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Mesa JC, MacLean MD, Ms M, Nguyen A, Patel R, Diemer T, Lim J, Lee CH, Lee H. A Wearable Device Towards Automatic Detection and Treatment of Opioid Overdose. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2024; 18:396-407. [PMID: 37938943 DOI: 10.1109/tbcas.2023.3331272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Opioid-induced overdose is one of the leading causes of death among the US population under the age of 50. In 2021 alone, the death toll among opioid users rose to a devastating number of over 80,000. The overdose process can be reversed by the administration of naloxone, an opioid antagonist that rapidly counteracts the effects of opioid-induced respiratory depression. The idea of a closed-loop opioid overdose detection and naloxone delivery has emerged as a potential engineered solution to mitigate the deadly effects of the opioid epidemic. In this work, we introduce a wrist-worn wearable device that overcomes the portability issues of our previous work to create a closed-loop drug-delivery system, which includes (1) a Near-Infrared Spectroscopy (NIRS) sensor to detect a hypoxia-driven opioid overdose event, (2) a MOSFET switch, and (3) a Zero-Voltage Switching (ZVS) electromagnetic heater. Using brachial artery occlusion (BAO) with human subjects (n = 8), we demonstrated consistent low oxygenation events. Furthermore, we proved our device's capability to release the drug within 10 s after detecting a hypoxic event. We found that the changes in the oxyhemoglobin, deoxyhemoglobin and oxygenation saturation levels ( SpO2) were different before and after the low-oxygenation events ( 0.001). Although additional human experiments are needed, our results to date point towards a potential tool in the battle to mitigate the effects of the opioid epidemic.
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del Valle MF, Valenzuela J, Marzuca-Nassr GN, Godoy L, del Sol M, Lizana PA, Escobar-Cabello M, Muñoz-Cofré R. Use of the speed achieved on the 6MWT for programming aerobic training in patients recovering from severe COVID-19: an observational study. Ann Med 2023; 55:889-897. [PMID: 36881045 PMCID: PMC10795638 DOI: 10.1080/07853890.2023.2179658] [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: 07/27/2022] [Accepted: 02/07/2023] [Indexed: 03/08/2023] Open
Abstract
INTRODUCTION Patients who suffered severe COVID-19 need pulmonary rehabilitation. Training may be prescribed objectively based on the maximum speed in the six-minute walk test. The objective of this study was to determine the effects of a personalized pulmonary rehabilitation program based on the six-minute walk test speed for post-COVID-19 patients. METHODS Observational quasi-experimental study. The pulmonary rehabilitation program consisted of 8 weeks of training, twice a week for 60 minutes per session of supervised exercise. Additionally, the patients carried out home respiratory training. Patients were evaluated by exercise test, spirometry and the Fatigue Assessment Scale before and after the eight-week pulmonary rehabilitation program. RESULTS After the pulmonary rehabilitation program, forced vital capacity increased from 2.47 ± 0.60 to 3.06 ± 0.77 L (p < .001) and the six-minute walk test result increased from 363.50 ± 88.87 to 480.9 ± 59.25 m (p < .001). In fatigue perception, a significant decrease was observed, from 24.92 ± 7.01 to 19.10 ± 7.07 points (p < .01). Isotime evaluation of the Incremental Test and the Continuous Test showed a significant reduction in heart rate, dyspnoea and fatigue. CONCLUSION The eight-week personalized pulmonary rehabilitation program prescribed on the basis of the six-minute walk test speed improved respiratory function, fatigue perception and the six-minute walk test result in post-COVID-19 patients.KEY MESSAGESCOVID-19 is a multisystem disease with common complications affecting the respiratory, cardiac and musculoskeletal systems.The 6MWT speed-based training plan allowed for increased speed and incline during the eight-week RP program.Aerobic, strength and flexibility training reduced HR, dyspnoea and fatigue in severe post-COVID-19 patients.
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Affiliation(s)
| | - Jorge Valenzuela
- Servicio de Medicina Física y Rehabilitación, Hospital el Carmen, Maipú, Chile
| | - Gabriel Nasri Marzuca-Nassr
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Loretto Godoy
- Servicio de Medicina Física y Rehabilitación, Hospital el Carmen, Maipú, Chile
| | - Mariano del Sol
- Centro de Excelencia en Estudios Morfológicos y Quirúrgicos, Universidad de La Frontera, Temuco, Chile
| | - Pablo A. Lizana
- Laboratory of Morphological Sciences, Instituto de Biología, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Máximo Escobar-Cabello
- Laboratorio de Función Disfunción Ventilatoria, Departamento de Kinesiología, Universidad Católica del Maule, Talca, Chile
| | - Rodrigo Muñoz-Cofré
- Servicio de Medicina Física y Rehabilitación, Hospital el Carmen, Maipú, Chile
- Posdoctorado en Ciencias Morfológicas, Universidad de La Frontera, Temuco, Chile
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NEUNHÄUSERER DANIEL, HUDELMAIER MARTIN, NIEDERSEER DAVID, VECCHIATO MARCO, WIRTH WOLFGANG, STEIDLE-KLOC EVA, KAISER BERNHARD, LAMPRECHT BERND, ERMOLAO ANDREA, STUDNICKA MICHAEL, NIEBAUER JOSEF. The Impact of Exercise Training and Supplemental Oxygen on Peripheral Muscles in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Med Sci Sports Exerc 2023; 55:2123-2131. [PMID: 37535316 PMCID: PMC10662626 DOI: 10.1249/mss.0000000000003268] [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: 08/04/2023]
Abstract
OBJECTIVE Exercise training is a cornerstone of the treatment of chronic obstructive pulmonary disease, whereas the related interindividual heterogeneity in skeletal muscle dysfunction and adaptations are not yet fully understood. We set out to investigate the effects of exercise training and supplemental oxygen on functional and structural peripheral muscle adaptation. METHODS In this prospective, randomized, controlled, double-blind study, 28 patients with nonhypoxemic chronic obstructive pulmonary disease (forced expiratory volume in 1 second, 45.92% ± 9.06%) performed 6 wk of combined endurance and strength training, three times a week while breathing either supplemental oxygen or medical air. The impact on exercise capacity, muscle strength, and quadriceps femoris muscle cross-sectional area (CSA) was assessed by maximal cardiopulmonary exercise testing, 10-repetition maximum strength test of knee extension, and magnetic resonance imaging, respectively. RESULTS After exercise training, patients demonstrated a significant increase in functional capacity, aerobic capacity, exercise tolerance, quadriceps muscle strength, and bilateral CSA. Supplemental oxygen affected significantly the training impact on peak work rate when compared with medical air (+0.20 ± 0.03 vs +0.12 ± 0.03 W·kg -1 , P = 0.047); a significant increase in CSA (+3.9 ± 1.3 cm 2 , P = 0.013) was only observed in the training group using oxygen. Supplemental oxygen and exercise-induced peripheral desaturation were identified as significant opposing determinants of muscle gain during this exercise training intervention, which led to different adaptations of CSA between the respective subgroups. CONCLUSIONS The heterogenous functional and structural muscle adaptations seem determined by supplemental oxygen and exercise-induced hypoxia. Indeed, supplemental oxygen may facilitate muscular training adaptations, particularly in limb muscle dysfunction, thereby contributing to the enhanced training responses on maximal aerobic and functional capacity.
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Affiliation(s)
- DANIEL NEUNHÄUSERER
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, ITALY
| | - MARTIN HUDELMAIER
- Institute of Anatomy and Cell Biology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - DAVID NIEDERSEER
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, SWITZERLAND
| | - MARCO VECCHIATO
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, ITALY
| | - WOLFGANG WIRTH
- Institute of Anatomy and Cell Biology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - EVA STEIDLE-KLOC
- Institute of Anatomy and Cell Biology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - BERNHARD KAISER
- University Clinic of Pneumology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - BERND LAMPRECHT
- University Clinic of Pneumology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Department of Pulmonary Medicine, Faculty of Medicine, Kepler-University-Hospital, Johannes-Kepler-University, Linz, AUSTRIA
| | - ANDREA ERMOLAO
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, ITALY
| | - MICHAEL STUDNICKA
- University Clinic of Pneumology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - JOSEF NIEBAUER
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
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Lu S, Zhang Q. Pilot testing the impact of an aerobic exercise plus rehabilitation training on respiratory function in older adults with COPD. Geriatr Nurs 2023; 51:238-244. [PMID: 37023683 DOI: 10.1016/j.gerinurse.2023.03.011] [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: 12/07/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/08/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic intractable lung disease. To investigate the therapeutic effect, older adult patients were subjected to aerobic exercise and respiratory rehabilitation (diaphragmatic breathing) for six months. At the end of six-month intervention, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 6-minute walking distance (6 MWD), and patient activation measure scores increased; St. George's respiratory questionnaire scores and disease impact score decreased; and PaCO2 and PaO2 were significantly improved in both groups, particularly in the experimental group. In addition, FEV1, FEV1/FVC, 6 MWD, blood gas levels, quality of life, and self-care ability in the experimental group were significantly improved compared with those in the control group, and the improvements were significantly greater in male, younger, and less diseased patients. Our study demonstrated that aerobic exercise combined with diaphragmatic breathing significantly improves respiratory function and quality of life in older adult patients.
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Affiliation(s)
- Shuangping Lu
- Department of Respiratory Medicine, The First People's Hospital of Fuyang District, Hangzhou, China
| | - Qundan Zhang
- Department of Respiratory Medicine, The First People's Hospital of Fuyang District, Hangzhou, China.
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Wang H, Liu Q, Liu L, Cao J, Liang Q, Zhang X. High-intensity interval training improves the outcomes of patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials. Respir Med 2023; 208:107128. [PMID: 36717003 DOI: 10.1016/j.rmed.2023.107128] [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: 10/07/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Pulmonary exercise is an important part in the treatment of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects and safety of high-intensity interval training (HIIT) in patients with COPD, to provide insights to the COPD treatment and care. METHODS Two investigators searched PubMed, Medline, Embase, web of Science, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases up to Sept 15, 2022 for randomized controlled trials (RCTs) on the effects and safety of HIIT for COPD patients. RevMan5.3 software was used for statistical analysis. RESULTS A total of 20 RCTs involving 962 COPD patients were finally included. 514 patients underwent HIIT interventions. Meta-analysis showed that HIIT increased the peak oxygen consumption (SMD = 0.30, 95%CI:0.14-0.46), peak minute ventilation (SMD = 0.26, 95%CI: 0.05-0.47), peak work rate (SMD = 0.34, 95%CI: 0.17-0.51), 6-min walking distance (SMD = 0.39, 95%CI: 0.23-0.55) in COPD patients (all P < 0.05). HIIT improved the quality of life (SMD = 0.30, 95%CI: 0.06-0.54) and reduced the dyspnea (SMD = -0.27, 95%CI: -0.51∼-0.03) in COPD patients (all P < 0.05). There were no significant differences in the forced expiratory volume in 1 s/forced vital capacity (SMD = 0.28, 95%CI: -0.01-0.56) and St. George's Respiratory Questionnaire score (SMD = -0.35, 95%CI: -0.73-0.03) between HIIT and control group (all P > 0.05). There was no publication bias analyzed by the Egger test and funnel plots (all P > 0.05). CONCLUSIONS HIIT may be beneficial to improve the pulmonary function, exercise capacity and quality of life of patients with COPD, which is worthy of clinical promotion for COPD treatment and care.
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Affiliation(s)
- Hongyan Wang
- School of Nursing, Sichuan Nursing Vocational College, China
| | - Qin Liu
- School of Nursing, Chengdu University of TCM, China
| | - Linfeng Liu
- School of Nursing, Sichuan Nursing Vocational College, China
| | - Jun Cao
- School of Nursing, Sichuan Nursing Vocational College, China
| | | | - Xiangeng Zhang
- School of Nursing, Sichuan Nursing Vocational College, China.
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Pan Y, Yang H, Quan L, Wang S, Xu Y, Chen Y. Effects of full-body exercise-based pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e064212. [PMID: 36564122 PMCID: PMC9791421 DOI: 10.1136/bmjopen-2022-064212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterised by progressive and irreversible fibrosis of the lung parenchyma, resulting in reduced lung function. Since conventional medicines can be associated with low effective rates and adverse events, pulmonary rehabilitation may be a promising non-pharmacological therapy for IPF. Thus, we aimed to evaluate the effects of full-body exercise-based pulmonary rehabilitation on patients with IPF by conducting a systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS AND ANALYSIS This systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). From inception to 31 August 2022, electronic databases in English and Chinese were searched, including PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials among the English databases. China National Knowledge Infrastructure, Chinese Biomedical Literature, VIP Chinese Science and Technology Periodical, and Wan Fang Data were among the Chinese databases. Two independent reviewers then screened the potential RCT studies, which were analysed according to the Cochrane Handbook criteria. The efficacy and safety of full-body exercise pulmonary rehabilitation for IPF were evaluated based on outcomes, including exercise capacity measured by 6 min walking distance and quality of life measured by St. George's Respiratory Questionnaire. Lung function was measured based on the forced vital capacity, total lung capacity, diffusing capacity of the lungs for carbon monoxide and dyspnoea assessed by the modified Medical Research Council scale. ETHICS AND DISSEMINATION Ethical approval was not required for this systematic review and meta-analysis. Results will be published in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42021284293.
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Affiliation(s)
- Yi Pan
- Chengdu Second People's Hospital, Chengdu, China
| | - Han Yang
- Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, Sichuan, China
| | - Luo Quan
- Chengdu Second People's Hospital, Chengdu, Sichuan Province, China
| | - Shurong Wang
- Chengdu Second People's Hospital, Chengdu, Sichuan Province, China
| | - Youli Xu
- Chengdu Second People's Hospital, Chengdu, Sichuan Province, China
| | - Yu Chen
- Chengdu Second People's Hospital, Chengdu, Sichuan, China
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Ortolan S, Neunhaeuserer D, Quinto G, Barra B, Centanini A, Battista F, Vecchiato M, De Marchi V, Celidoni M, Rebba V, Ermolao A. Potential Cost Savings for the Healthcare System by Physical Activity in Different Chronic Diseases: A Pilot Study in the Veneto Region of Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127375. [PMID: 35742622 PMCID: PMC9224390 DOI: 10.3390/ijerph19127375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/03/2022]
Abstract
Background: Sedentary behaviour (SB) and physical inactivity (PI) are associated with an increased risk of chronic diseases and a significant economic burden. This pilot study aims to estimate the possible cost savings for the Veneto Regional Health Service (Italy) due to a population-based physical activity (PA) intervention. Methods: The PA-related cost-savings were assessed for four chronic diseases in the whole and sedentary populations of the Veneto region. The SB and PA epidemiological data, regarding an additional percutaneous coronary intervention in coronary artery disease, hospitalizations in chronic obstructive pulmonary disease, surgery for colorectal cancer, and femur fracture, were obtained from national and regional administrative sources. A relative risk reduction, due to PA, was obtained from the recent literature. The annual healthcare costs were estimated using the regional diagnosis-related group tariffs. Results: The annual estimated cost-savings for the regional healthcare service related to these four outcomes: an amount between EUR 5,310,179 (if a conservative analysis was performed) and EUR 17,411,317. Conclusion: By a downward estimate, regarding the direct healthcare costs, PA interventions could lead to important cost-savings in the Veneto region. The savings would be greater when considering the cross-sectional impact on other healthcare costs, comorbidities, and indirect costs.
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Affiliation(s)
- Sara Ortolan
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-049-8217456
| | - Giulia Quinto
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
| | - Barbara Barra
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
| | - Anna Centanini
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
| | - Valentina De Marchi
- Department of Economics and Management “Marco Fanno”, University of Padova, Via Bassi 1, 35131 Padova, Italy; (V.D.M.); (M.C.); (V.R.)
| | - Martina Celidoni
- Department of Economics and Management “Marco Fanno”, University of Padova, Via Bassi 1, 35131 Padova, Italy; (V.D.M.); (M.C.); (V.R.)
| | - Vincenzo Rebba
- Department of Economics and Management “Marco Fanno”, University of Padova, Via Bassi 1, 35131 Padova, Italy; (V.D.M.); (M.C.); (V.R.)
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; (S.O.); (G.Q.); (B.B.); (A.C.); (F.B.); (M.V.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Via Giustiniani 2, 35128 Padova, Italy
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Du Y, Lin J, Wang X, Zhang Y, Ge H, Wang Y, Ma Z, Zhang H, Liu J, Wang Z, Lin M, Ni F, Li X, Tan H, Tan S. Early Pulmonary Rehabilitation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials. COPD 2022; 19:69-80. [PMID: 35099336 DOI: 10.1080/15412555.2022.2029834] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pulmonary rehabilitation (PR) is an essential method for Acute exacerbation in chronic obstructive pulmonary disease (AECOPD) recovery. We perform a meta-analysis to compare early PR with usual care. A literature search was performed through these databases: PubMed, MEDLINE database, Google Scholar, Cochrane, Embase from inception to July 2021. Eligible trials were clinical randomized controlled trials comparing the effects of early PR and usual care in AECOPD patients. The primary endpoint of this meta-analysis was FEV1% predicted, 6-min walk test (6MWD), modified Medical Research Council (mMRC) and George Respiratory Questionnaire-total (SGRQ-total). The secondary outcomes were borg dyspnea score, short-form 36 health survey questionnaire physical (SF-36 physical) and SF-36 mental. We included 13 RCTs with a total of 866 patients. There were no significant effects of the PR group on measures of FEV1% predicted (MD = 0.50, 95%CI -1.43 to 2.44, Z = 0.51, p = 0.61), borg dyspnea score (MD = -0.88, 95%CI -1.89 to 0.13, Z = 1.71, p = 0.09) and SF-36 mental (MD = 4.34, 95%CI -1.64 to 10.32, Z = 1.42, p = 0.16) compared with usual care. PR group achieved better 6MWD (MD = 97.58, 95%CI 17.21 to 177.96, Z = 2.38, p = 0.02), mMRC (MD = -0.36, 95%CI -0.52 to -0.21, Z = 4.56, p ˂ 0.00001), SGRQ-total (MD= -9.67, 95%CI -16.23 to -3.11, Z = 2.89, p = 0.004) and SF-36 physical (MD = 4.98, 95%CI 0.60 to 9.35, Z = 2.23, p = 0.03) compared with usual care group. Early PR in AECOPD patients would lead to better 6MWD, mMRC, SGRQ-total and SF-36 physical. But there were no significant effects of the PR group on measures of FEV1% predicted, borg dyspnea score and SF-36 mental.
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Affiliation(s)
- Yanping Du
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Jun Lin
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Xiaoxia Wang
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Yan Zhang
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Hua Ge
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Ye Wang
- Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China
| | - Zhiyi Ma
- Pulmonary and Critical Care Medicine, The First Hospital of Longyan Affiliated to Fujian Medical University, Longyan, Fujian, China
| | - Huaping Zhang
- Pulmonary and Critical Care Medicine, Second Affiliated Hospital of Fujian Medical University, Respiratory Medicine Center of Fujian Province, Quanzhou, Fujian, China
| | - Jun Liu
- Pulmonary and Critical Care Medicine, The Second Hospital of Longyan, Longyan, Fujian, China
| | - Zhiyong Wang
- Pulmonary and Critical Care Medicine, The First Hospital of Putian, Putian, Fujian, China
| | - Meixia Lin
- Pulmonary and Critical Care Medicine, The First Hospital of Putian, Putian, Fujian, China
| | - Fayu Ni
- Pulmonary and Critical Care Medicine, Fuqing Hospital, Fuqing, Fujian, China
| | - Xi Li
- Pulmonary and Critical Care Medicine, The Second People's Hospital Affiliated to Fujian Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Hui Tan
- Pulmonary and Critical Care Medicine, Chenzhou No. 1 People's Hospital, Chenzhou Hunan, China
| | - Shifan Tan
- Pulmonary and Critical Care Medicine, Chenzhou No. 1 People's Hospital, Chenzhou Hunan, China.,Pulmonary and Critical Care Medicine, Maoming People's Hospital, Maoming, Guangdong, Chian
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Foccardi G, Vecchiato M, Neunhaeuserer D, Mezzaro M, Quinto G, Battista F, Duregon F, Carlon R, Ermolao A. Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126645. [PMID: 34205551 PMCID: PMC8296387 DOI: 10.3390/ijerph18126645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/04/2021] [Accepted: 06/17/2021] [Indexed: 02/07/2023]
Abstract
Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.
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Affiliation(s)
- Giulia Foccardi
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35128 Padova, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35128 Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-049-8217456
| | - Michele Mezzaro
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
| | - Giulia Quinto
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35128 Padova, Italy
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35128 Padova, Italy
| | - Federica Duregon
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
| | - Roberto Carlon
- UOA Cardiology, Rehabilitation Cardiology, ASSL 6 “Euganea”, Cittadella Hospital, 35013 Cittadella, Italy;
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy; (G.F.); (M.V.); (M.M.); (G.Q.); (F.B.); (F.D.); (A.E.)
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35128 Padova, Italy
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Neunhäuserer D, Reich B, Mayr B, Kaiser B, Lamprecht B, Niederseer D, Ermolao A, Studnicka M, Niebauer J. Impact of exercise training and supplemental oxygen on submaximal exercise performance in patients with COPD. Scand J Med Sci Sports 2020; 31:710-719. [PMID: 33155295 PMCID: PMC7984048 DOI: 10.1111/sms.13870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 12/30/2022]
Abstract
Functional impairment caused by chronic obstructive pulmonary disease (COPD) impacts on activities of daily living and quality of life. Indeed, patients' submaximal exercise capacity is of crucial importance. It was the aim of this study to investigate the effects of an exercise training intervention with and without supplemental oxygen on submaximal exercise performance. This is a secondary analysis of a randomized, controlled, double-blind, crossover trial. 29 COPD patients (63.5 ± 5.9 years; FEV1 46.4 ± 8.6%) completed two consecutive 6-week periods of high-intensity interval cycling and strength training, which was performed three times/week with either supplemental oxygen or medical air (10 L/min). Submaximal exercise capacity as well as the cardiocirculatory, ventilatory, and metabolic response were evaluated at isotime (point of termination in the shortest cardiopulmonary exercise test), at physical work capacity at 110 bpm of heart rate (PWC 110), at the anaerobic threshold (AT), and at the lactate-2 mmol/L threshold. After 12 weeks of exercise training, patients improved in exercise tolerance, shown by decreased cardiocirculatory (heart rate, blood pressure) and metabolic (respiratory exchange ratio, lactate) effort at isotime; ventilatory response was not affected. Submaximal exercise capacity was improved at PWC 110, AT and the lactate-2 mmol/L threshold, respectively. Although supplemental oxygen seems to affect patients' work rate at AT and the lactate-2 mmol/L threshold, no other significant effects were found. The improved submaximal exercise capacity and tolerance might counteract patients' functional impairment. Although cardiovascular and metabolic training adaptations were shown, ventilatory efficiency remained essentially unchanged. The impact of supplemental oxygen seems less important on submaximal training effects.
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Affiliation(s)
- Daniel Neunhäuserer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria.,Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Barbara Mayr
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Bernhard Kaiser
- University Clinic of Pneumology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Bernd Lamprecht
- University Clinic of Pneumology, Paracelsus Medical University Salzburg, Salzburg, Austria.,Department of Pulmonary Medicine, Faculty of Medicine, Kepler-University-Hospital, Johannes-Kepler-University, Linz, Austria
| | - David Niederseer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria.,Division of Cardiology, University Heart Centre, University Hospital Zurich, Zurich, Switzerland
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Michael Studnicka
- University Clinic of Pneumology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
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