Evaluation in pulmonary rehabilitation

Consumption of star fruit juice on pro-inflammatory markers and walking distance in the community dwelling elderly

PURPOSE

This study aimed to evaluate the effect of star fruit juice supplementation on tumor necrosis factor-alpha (TNF-α), interleukin-23 (IL-23) and interleukin-2 (IL-2), nitric oxide (NO), and 6 min walking distance (6MWD) in a group of elderly individuals.

METHODS

Twenty-nine individuals (20 males, 9 females) with a mean age of 72.4±8.3 years completed this study. A two-week control period was followed by four weeks of 100g fresh star fruit juice consumption twice per day after meals.

RESULTS

Plasma TNF-α, IL-23, IL-2, NO and the 6MWD were evaluated twice during the control period (weeks 0 and 2) and once after the star fruit juice consumption (week 6).

RESULTS

The results showed that all parameters in the blood did not change significantly during the control period. After 4 weeks of star fruit juice consumption, a significant reduction in NO, TNF-α and IL-23 was found; however, there was no change in IL-2. Moreover, the 6MWD increased significantly at week 6, when compared to that at week 0 and 2. Furthermore, the results also showed a significantly positive and negative correlation of NO and TNF-α to the 6MWD, but no correlation of IL-23 and IL-2.

CONCLUSION

This preliminary study concluded that consumption of star fruit juice at 100g twice daily for one month can significantly depress the pro-inflammation cytokines: TNF-α, IL-23, and NO, while increasing walking distance. Low TNF-α and high NO also present a significant correlation to walking capacity in elderly individuals.

The comparison of different dyspnoea scales in patients with COPD

OBJECTIVES

(i) To compare the relationship between different dyspnoea scales and physical and clinical parameters of patients with chronic obstructive pulmonary disease (COPD); and (ii) to determine the most suitable scale among these scales for this patient group.

METHODS

Forty patients with COPD [mean 1st second forced expiratory volume (FEV(1)), 49.16 +/- 2.33% predicted], aged 53-85 participated in this study. The severity of dyspnoea was assessed with different five scales [Modified Borg Scale (MBS), Visual Analogue Scale (VAS), Medical Research Council Dyspnoea Scale (MRCS), Baseline Dyspnoea Index (BDI) and Oxygen Cost Diagram (OCD)]. As clinical parameters, respiratory function was measured by means of pulmonary function test and arterial blood gas analysis. As physical parameters, age and body mass index was recorded.

RESULTS

Patient's dyspnoea severities were 1.59 +/- 2.75, 2.03 +/- 2.82, 2.14 +/- 1.44, 6.81 +/- 4.07, 4.56 +/- 2.47 for MBS, VAS, MRCS, BDI, OCD, respectively (P = 0.08). It was proven that only %FEV(1) had a correlation with MRCS (r = -0.67, P = 0.01) and BDI (r = 0.58, P = 0.02). In addition to these determinations MRCS, MBS and VAS had a strong correlation defining their relationships with each other (P < 0.05).

CONCLUSIONS

MRCS and BDI could assess dyspnoea during daily activities, so these scales showed strength correlation with physical and clinical values. Briefly MRCS is the most suitable dyspnoea scale for the patients with COPD, moreover, BDI, as the second suitable scale, is correlated only with MRCS. Based on these findings, we recommended that MRCS and BDI are appropriate scales for evaluation of dyspnoea in the patients with COPD.

Study of Energy Expenditure During Activities of Daily Living Using and Not Using Body Position Recommended by Energy Conservation Techniques in Patients With COPD

STUDY OBJECTIVES

To assess the energy spent by COPD patients using or not using energy conservation techniques (ECTs) during activities of daily living (ADL).

METHOD

The patients were evaluated in two different situations as stated above. For both applications, the following variables were measured during four ADL with or without using postures recommended by ECTs: metabolic (oxygen consumption [V(O2)] and carbon dioxide production [V(CO2)]), ventilatory (minute ventilation), cardiovascular (heart rate [HR] and oxygen pulse), and dyspnea (Borg score).

PARTICIPANTS

Sixteen male COPD patients (mean age, 62 years) with moderate-to-very-severe COPD (mean FEV1, 40%) participated in the study.

MEASUREMENTS AND RESULTS

The use of ECTs during ADL related to personal hygiene reduced V(O2) (13.4%), V(CO2) (12.8%), HR (13.7%), and Borg score (1 point) [p < 0.05]. Putting on and taking off shoes did not change V(O2), V(CO2), and HR but reduced the Borg score (0.6 point) [p < 0.05]. Storing groceries on high shelves reduced V(O2) (12.2%), V(CO2) (9.9%), HR (5.1%), and Borg score (0.75 point). Storing groceries on low shelves reduced V(O2) (28.1%), V(CO2) (24.3%), HR (5.4%), and Borg score (0.8 point) [p < 0.05].

CONCLUSION

The use of energy conservation techniques in COPD patients during ADL reduces energy cost and dyspnea perception.