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Valentino MR, Annunziata A, Atripaldi L, Fiorentino G. An unusual way to improve lung function in congenital myopathies: the power of singing. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2023; 42:86-88. [PMID: 38090546 PMCID: PMC10712659 DOI: 10.36185/2532-1900-357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/04/2023] [Indexed: 12/18/2023]
Abstract
Congenital myopathies (CMs) are a clinically and genetically heterogeneous group of disorders characterized by early onset weakness, hypotonia and characteristic structural abnormalities in muscle fibres. Hypotonia and weakness can be present at birth or appear in infancy, and a static or slowly progressive clinical course may present with muscle weakness, loss of spontaneous movement, involuntary muscle activity, and muscle atrophy. Often patients develop a restrictive syndrome and respiratory failure and require respiratory support In our case, we described lung improvement and respiratory muscle training due to singing in a young patient, affected by CMs with a poor adherence to non-invasive mechanical ventilation.
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Affiliation(s)
| | - Anna Annunziata
- UOC Malattie, Fisiopatologia e Riabilitazione dell’Apparato Respiratorio, Monaldi Hospital, Naples, Italy
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Kaasgaard M, Rasmussen DB, Andreasson KH, Hilberg O, Løkke A, Vuust P, Bodtger U. Use of Singing for Lung Health as an alternative training modality within pulmonary rehabilitation for COPD: a randomised controlled trial. Eur Respir J 2022; 59:2101142. [PMID: 34625480 PMCID: PMC9117735 DOI: 10.1183/13993003.01142-2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/22/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pulmonary rehabilitation (PR) is a cornerstone in chronic obstructive pulmonary disease (COPD) management. However, PR adherence is generally low, and barriers include availability, economic issues, motivation and an inability to attend or perform physical training. Therefore, alternative, evidence-based PR activities are required. Singing may have benefits for quality of life (QoL), respiratory control and well-being in COPD, but the impact on the PR key outcome, physical exercise capacity, is uncertain. METHODS In this randomised controlled trial (NCT03280355), we investigated the effectiveness of 10 weeks of PR, including either "Singing for Lung Health" (SLH) training or standard physical exercise training (PExT). The primary outcome was a change in exercise capacity (6-min walk distance (6MWD)) from baseline to post-PR. Secondary outcomes were changes in QoL (St George's Respiratory Questionnaire (SGRQ)), Hospital Anxiety and Depression Score (HADS), lung function, dyspnoea and adherence. RESULTS We included 270 COPD patients, and 195 completed the study. Demographics across groups were comparable, and both groups improved significantly in 6MWD and SGRQ score. SLH was non-inferior to PExT in improving 6MWD (mean±sd 13.1±36.3 m versus 14.1±32.3 m, p=0.81; difference 1.0 m, 95% CI -7.3-9.3 m) with 21.8% and 25.0%, respectively (p=0.57), reaching the 6MWD minimal important difference of 30 m. We found no significant between-group differences concerning SGRQ, HADS, lung function, dyspnoea or adherence. CONCLUSION Our study suggests that SLH is non-inferior to PExT in improving 6MWD during a 10-week PR programme. Future studies addressing reproducibility, long-term effects and health economics are needed.
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Affiliation(s)
- Mette Kaasgaard
- Pulmonary Research Unit Region Zealand (PLUZ), Dept of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
- Dept of Clinical Medicine, Center for Music in the Brain, Aarhus University, Denmark and the Royal Academy of Music, Aarhus/Aalborg, Denmark
| | - Daniel Bech Rasmussen
- Pulmonary Research Unit Region Zealand (PLUZ), Dept of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
- Dept of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Karen Hjerrild Andreasson
- Pulmonary Research Unit Region Zealand (PLUZ), Dept of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
- Dept of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Dept of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Naestved, Denmark
| | - Ole Hilberg
- Dept of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Dept of Respiratory Medicine, Lillebaelt Hospital, Vejle, Denmark
| | - Anders Løkke
- Dept of Respiratory Medicine, Lillebaelt Hospital, Vejle, Denmark
| | - Peter Vuust
- Dept of Clinical Medicine, Center for Music in the Brain, Aarhus University, Denmark and the Royal Academy of Music, Aarhus/Aalborg, Denmark
| | - Uffe Bodtger
- Pulmonary Research Unit Region Zealand (PLUZ), Dept of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
- Dept of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Dept of Internal Medicine, Zealand University Hospital Roskilde, Roskilde, Denmark
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Shibuya M, Yamamoto S, Kobayashi S, Nishie K, Yamaga T, Kawachi S, Matsunaga A. Pulmonary Rehabilitation for Patients After COPD Exacerbation. Respir Care 2022; 67:360-369. [PMID: 34876493 PMCID: PMC9993499 DOI: 10.4187/respcare.09066] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The aim of this study was to clarify the effectiveness of pulmonary rehabilitation in patients after exacerbations of COPD and to explore the initiation timing of pulmonary rehabilitation. METHODS Systematic review and meta-analysis were performed to assess the effects of pulmonary rehabilitation in subjects with exacerbations of COPD on mortality and readmission compared with usual care. We searched for studies published up to October 2020 in MEDLINE, Embase, Cochrane Library, and other sources. Risk of bias was assessed for the randomization process, deviations from intended interventions, missing outcome data, outcome measurements, and selection of the reported result using the Risk of Bias 2 tool. We pooled mortality and readmission data and performed comparisons between pulmonary rehabilitation and usual care. The subgroup analysis compared pulmonary rehabilitation at different start times (early: ≤ 1 week from admission; and late: > 1 week from admission). RESULTS We identified 10 randomized trials (1,056 participants). Our meta-analysis showed a clinically relevant reduction in readmission up to 3-6 months after pulmonary rehabilitation in both early group (4 trials, 190 subjects; risk ratio [RR] 0.58, [95% CI 0.34-0.99]) and late group (3 trials, 281 subjects; RR 0.48, [95% CI 0.32-0.71]). However, pulmonary rehabilitation had no significant effect on mortality 1 y later compared with usual care (4 trials, 765 subjects; RR 1.27, [95% CI 0.91-1.79]). CONCLUSIONS Pulmonary rehabilitation showed short-term effects for subjects with exacerbations of COPD even if initiated within 1 week; however, further study is required to determine its long-term effects.
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Affiliation(s)
- Manaka Shibuya
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan.
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, 3-1-1, Asahi, Matsumoto, Nagano, Japan
| | - Shuken Kobayashi
- Department of Rehabilitation, Kitasato University Hospital, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan
| | - Kenichi Nishie
- The First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Nagano, Japan and Department of Respiratory Medicine, Iida Municipal Hospital, 438, Yawatamachi, Iida, Nagano, Japan
| | - Takayoshi Yamaga
- Department of Occupational Therapy, Health Science University, 7187 Kodachi, Fujikawaguchiko-machi, minamitsuru-gun, Yamanashi, Japan
| | - Shohei Kawachi
- Department of Biomedical Laboratory Science, Graduate School of Medicine, Shinshu University, 3-1-1, Asahi, Matsumoto, Nagano, Japan and Institute for Biomedical Sciences, Shinshu University, 3-1-1, Asahi, Matsumoto, Nagano, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan and Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan
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