
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA.
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Tarasconi M, Oliva FM, Ambrosino N, Sotgiu G, Saderi L, Zampogna E, Mentasti O, Spanevello A, Visca D. Pulmonary rehabilitation and risk of fall in elderly with chronic obstructive pulmonary disease. Panminerva Med 2024; 66:10-17. [PMID: 37712861 DOI: 10.23736/s0031-0808.23.04892-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND Few data are available on the effects of pulmonary rehabilitation (PR) on risk of fall in over 80 individuals with chronic obstructive pulmonary disease (COPD). We investigated the effectiveness of PR on the risk of fall in older as compared to younger than 80 individuals. METHODS Parallel-group retrospective exploratory study of individuals undergone in-hospital PR. The risk of fall was defined as a gait speed ≤0.8 m/s (primary outcome). Outcome measures (exercise capacity, physical performance, symptoms, and health status) were also assessed. RESULTS As compared to younger, individuals over 80 suffered from more severe symptoms, a reduction in physical performance and in exercise capacity and greater risk of fall (P=0.0001). The proportion of participants at risk of fall increased with age, and after PR decreased significantly without any significant difference between age groups. However, 53.4% of older individuals were still at risk of fall, as compared to 17.5% of those under 80 (P=0.0001). After PR, both populations had improved outcomes measures, without any significant between group differences. CONCLUSIONS In individuals with COPD pulmonary rehabilitation reduced the risk of fall, while improving outcome measures independent of age, however, more than 50% of those over 80 were still at risk of fall. The pulmonary rehabilitation programs for individuals over 80 should include strategies effective in reducing the risk of fall.
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Affiliation(s)
- Matteo Tarasconi
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy
| | - Federico M Oliva
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy
| | - Nicolino Ambrosino
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano, Pavia, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy -
| | - Ombretta Mentasti
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy
| | - Antonio Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Varese, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Urroz Guerrero PD, Oliveira JM, Lewthwaite H, Gibson PG, McDonald VM. Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma. J Clin Med 2023; 12:5998. [PMID: 37762938 PMCID: PMC10531510 DOI: 10.3390/jcm12185998] [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: 08/02/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
People with asthma tend to be less physically active and more sedentary than people without asthma. This narrative review aimed to present key considerations when addressing physical inactivity and sedentary behaviour in people with asthma by identifying barriers and facilitators, determinants and correlates, and intervention approaches. Using a search strategy, electronic databases were searched for relevant studies. Data extracted from studies were qualitatively synthesised. A total of 26 studies were included in the review. Six studies reported asthma symptoms as a barrier to physical activity, while four studies reported having a supportive network as a physical activity facilitator. Across studies, physical activity correlates/determinants were pulmonary function, exercise capacity, body mass index, dyspnoea, psychological health, and asthma control. Interventions that effectively improved physical activity in the short term were a step-based prescription programme, a weight loss programme incorporating aerobic and resistance training, and a weight loss lifestyle intervention, while a high-intensity interval training pulmonary rehabilitation program was effective in the long term. The collective findings suggest that a personalised physical activity programme incorporating different strategies is needed. There was minimal evidence to provide recommendations to optimise sedentary behaviour in asthma, and more research is needed on the topic.
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Affiliation(s)
- Paola D. Urroz Guerrero
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Joice M. Oliveira
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
- Graduate Program in Rehabilitation Sciences, Pitagoras Unopar University, Londrina 86041-140, PR, Brazil
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina, Londrina 86038-350, PR, Brazil
| | - Hayley Lewthwaite
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Peter G. Gibson
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Vanessa M. McDonald
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
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Reizes Z, McNamara RJ, Dale M, McKeough Z. Establishing the Validity of Using the COPD Assessment Test to Screen for Fatigue in People With Chronic Obstructive Pulmonary Disease Referred to Pulmonary Rehabilitation. Phys Ther 2023; 103:pzad064. [PMID: 37329503 PMCID: PMC10471199 DOI: 10.1093/ptj/pzad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/20/2023] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE Fatigue is the second most prevalent symptom in chronic obstructive pulmonary disease (COPD), yet it is often undetected in pulmonary rehabilitation. The aim of this study was to assess the validity of using a health status questionnaire (COPD Assessment Test [CAT] and CAT-energy score) to detect fatigue in people with COPD referred to a pulmonary rehabilitation program. METHODS This study was a retrospective audit of people with COPD referred to pulmonary rehabilitation. The validity of the CAT-total score and CAT-energy score for detecting fatigue was analyzed compared to a validated fatigue questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Cut-off values defining fatigue included a CAT-total score ≥ 10, a CAT-energy score ≥ 2, and a FACIT-F score ≤ 43. Data were analyzed using 2 × 2 tables from which accuracy, sensitivity, specificity, and likelihood ratios were calculated. RESULTS Data from 97 participants with COPD (age in years mean [SD] = 72 [9]; FEV1% predicted mean [SD] = 46% [18]) were used. The FACIT-F score ≤ 43 classified 84 participants (87%) as fatigued. A CAT-total score ≥ 10 yielded an accuracy of 0.87, sensitivity of 0.95, specificity of 0.31, and positive and negative likelihood ratios of 1.38 and 0.15, respectively. A CAT-energy score ≥ 2 yielded an accuracy of 0.85, sensitivity of 0.93, a specificity of 0.31, and positive and negative likelihood ratios of 1.34 and 0.23, respectively. CONCLUSION The CAT-total score is an accurate and sensitive measure for fatigue, and the CAT could be an appropriate tool to screen for fatigue in people with COPD referred to pulmonary rehabilitation. IMPACT Use of the CAT as a screening tool for fatigue has the potential to improve clinician awareness of fatigue, simplify the pulmonary rehabilitation assessment process by reducing survey burden, and inform fatigue management, which may subsequently reduce the symptomatic burden of fatigue in people with COPD.
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Affiliation(s)
- Zoe Reizes
- Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Renae J McNamara
- Department of Physiotherapy, Prince of Wales Hospital, Randwick, New South Wales, Australia
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia
| | - Marita Dale
- Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Zoe McKeough
- Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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Couto N, Cid L, Alves S, Brito JP, Pimenta N, Bento T. Analysing the Effects of Different Types of Exercise on Dyspnoea and Fatigue in Adults through COPD-Systematic Review and Meta-Analysis of Randomised Clinical Trials. Healthcare (Basel) 2023; 11:healthcare11101449. [PMID: 37239735 DOI: 10.3390/healthcare11101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/09/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition, the main symptoms of which are dyspnoea and fatigue. Though exercise has been recommended for subjects with COPD, its benefits remain unclear. The aim of this study was to summarise, through a systematic review and meta-analysis, the available evidence on the effects of aerobic, resistance, stretching, and combined exercise on the main symptoms of COPD. METHODS Search was performed using the electronic databases PubMed and Web of Science. Randomised controlled trials (RCTs) with interventions based on aerobic, resistance and/or combined exercise published until July 2022 were identified. The effects were summarised based on standardised mean differences (95% confidence intervals) using random and fixed effect models. RESULTS Eight studies were selected, including a total of 375 subjects. The results obtained showed that resistance exercise, aerobic exercise and combined exercise seem to improve dyspnoea and fatigue symptoms in COPD subjects. CONCLUSIONS In general, we can conclude that exercise-based interventions appear to improve the main COPD symptoms and may benefit quality of life in this population.
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Affiliation(s)
- Nuno Couto
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
| | - Luís Cid
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Santarém, Portugal
| | - Susana Alves
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Santarém, Portugal
| | - João Paulo Brito
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Santarém, Portugal
| | - Nuno Pimenta
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, 1495-207 Lisbon, Portugal
- The Interdisciplinary Health Research Centre, Catholic University of Portugal, 1649-023 Lisbon, Portugal
| | - Teresa Bento
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-556 Vila Real, Portugal
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7
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Maestri R, Vitacca M, Paneroni M, Zampogna E, Ambrosino N. Gender and Age as Determinants of Success of Pulmonary Rehabilitation in Individuals With Chronic Obstructive Pulmonary Disease. Arch Bronconeumol 2023; 59:174-177. [PMID: 36192251 DOI: 10.1016/j.arbres.2022.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/30/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Roberto Maestri
- Department of Biomedical Engineering of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | - Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy.
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - Elisabetta Zampogna
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
| | - Nicolino Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
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8
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Qomi M, Rakhshan M, Ebrahimi Monfared M, Khademian Z. The effect of distance nurse-led fatigue management on fatigue, sleep quality, and self-efficacy in patients with multiple sclerosis: a quasi-experimental study. BMC Neurol 2023; 23:71. [PMID: 36788480 PMCID: PMC9926409 DOI: 10.1186/s12883-023-03115-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Fatigue is one of the most common problems in patients with multiple sclerosis (MS) and has adverse effects on their sleep status and self-efficacy. This study aimed to determine the effect of distance nurse-led fatigue management on fatigue, sleep quality, and self-efficacy in patients with MS. METHODS This quasi-experimental study was performed on 60 patients with MS in Arak, Iran. Subjects were randomly assigned into intervention and control groups. The intervention group received eight sessions of nurse-led fatigue management training through the Skyroom platform. The control group received only the usual programs. Data were collected before and two months after the intervention using the Fatigue Severity Scale, the Pittsburgh Sleep Quality Index, and the Multiple Sclerosis Self-Efficacy Scale. The significance level in this study was determined 0.05. RESULTS After the intervention, the mean score of fatigue severity in the intervention group was significantly lower than the control group (2.52 ± 0.40 vs 5.65 ± 0.52) (P < 0.001). Also, after the intervention, the mean score of self-efficacy in the intervention group was significantly higher than the control group (49.37 ± 3.25 vs 24.43 ± 2.52) (P < 0.001). Furthermore, after the intervention the mean score of sleep quality was lower in intervention group (11.92 ± 2.01) than the control group (15.46 ± 1.40) (P < 0.001). CONCLUSION Distance nurse-led fatigue management improved fatigue, sleep quality, and self-efficacy in patients with MS. We recommend the use of these courses as an important step toward improving fatigue, sleep quality, and self-efficacy among these patients.
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Affiliation(s)
- Mahla Qomi
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zahra Khademian
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Vitacca M, Malovini A, Spanevello A, Ceriana P, Paneroni M, Maniscalco M, Balbi B, Rizzello L, Murgia R, Bellazzi R, Ambrosino N. Clusters of individuals recovering from an exacerbation of chronic obstructive pulmonary disease and response to in-hospital pulmonary rehabilitation. Pulmonology 2023; 29:230-239. [PMID: 36717292 DOI: 10.1016/j.pulmoe.2023.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Due to the present low availability of pulmonary rehabilitation (PR) for individuals recovering from a COPD exacerbation (ECOPD), we need admission priority criteria. We tested the hypothesis that these individuals might be clustered according to baseline characteristics to identify subpopulations with different responses to PR. METHODS Multicentric retrospective analysis of individuals undergone in-hospital PR. Baseline characteristics and outcome measures (six-minute walking test - 6MWT, Medical Research Council scale for dyspnoea -MRC, COPD assessment test -CAT) were used for clustering analysis. RESULTS Data analysis of 1159 individuals showed that after program, the proportion of individuals reaching the minimal clinically important difference (MCID) was 85.0%, 86.3%, and 65.6% for CAT, MRC, and 6MWT respectively. Three clusters were found (C1-severe: 10.9%; C2-intermediate: 74.4%; C3-mild: 14.7% of cases respectively). Cluster C1-severe showed the worst conditions with the largest post PR improvements in outcome measures; C3-mild showed the least severe baseline conditions, but the smallest improvements. The proportion of participants reaching the MCID in ALL three outcome measures was significantly different among clusters, with C1-severe having the highest proportion of full success (69.0%) as compared to C2-intermediate (48.3%) and C3-mild (37.4%). Participants in C2-intermediate and C1-severe had 1.7- and 4.6-fold increases in the probability to reach the MCID in all three outcomes as compared to those in C3-mild (OR = 1.72, 95% confidence interval [95% CI] = 1.2 - 2.49, p = 0.0035 and OR = 4.57, 95% CI = 2.68 - 7.91, p < 0.0001 respectively). CONCLUSIONS Clustering analysis can identify subpopulations of individuals recovering from ECOPD associated with different responses to PR. Our results may help in defining priority criteria based on the probability of success of PR.
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Affiliation(s)
- M Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy.
| | - A Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - A Spanevello
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Varese, Italy; Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - P Ceriana
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - M Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - M Maniscalco
- Respiratory Rehabilitation of the Institute of Telese, Istituti Clinici Scientifici Maugeri IRCCS, Benevento, Italy
| | - B Balbi
- Respiratory Rehabilitation of the Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Novara, Italy
| | - L Rizzello
- Respiratory Rehabilitation of the Institute of Milano Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | - R Murgia
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - R Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy; Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - N Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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10
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Vitacca M, Paneroni M, Salvi B, Spanevello A, Ceriana P, Bruschi C, Balbi B, Aliani M, Ambrosino N. Airflow grades, outcome measures and response to pulmonary rehabilitation in individuals after an exacerbation of severe chronic obstructive pulmonary disease. Eur J Intern Med 2023; 107:81-85. [PMID: 36396523 DOI: 10.1016/j.ejim.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/27/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with COPD may be staged according to symptoms and exacerbation history (GOLD groups: A-D) and on airflow obstruction (GOLD grades: 1-4). Guidelines recommend pulmonary rehabilitation (PR) for these individuals, including those recovering from an exacerbation (ECOPD) OBJECTIVE: To evaluate whether in individuals with clinically severe COPD, recovering from an ECOPD, the effect size of an in-hospital PR program would be affected by airflow severity grades and assessed outcome measures. METHODS Retrospective, multicentre study. Participants were compared according to different GOLD airflow grades. In addition to the MRC dyspnoea scale, six-minute walking distance test and COPD assessment test (CAT), Barthel dyspnoea index (Bid), and Short Physical Performance Battery (SPPB) were assessed, evaluating the proportion of individuals reaching the minimum clinically important difference (MCID) (responders). RESULTS Data of 479 individuals, completing the program were evaluated. Most of the participants were allocated in GOLD grades 4, (57.6%) and 3 (22.1%). All outcome measures significantly improved after PR (p < 0.05), without any significant difference in the proportion of responders in any measure. CONCLUSIONS in individuals with severe COPD, recovering from ECOPD the success rate of PR does not depend on airflow severity, or outcome measure assessed. In addition to the most used outcome measures, also Bid and SPPB are sensitive to PR.
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Affiliation(s)
- Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy.
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy
| | - Beatrice Salvi
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy
| | - Antonio Spanevello
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Varese, Italy; Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Piero Ceriana
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Claudio Bruschi
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Bruno Balbi
- Respiratory Rehabilitation of the Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Novara, Italy
| | - Maria Aliani
- Respiratory Rehabilitation of the Institute of Bari, Istituti Clinici Scientifici Maugeri IRCCS, Bari, Italy
| | - Nicolino Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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de Medeiros Nogueira MG, Silva GAG, Marinho MHT, de Fátima Costa Brito O, de Brito Vieira WH, Ururahy MAG, Nogueira IDB, da Silva IS, de Miranda Silva Nogueira PA. Acute effects of NIV on peripheral muscle function and aerobic performance in patients with chronic obstructive pulmonary disease: a pilot study. BMC Pulm Med 2022; 22:399. [PMID: 36333720 PMCID: PMC9635205 DOI: 10.1186/s12890-022-02201-w] [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: 04/22/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Non-invasive ventilation (NIV) reduces respiratory load and demands on peripheral muscles. Methods This study aims to evaluate the acute effects of bi-level NIV on peripheral muscle function during isokinetic exercise and aerobic performance in chronic obstructive pulmonary disease (COPD) patients. This is a pilot crossover study performed with a non-probabilistic sample of 14 moderate to very severe COPD patients. Procedures carried out in two days. Dyspnea, quality of life, lung function, respiratory muscle strength, functional capacity (6-min walk test—6MWT), and isokinetic assessment of the quadriceps were assessed. Blood samples (lactate, lactate dehydrogenase, and creatine kinase concentration) were also collected. Right after, NIV was performed for 30 min (bi-level or placebo, according to randomization) followed by new blood sample collection, 6MWT, and isokinetic dynamometer tests. Before and after evaluations, the subjective perception of dyspnea and fatigue in the lower limbs was quantified. After a wash-out period of seven days, participants returned, and all assessments were performed again. Results NIV showed improvements in perceived exertion and dyspnea after isokinetic exercise (p < 0.02 and p < 0.05, respectively). Conclusions NIV improves the perception of dyspnea and fatigue during the isokinetic exercise.
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Affiliation(s)
- Mariana Galvão de Medeiros Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Gabriely Azevêdo Gonçalo Silva
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | | | - Ozana de Fátima Costa Brito
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Wouber Hérickson de Brito Vieira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Marcela Abbott Galvão Ururahy
- grid.411233.60000 0000 9687 399XDepartment of Clinical and Toxicological Analysis, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte Brazil
| | - Ivan Daniel Bezerra Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Ivanízia Soares da Silva
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Patrícia Angélica de Miranda Silva Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
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12
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Vitacca M, Paneroni M, Spanevello A, Ceriana P, Ambrosino N. Inhaled triple therapy in individuals with Chronic Obstructive Pulmonary Disease and indications of pulmonary rehabilitation. Eur J Intern Med 2022; 105:125-127. [PMID: 35981915 DOI: 10.1016/j.ejim.2022.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy.
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - Antonio Spanevello
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS(,) Tradate, Varese, Italy; Department of Medicine and Surgery University of Insubria, Varese, Italy
| | - Piero Ceriana
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Nicolino Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
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13
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Zampogna E, Ambrosino N, Oliva FM, Rudi M, Sotgiu G, Saderi L, Spanevello A, Visca D. Effect of pulmonary rehabilitation on heart rate recovery in adult individuals with asthma or chronic obstructive pulmonary disease. Front Pharmacol 2022; 13:956549. [PMID: 36238578 PMCID: PMC9551028 DOI: 10.3389/fphar.2022.956549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Heart rate recovery (HRR) after exercise is a marker of disease severity and prognosis in cardiovascular and respiratory disorders. More than 30% of adult individuals with asthma may show a slow HRR. Pulmonary rehabilitation improves exercise capacity in individuals with asthma or chronic obstructive pulmonary disease (COPD). Aim: The study aimed to evaluate the effect of pulmonary rehabilitation on HRR in individuals with asthma as compared to those with COPD. Methods: Retrospective analysis of HRR one minute after the six-minute walking test (6MWT) was performed before and after an exercise training program. The COPD Assessment Test (CAT), Barthel Index-Dyspnea (BI-D), Medical Research Council (MRC) score for dyspnea, and the Five-Times-Sit-to-Stand test (5STS) were also assessed as secondary outcome measures. Results: Slow HRR prevalence was significantly lower in individuals with asthma than with COPD (29.1 vs. 46.7%, respectively: p = 0.003). Post-program HRR did not change in more than 70% of individuals in either population and improved in 16% of both populations, whereas it actually worsened in 12 and 10% of individuals with asthma and COPD, respectively. The outcome measures significantly improved in both populations, irrespective of baseline HRR. Conclusion: In individuals with asthma or COPD, exercise training does not significantly improve HRR.
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Affiliation(s)
- Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
- *Correspondence: Elisabetta Zampogna,
| | - Nicolino Ambrosino
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano, Italy
| | - Federico Mattia Oliva
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - Monica Rudi
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, Clinical Epidemiology and Medical Statistics Unit, University of Sassari, Sassari, Italy
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, Clinical Epidemiology and Medical Statistics Unit, University of Sassari, Sassari, Italy
| | - Antonio Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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14
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Tian J, Zhou F, Zhang XG, Wang HY, Peng SH, Li X, Cao J, Zhang H. Experience of physical activity in patients with COPD: A systematic review and qualitative meta-synthesis. Geriatr Nurs 2022; 47:211-219. [PMID: 35940039 DOI: 10.1016/j.gerinurse.2022.07.013] [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: 04/30/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To systematically evaluate and integrate the qualitative research on physical activity (PA) experience of patients with chronic obstructive pulmonary disease (COPD). METHODS Web of Science, Cochrane Library, Embase, CINAHL and other databases were searched, and the qualitative research on PA experience of patients with COPD was collected. The systematic review was conducted in line with Joanna Briggs Institute (JBI) methodology for systematic reviews of qualitative evidence. RESULTS 12 studies were included and 3 themes were summarized, included: COPD patients experience more barriers while participating in physical activities than facilitators; COPD patients experience more positive effects post-physical activities than negative effects; Guaranteeing safety, goal setting, and establishing a professional support group improve compliance in COPD patients. CONCLUSION Health care professionals should help patients overcome the obstacles of PA, pay attention to the PA experience of patients, adopt diversified PA methods, improve PA participation and compliance, and make patients develop good PA habits.
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Affiliation(s)
- Jing Tian
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fan Zhou
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Xian Geng Zhang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China.
| | - Hong Yan Wang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China
| | - Si Han Peng
- Affiliated hospital of Chengdu University of Traditional Chinese Medicine,Chengdu, Sichuan 610032, China
| | - Xin Li
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Jun Cao
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu, Sichuan 610100, China
| | - Hong Zhang
- College of Nursing,Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
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15
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Vitacca M, Paneroni M, Spanevello A, Ceriana P, Balbi B, Salvi B, Ambrosino N. Effectiveness of pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease according to inhaled therapy: The Maugeri study. Respir Med 2022; 202:106967. [DOI: 10.1016/j.rmed.2022.106967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 10/15/2022]
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Gable KL, Peric S, Lutz MW, Bozovic I, Petrovic M, Stojanov A, Basta I, Allen JA. A longitudinal evaluation of fatigue in chronic inflammatory demyelinating polyneuropathy. Brain Behav 2022; 12:e2712. [PMID: 35862228 PMCID: PMC9392529 DOI: 10.1002/brb3.2712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/24/2022] [Accepted: 07/03/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Fatigue is a common but poorly understood complaint in patients with immune-mediated polyneuropathies. We sought to evaluate changes in fatigue over 1 year in a cohort of chronic inflammatory demyelinating polyneuropathy (CIDP) patients and to correlate changes in fatigue with changes in disability and quality of life. Investigation into other factors that may contribute to fatigue with a particular interest in the role other chronic disease states may play was also performed. METHODS Fifty patients with CIDP who satisfied the 2010 EFNS/PNS diagnostic criteria were followed over the period of 1 year at three tertiary care centers in Serbia. Assessments of disability, quality of life, and patient perception of change and fatigue were collected at two time points 12 months apart. Comorbidities, treatment regimens, and sedating medication use was collected. RESULTS Disability, quality of life, and patient perception of change showed statistically significant correlations with change in fatigue (p < .01). Increased levels of fatigue were noted in patients who used sedating medications (p = .05) and who had a comorbid chronic medical condition (p = .01). INTERPRETATION Worsening fatigue correlates over time with increased disability and worse quality of life. Fatigue is not specific to CIDP, but is common in many chronic medical conditions and with the use of sedating medications. Our findings support the importance of identifying and supportively managing fatigue in patients with CIDP, but cautions against considering fatigue as a CIDP diagnostic symptom or using fatigue to justify immunotherapy utilization.
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Affiliation(s)
- Karissa L Gable
- Duke Neurological Disorders Clinic, Duke University Medical Center, Durham, North Carolina, USA
| | - Stojan Peric
- Faculty of Medicine and University Clinical Center of Serbia, Neurology Clinic, University of Belgrade, Belgrade, Serbia
| | - Michael W Lutz
- Duke Neurological Disorders Clinic, Duke University Medical Center, Durham, North Carolina, USA
| | - Ivo Bozovic
- Neurology Clinic, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milutin Petrovic
- Neurology Clinic, University Clinical Center of Kragujevac, Kragujevac, Serbia
| | | | - Ivana Basta
- Faculty of Medicine and University Clinical Center of Serbia, Neurology Clinic, University of Belgrade, Belgrade, Serbia
| | - Jeffrey A Allen
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
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Al Chikhanie Y, Bailly S, Amroussa I, Veale D, Hérengt F, Verges S. Clustering of COPD patients and their response to pulmonary rehabilitation. Respir Med 2022; 198:106861. [DOI: 10.1016/j.rmed.2022.106861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/09/2022] [Accepted: 04/23/2022] [Indexed: 11/26/2022]
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18
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Valle MS, Casabona A, Di Fazio E, Crimi C, Russo C, Malaguarnera L, Crimi N, Cioni M. Impact of chronic obstructive pulmonary disease on passive viscoelastic components of the musculoarticular system. Sci Rep 2021; 11:18077. [PMID: 34508166 PMCID: PMC8433214 DOI: 10.1038/s41598-021-97621-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/27/2021] [Indexed: 01/08/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) produces skeletal muscle atrophy and weakness, leading to impairments of exercise performance. The mechanical work needed for movement execution is also provided by the passive tension developed by musculoarticular connective tissue. To verify whether COPD affects this component, the passive viscoelastic properties of the knee joint were evaluated in 11 patients with COPD and in 11 healthy individuals. The levels of stiffness and viscosity were assessed by means of the pendulum test, consisting in a series of passive leg oscillations. In addition, to explore the contribution of passive tension in the mechanical output of a simple motor task, voluntary leg flexion-extension movements were performed. Patients with COPD showed a statistically significant reduction in stiffness and viscosity compared to controls. Voluntary execution of flexion-extension movements revealed that the electromyographic activity of the Rectus Femoris and Biceps Femoris was lower in patients than in controls, and the low viscoelastic tension in the patients conditioned the performance of active movements. These results provide novel insights on the mechanism responsible for the movement impairments associated with COPD.
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Affiliation(s)
- Maria Stella Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy.
| | - Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Eugenia Di Fazio
- Respiratory Medicine Unit, "Policlinico Vittorio Emanuele-San Marco" University Hospital, Catania, Italy
| | - Claudia Crimi
- Respiratory Medicine Unit, "Policlinico Vittorio Emanuele-San Marco" University Hospital, Catania, Italy
| | - Cristina Russo
- Section of Pathology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Lucia Malaguarnera
- Section of Pathology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Nunzio Crimi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
- Gait and Posture Analysis Laboratory, "Policlinico Vittorio Emanuele-San Marco" University Hospital, Catania, Italy
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19
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Ghazanfari MJ, Karkhah S, Emami Zeydi A, Mortazavi H, Tabatabaee A, Adib-Hajbaghery M. A Systematic Review of Potentially Effective Nonpharmacological Interventions for Reducing Fatigue among Iranian Patients Who Receive Hemodialysis. Complement Med Res 2021; 29:147-157. [PMID: 34518448 DOI: 10.1159/000518626] [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: 10/01/2020] [Accepted: 07/21/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE Fatigue control in hemodialysis (HD) patients requires a multidisciplinary approach. This study aimed to comprehensively review the available research literature regarding the nonpharmacological interventions used for reducing fatigue among Iranian HD patients. METHODS In this systematic review, an extensive search of the literature was conducted on PubMed, Web of Science, and Scopus databases, using the keywords related to the purpose. Also, the Persian equivalent of these keywords was searched in Iranian databases, such as Iranmedex and Scientific Information Database (SID) from the inception to June 16, 2020. RESULTS Of 2,761 articles, 25 studies were included in the review. Among a total of 1,748 Iranian HD patients with a mean age of 54.17 (SD = 12.27) years, 61.38% were male. Interventions such as educational-based programs (n = 5), nutrition-based programs (n = 2), massage therapy (n = 3), exercise-based programs (n = 4), relaxation technique (n = 3), combination of relaxation technique and inhalation aromatherapy (n = 1), energy therapy (reflexology and acupressure) (n = 3), and mind-guided imagery (n = 1) were effective in reducing fatigue in Iranian HD patients. DISCUSSION/CONCLUSION These simple, low-cost, and practical interventions can be used for the reduction of fatigue among HD patients by nurses. However, future well-designed studies are recommended to confirm the efficacy of these and other potentially effective interventions for reducing fatigue in HD patients.
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Affiliation(s)
- Mohammad Javad Ghazanfari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.,Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Mortazavi
- Geriatric Care Research Center, Department of Geriatric Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Amir Tabatabaee
- Nursing Department, Quchan Branch, Islamic Azad University, Quchan, Iran
| | - Mohsen Adib-Hajbaghery
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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20
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Pisi R, Aiello M, Calzetta L, Frizzelli A, Tzani P, Bertorelli G, Chetta A. The COPD assessment test and the modified Medical Research Council scale are not equivalent when related to the maximal exercise capacity in COPD patients. Pulmonology 2021; 29:194-199. [PMID: 34233862 DOI: 10.1016/j.pulmoe.2021.06.001] [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: 12/14/2020] [Revised: 05/20/2021] [Accepted: 06/05/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The management and treatment of Chronic Obstructive Pulmonary Disease (COPD) are based on a cutoff point either of ≥ 10 on the COPD Assessment Test (CAT) or of ≥ 2 of the Medical Research Council (mMRC). Up to now, no study has assessed the equivalence between CAT and mMRC, as related to exercise tolerance in COPD. The aim of this study was to investigate as primary outcome the relationship between CAT and mMRC and maximal exercise capacity in COPD patients. We also evaluated as secondary outcome the agreement between CAT (≥ 10) and mMRC (≥ 2) to categorize patients according to their exercise tolerance. MATERIAL AND METHODS 118 consecutive COPD patients (39 females), aged between 47 and 85 years with a wide range of airflow obstruction and lung hyperinflation were studied. Maximal exercise capacity was assessed by cardiopulmonary exercise test. RESULTS CAT and mMRC scores were significantly related to VO2 peak (p<0.01). CAT (≥ 10) and mMRC (≥ 2) have a high likelihood to be associated to a value of VO2 peak less than 15.7 and 15.6 mL/kg/min, respectively. The interrater agreement between CAT (≥ 10) and mMRC (≥ 2) was found to be fair (κ = 0.20) in all patients but slight when they were subdivided in those with VO2 peak < 15 mL/kg/min and in those with VO2 peak ≥ 15 mL/kg/min (κ = 0.10 and κ = 0.20 respectively). CONCLUSION This study shows that CAT and mMRC are useful tools to predict exercise tolerance in COPD, but they cannot be considered as supplementary measures.
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Affiliation(s)
- Roberta Pisi
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Viale A. Gramsci, 14, 43126 Parma, Italy
| | - Marina Aiello
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Viale A. Gramsci, 14, 43126 Parma, Italy
| | - Luigino Calzetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Viale A. Gramsci, 14, 43126 Parma, Italy.
| | - Annalisa Frizzelli
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Viale A. Gramsci, 14, 43126 Parma, Italy
| | - Panagiota Tzani
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Viale A. Gramsci, 14, 43126 Parma, Italy
| | - Giuseppina Bertorelli
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Viale A. Gramsci, 14, 43126 Parma, Italy
| | - Alfredo Chetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Viale A. Gramsci, 14, 43126 Parma, Italy
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21
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Brunetti G, Malovini A, Maniscalco M, Balestrino A, Carone M, Visca D, Capelli A, Vitacca M, Bellazzi R, Piaggi G, Fuschillo S, Aliani M, Spanevello A, Prince I, Paneroni M, Ambrosino N. Pulmonary rehabilitation in patients with interstitial lung diseases: Correlates of success. Respir Med 2021; 185:106473. [PMID: 34038844 DOI: 10.1016/j.rmed.2021.106473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/09/2021] [Accepted: 05/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Benefits of pulmonary rehabilitation in Interstitial Lung Diseases (ILD) have been reported. The aim of this large multicenter study was to identify the success predictors of pulmonary rehabilitation in a real-life setting. METHODS Data of 240 in-patients (110 idiopathic pulmonary fibrosis (IPF), 106 ILD other than IPF and 24 undetermined ILD) undergoing pulmonary rehabilitation in a 10-year period were retrospectively evaluated. Six minute walking distance (6MWT), body weight-walking distance product tests, dyspnoea and arterial blood gases were assessed at admission and discharge. Differences in post rehabilitation changes in outcome measures as function of baseline characteristics were evaluated. RESULTS After rehabilitation, patients showed improvements in all outcome measures (p < 0.05), regardless of the underlying diagnosis or disease severity. Patients needing oxygen therapy at rest showed reduced benefits. Baseline 6MWD inversely correlated with its changes at discharge. Non-significant greater benefits after rehabilitation were found in IPF patients under antifibrotic therapy. In a subset of 50 patients assessed on average 10.3 ± 3.5 months after discharge, the benefits in 6MWD were not maintained (312.9 ± 139.4, 369.7 ± 122.5 and 310.8 ± 139.6 m at admission, discharge and follow up respectively: p < 0.0001). CONCLUSION Pulmonary rehabilitation may improve dyspnoea, exercise capacity and fatigue in patients with ILD of different aethiologies and level of severity. The long-term effects need to be established.
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Affiliation(s)
- Giuseppe Brunetti
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Pavia, Italy.
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Pavia, Italy
| | - Mauro Maniscalco
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Telese, Benevento, Italy
| | - Antonella Balestrino
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Pavia, Italy
| | - Mauro Carone
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Bari, Italy
| | - Dina Visca
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Tradate, Varese, Italy
| | - Armando Capelli
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Veruno, Novara, Italy
| | - Michele Vitacca
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Lumezzane, Brescia, Italy
| | - Riccardo Bellazzi
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Pavia, Italy; Department of Electrical Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Giancarlo Piaggi
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Montescano, Pavia, Italy
| | - Salvatore Fuschillo
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Telese, Benevento, Italy
| | - Maria Aliani
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Bari, Italy
| | - Antonio Spanevello
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Tradate, Varese, Italy
| | - Ilaria Prince
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Veruno, Novara, Italy
| | - Mara Paneroni
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Lumezzane, Brescia, Italy
| | - Nicolino Ambrosino
- Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri SpA-SB IRCCS, Montescano, Pavia, Italy
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22
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Vitacca M, Ambrosino N, Belli S, Vigna M, Zampogna E, Aliani M, Piaggi G, Paneroni M. The severity of acute exacerbations of COPD and the effectiveness of pulmonary rehabilitation. Respir Med 2021; 184:106465. [PMID: 34023740 DOI: 10.1016/j.rmed.2021.106465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/03/2021] [Accepted: 05/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Pulmonary rehabilitation is effective also in patients recovering from acute exacerbations of COPD (AECOPD). We aimed to evaluate whether levels of dyspnoea affect the outcome of pulmonary rehabilitation in patients recovering from AECOPD requiring different levels of care. MATERIALS AND METHODS Retrospective data analysis of 1057 patients recovering from AECOPD requiring either hospital (Hospital group: 291) or home management (Home group: 766), undergone post AECOPD in-patient pulmonary rehabilitation. The 6-min walking distance (6MWD) test was the primary outcome, stratified by the Barthel index Dyspnoea (Bid). Data of modified Medical Research Council scale, Short Physical Performance Battery, COPD Assessment Test were also analysed, when available. RESULTS In overall population 6MWD improved significantly from 278 (129) to 335 (139) meters (p < 0.001). As compared to Home, 6MWD improved more in Hospital group [by 81.9 (79.6) vs 48.9 (94.4) meters respectively, p < 0.001] also when stratified by Bid levels (all: p < 0.01). In Hospital group, 6MWD improved significantly more in patients with Bid level 3 than levels 4 and 5 (p < 0.05). Hospital group showed a greater proportion of patients reaching the Minimal Clinically Important Difference for 6MWD (75.9 vs 56.7% in Hospital and Home group respectively p < 0.001). All other available outcome measures significantly (p < 0.01) improved independent of the Bid levels. There was no significant correlation between baseline severity of airflow obstruction and effect of the program. CONCLUSIONS In-patient pulmonary rehabilitation results in clinically meaningful improvement in patients recovering from AECOPD, independent of severity of dyspnoea. However, the levels of dyspnoea severity and the care required by AECOPD influenced the magnitude of success.
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Affiliation(s)
- Michele Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
| | - Nicolino Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano, Italy
| | - Stefano Belli
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Veruno, Italy
| | - Matteo Vigna
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Pavia, Italy
| | - Elisabetta Zampogna
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Tradate, Italy
| | - Maria Aliani
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Bari, Italy
| | - Giancarlo Piaggi
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano, Italy
| | - Mara Paneroni
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy
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23
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Zampogna E, Bertolotti G, Ambrosino N, Lo Bello G, Cherubino F, Ianni A, Paneroni M, Pignatti P, Visca D, Zanini A, Giordano A. The Maugeri daily activity profile: a tool to assess physical activity in patients with chronic obstructive pulmonary disease. Monaldi Arch Chest Dis 2021; 91. [PMID: 33840180 DOI: 10.4081/monaldi.2021.1680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/22/2021] [Indexed: 11/23/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) report reduced physical activity (PA). There are only few tools available to assess PA and sedentary behavior in these patients, and none of them aims to differentiate between sedentary and active patterns. The aim of the study was to evaluate an easy tool to profile daily activity time in a cohort of patients with COPD, compared to healthy subjects; the study was set at the Istituti Clinici Scientifici Maugeri (ICS), IRCCS of Tradate and Lumezzane, Italy, and at the Ente Ospedaliero Cantonale Novaggio, Switzerland (Italian Speaking). The populations were inpatients with COPD, healthy subjects. The items of the Maugeri Daily Activity (MaDA) profile were chosen based on literature, interviews with patients and health professionals. Time spent during sleep (ST), when awake (AT), active (ACT) or in sedentary behavior (SET) were recorded. Lung function tests, arterial blood gases, the modified Medical Research Council (mMRC), the six-minute walking distance test (6MWD), the COPD Assessment Test (CAT), and the body-mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index were also assessed in patients. Sixty patients with COPD and 60 healthy controls filled in the questionnaire. As compared to controls, patients showed longer AT and SET. Active time of patients was significantly correlated with mMRC, CAT, Bode Index and 6MWD, but not with demographics, anthropometrics or stages of disease. Using this tool, we found that patients with COPD spent longer time awake and in sedentary behavior. The MaDA may be useful to evaluate PA in patients with COPD.
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Affiliation(s)
| | | | | | | | | | - Alessandra Ianni
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate.
| | - Mara Paneroni
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Lumezzane.
| | | | - Dina Visca
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Tradate.
| | | | - Andrea Giordano
- Respiratory Rehabilitation, ICS Maugeri IRCCS Institute of Veruno.
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24
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Paneroni M, Simonelli C, Saleri M, Bertacchini L, Venturelli M, Troosters T, Ambrosino N, Vitacca M. Muscle Strength and Physical Performance in Patients Without Previous Disabilities Recovering From COVID-19 Pneumonia. Am J Phys Med Rehabil 2021; 100:105-109. [PMID: 33181531 DOI: 10.1097/phm.0000000000001641] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT In this cross-sectional study, we evaluated skeletal muscle strength and physical performance (1-min sit-to-stand and short physical performance battery tests), dyspnea, fatigue, and single-breath counting at discharge from a postacute COVID department, in patients recovering from COVID-19 pneumonia who had no locomotor disability before the infection.Quadriceps and biceps were weak in 86% and 73% of the patients, respectively. Maximal voluntary contraction for quadriceps was 18.9 (6.8) kg and for biceps 15.0 (5.5) kg (i.e., 54% and 69% of the predicted normal value, respectively). The number of chair rises in the 1-min sit-to-stand test was 22.1 (7.3 corresponding to 63% of the predicted normal value), whereas the short physical performance battery score was 7.9 (3.3 corresponding to 74% of the predicted normal value). At the end of the 1-min sit-to-stand test, 24% of the patients showed exercise-induced desaturation. The single-breath counting count was 35.4 (12.3) corresponding to 72% that of healthy controls. Mild-to-moderate dyspnea and fatigue were found during activities of daily living (Borg scale score, median value = 0.5 [0-2] and 1 [0-2]) and after the 1-min sit-to-stand (Borg scale score, median value = 3 [2-5] and 1 [0-3]). Significant correlations were observed between muscle strength and physical performance indices (R = 0.31-0.69).The high prevalence of impairment in skeletal muscle strength and physical performance in hospitalized patients recovering from COVID-19 pneumonia without previous locomotor disabilities suggests the need for rehabilitation programs after discharge.
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Affiliation(s)
- Mara Paneroni
- From the Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy (MP, CS, MS, LB, M. Vitacca); Department of Neurosciences, Biomedicine and Movement Sciences, Università di Verona, Verona, Italy (M. Venturelli); Department of Rehabilitation Sciences, University Hospitals Gasthuisberg, Leuven, Belgium (TT); Respiratory Division, KU Leuven, Leuven, Belgium (TT); and Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy (NA)
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25
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Zampogna E, Migliori GB, Centis R, Cherubino F, Facchetti C, Feci D, Palmiotto G, Pignatti P, Saderi L, Sotgiu G, Spanevello A, Zappa M, Visca D. Functional impairment during post-acute COVID-19 phase: Preliminary finding in 56 patients. Pulmonology 2021; 27:452-455. [PMID: 33454281 PMCID: PMC7833519 DOI: 10.1016/j.pulmoe.2020.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/26/2020] [Accepted: 12/15/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- E Zampogna
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy.
| | - G B Migliori
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - R Centis
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - F Cherubino
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - C Facchetti
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
| | - D Feci
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - G Palmiotto
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - P Pignatti
- Allergy and Immunology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - L Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Spanevello
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - M Zappa
- Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - D Visca
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
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26
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Simonelli C, Paneroni M, Vitacca M, Ambrosino N. Measures of physical performance in COVID-19 patients: a mapping review. Pulmonology 2021; 27:518-528. [PMID: 34284976 PMCID: PMC8221906 DOI: 10.1016/j.pulmoe.2021.06.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVE There is evidence of short- and long-term impairment of physical performance in patients with COVID-19 infection, but a verification of measures of physical impairment in this condition is lacking. We reviewed the measures used to assess physical performance in these patients. Secondary targets were measures of exercise or daily life activities induced symptoms. METHODS Medline, CINAHL, and Pedro databases were searched from January 2020 to February 2021 for articles in the English language. Two investigators independently conducted the search, screened all titles and/or abstracts based on the inclusion criteria and independently scored the studies. The quality of the studies was evaluated by two reviewers according to the NIH quality assessment tool for observational cohort and cross-sectional studies. Discrepancies were resolved through consensus. RESULTS Out of 156 potentially relevant articles, 31 observational studies (8 cross-sectional), 1 randomized controlled trial, and 1 protocol were included. The quality of most of the 31 evaluable studies was judged as low (11 studies) or fair (14 studies). Sample sizes of the studies ranged from 14 to 20,889 patients. among the 28 reported measures, Barthel Index (42.4% of studies), Six-Minute Walking Distance Test (36.4%), Short Physical Performance Battery (21.2%) and 1-Minute Sit-to-Stand (12.1%) were the most used. Fifteen% and 36% of studies reported exercise induced desaturation and dyspnoea when performing the assessments, respectively. Other exercise induced symptoms were fatigue and pain. Studies reported wide ranges of impairment in physical performance as compared to "reference" values (range of mean or median reported values vs "reference values": 11-77 vs 100 points for Barthel Index; 11-22 vs 22-37 repetitions/min for 1m-STS; 0.5-7.9 vs 11.4 ± 1.3 points for SPPB; and 45-223 vs 380-782 m for 6MWT respectively). CONCLUSION This review found that a wide variety of functional status tests have been used, making comparisons difficult between studies. These measures show impairment in physical performance in COVID-19 patients. However, the quality of most of the studies was judged as low or fair.
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Affiliation(s)
- Carla Simonelli
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Division of the Institute of Lumezzane, Via G Mazzini 129, 25065 Lumezzane (Brescia), Italy
| | - Mara Paneroni
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Division of the Institute of Lumezzane, Via G Mazzini 129, 25065 Lumezzane (Brescia), Italy,Corresponding author
| | - Michele Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Division of the Institute of Lumezzane, Via G Mazzini 129, 25065 Lumezzane (Brescia), Italy
| | - Nicolino Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Division of the Institute of Montescano, Pavia, Italy
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27
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Marillier M, Bernard AC, Verges S, Neder JA. The role of peripheral muscle fatigability on exercise intolerance in COPD. Expert Rev Respir Med 2020; 15:117-129. [PMID: 33148059 DOI: 10.1080/17476348.2021.1836964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Exercise limitation in chronic obstructive pulmonary disease (COPD) is multi-factorial; however, growing evidence indicates that muscle dysfunction may contribute in some patients. AREAS COVERED This work outlines current evidence for and against increased peripheral muscle fatigability in COPD through a comprehensive review of relevant literature available on PubMed/MEDLINE until May 2020. The authors first discuss key methodological issues relative to muscle fatigue assessment by non-volitional techniques, particularly magnetic stimulation. The authors then provide a detailed discussion of critical studies to have objectively measured skeletal muscle fatigue in individuals with COPD. EXPERT OPINION Current evidence indicates that localized (knee extension) and cycling exercise are associated with increased quadriceps fatigability in most COPD patients. Increased fatigability, however, has not been consistently found in response to walking, likely reflecting the tendency of 'central' respiratory constraints to overshadow potential functional impairments in the appendicular muscles in this form of exercise. Thus, addressing skeletal muscle abnormalities may be critical to translate improvements in lung mechanics (e.g., due to bronchodilator therapy) into better exercise tolerance. The positive effects of pulmonary rehabilitation on muscle fatigability are particularly encouraging and suggest a role for these measurements to test the efficacy of emerging adjunct training strategies focused on the peripheral muscles.
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Affiliation(s)
- Mathieu Marillier
- Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital , Kingston, ON, Canada.,HP2 Laboratory, INSERM U1042, Grenoble Alpes University , Grenoble, France
| | - Anne-Catherine Bernard
- Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital , Kingston, ON, Canada.,HP2 Laboratory, INSERM U1042, Grenoble Alpes University , Grenoble, France
| | - Samuel Verges
- HP2 Laboratory, INSERM U1042, Grenoble Alpes University , Grenoble, France
| | - J Alberto Neder
- Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital , Kingston, ON, Canada
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28
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Peric SZ, Cornblath DR. Fatigue in chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve 2020; 62:649-651. [DOI: 10.1002/mus.27076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/11/2020] [Accepted: 09/19/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Stojan Z. Peric
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine University of Belgrade Belgrade Serbia
| | - David R. Cornblath
- Department of Neurology John Hopkins University School of Medicine Baltimore Maryland USA
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